Nutrition and International Adoption Part III

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

Nutrition and the Child from China: Part II

child-smiling-in-schoolOverall, children from China do very well. In one study in looking at children adopted into Canada from China,in which the children on average were 13 months old when they arrived home, they were doing as well as other children in Canada at three years old.(Incidentally, these children arrived home about 10/11 years ago, when orphan conditions were not as good as they are today.) The children’s receptive language skills—even at a very young age—were just as good as other children. The good news is that children’s receptive language skills—which is the ability to understand what others are saying and respond—are related to positive cognitive and social development. Also, by the time the children were about three years old, they had caught up with their peers in their ability to talk, called expressive language skills [1].

So how do children’s language skills relate to nutrition? Children’s ability to understand language is related to the child’s height-to weight ratio as well as the child’s head circumference.A lack of stimulation in the child’s early years in an orphanage can have an impact on physical growth. That means that your child’s growth can be delayed because of lack of stimulation and not just lack of nutrition. The factor that related most to mental development and language skills was the child’s height.In the study of children adopted into Canada, the children from China did have growth spurts, but they stayed a bit shorter than other children their age. The weight of the child seems to have had less impact; in this same study the children’s weight upon arrival home did not indicate a child’s cognitive function at 11 years of age. Continue reading

Nutrition and the Child from China

ChildNutritionIf you listen to the webinar “Food for Thought” on Adoption Learning Partners, featuring Dr. Dana Johnson, you will see that parents are very concerned how the nutritional status of their children may affect their cognitive abilities [1]. What the parents are really asking is, “Will my child be smart, even if my child had a less than optimum diet while living in the orphanage?” The answer is usually “Yes,” but there are a few things you should know.

Overall, children from China have good nutrient status upon arrival home. In one study Dr. Johnson noted the percentage of children from China who were low or deficient in the following nutrients: iodine or selenium (20%), iron (8%); zinc (50%); and vitamin D (13%). None of the children were deficient in vitamin A, folic acid, or vitamin B 12. Of course, this is only one sampling of children [1]. The dates the children came home were not mentioned but, overall, the care of the children in the orphanages in China has been improving.

For nearly all children living in orphanages, the primary concern is getting enough calories and protein for growth and development. In general, babies in orphanages may receive less than adequate nutrition. In some cases, even if they are given plenty of formula, the children’s bottles are usually propped up, so the children may have limited ability and time to get the milk out of the bottles. Continue reading