Your internationally adopted child can suffer malnutrition before and after birth. The risk factors that negatively impact the child’s growth and development include alcohol exposure, poor maternal diet, and lack of maternal health care. In most instances you will receive little or no prenatal or early life history on your child.   And you may know little as to what your child was fed in the orphanage. Fortunately, however, there has been a marked improvement in the overall care children receive once in orphanages and this includes better diets.

While in an orphanage, your child may have received enough calories to fill their tummy, yet they may not have received the protein and micronutrients needed for optimal development. Such a calorie sufficient diet often consists of gruels or porridges made up of rice or other grains lacking sufficient protein, vitamins and minerals.

The food received in the first year of your child’s life is very important as brain development is affected by the level of protein and micronutrient the child receives. So even if your child was chubby and content, they may still have been malnourished. Although getting enough nutrients is required for optimal growth, some are more important than others, with iron being one of the most important nutrients. If a child does not get enough, it can affect cognitive development.

Once home, your child will most likely play catch-up. However, even if your child does show a nice growth spurt and tests negative for iron-deficiency anemia, all may not be well. First, if your child tests negative for anemia, they can still be iron deficient. Next, if they have a growth spurt, this could further exacerbate iron deficiency because the iron stores are not sufficient for the child’s increased blood volume. So a child who appears to be growing quickly and gaining weight may actually be suffering from iron-deficiency anemia.

Therefore, your child should be assessed for nutrient deficiencies at least twice in the first year home.  Also, your child should be checked for  intestinal parasites such as giardia. Such an infection can decrease the absorption of iron and other nutrients. This means that even if your child is getting enough iron in the diet, she may still be deficient because she is not absorbing it. Continue reading →