Health Issues of Orphaned Children

The health problems of children living in orphanages can be complex and clearly related to the living conditions in institutions. Children in orphanages are often abandoned by their families as infants, toddlers, or even at school age. The political unrest and economic instability of many countries leads to poverty for families living in both rural and urban environments. Prior to abandonment, children may sustain neglect, physical, emotional, and sexual abuse, and undernutrition when they are living with their parents. Prenatal care is most often non-existent for mothers who eventually abandon their children to the state. During the developmentally vulnerable months of an infant's life, the child can sustain enduring damage to the body, the mind, and the soul while living in an orphanage. The depression and withdrawal that sometimes results from institutionalization leads to immunosuppression and puts children at risk for many infectious diseases. Malnutrition can result from poor quality and insufficient quantities of food. Infant formulas are sometimes available, but are mixed in very dilute proportions and lose their nutritional value. Children are often fed foods that can cause allergic reactions when introduced prematurely. Spoon feeding of solids is uncommon due to lack of staffing and children do not learn to appropriately chew and handle foods leading to oral aversiveness. Bottle propping is a common way of feeding infants because there just aren't enough staff to feed babies individually. Propping can lead to interrupted feeds if the bottle falls away from the child's mouth..

Thousands of pre-adoption medical abstracts from Eastern Europe are reviewed by adoption medicine specialists in the United States each year. Many diagnoses found on these medical abstracts are not confirmed when the children are finally evaluated in the U.S. after adoption, but other diagnoses are sometimes identified. Many of these diagnoses are not well-understood because they do not conform to American medical research and beliefs.

Past medical history for children placed in orphanages particularly in Eastern Europe, can be vague and subject to the cultural biases of the medical practice of the particular country. Although detailed records are kept in some orphanages, they are hand-written and filled with the usual medical abbreviations; the translation of these records is compromised by the lack of staff, non-medical translators, and the exorbitant cost of translation. Dates of birth are sometimes recorded incorrectly simply because the day and month were transposed.

In Eastern Europe, physicians subscribe to a system based in pathology (disease). All children are considered to be neurologically immature at least for the first few years of life. Terms such as "perinatal or prenatal encephalopathy of hypoxic genesis or mixed genesis", "pyramidal deficiency or insufficiency", "hypertension-hydrocephalic syndrome", "hyperexcitability or neuro-excitability syndrome", "spastic tetraparesis", "muscular dystonia", " myatonic syndrome", and "hypotrophy" are commonly found as "boiler plate/generic diagnoses on the medical abstracts in Russia. Recently the terms enuresis (bedwetting) and encopresis (soiling) were diagnoses found on the medical abstract of a seven month old infant. Infants are by their very nature bedwetting and soiling! These medical diagnoses cannot be used in infancy! It is clear to adoption medicine specialists who review these adoption files in the United States, that these terms cannot help guide us in understanding the true medical status of orphans abroad.

Measurements of children in orphanages are usually performed by staff members who are not medically trained personnel. Scales are old, in disrepair, and go unbalanced. Children are often weighed with many layers of clothing.  Head circumferences may be measured with string or cloth which over time can stretch or shrink. Where the measuring device is placed around the head may also result in inaccuracies. Head circumferences are often completely ignored as a necessary part of the child's ongoing medical care. Chest circumferences are often mixed up with head circumferences when the records are translated. Metric measurements are sometimes converted into English measurements incorrectly when the records are typed and distributed in the U.S. There is every attempt to perform these measurements accurately, but without proper training the measurements are inevitably inaccurate.

Diagnoses commonly found on orphan medicals