Continued from previous post...

So what does this have to do with transracial adoption? With more and more parents adopting from Ethiopia all of the time (and with malnutrition also being epidemic in many other countries that Americans are adopting from), it is important for adoptive parents to understand the affects of malnutrition and to be prepared for the possibility of stunted growth or learning disabilities in their child.

While many (if not most) children adopted internationally are small for their age at homecoming and tend to catch up fairly quickly, some remain small for their age, and learning disabilities often do not become evident until the child enters school.

I think this NY Times article should serve as bit of a wake up call on two levels…for one, it is a good reminder to adoptive parents of a health issue in children that we need to be aware of and prepared for.

And secondly, it is a stark reminder of how great the need for help still is. It is painfully hard for me to sit here at my desk in my kitchen, with the cabinets and refrigerator and chest freezer overflowing with food, and think about two year olds so weak from malnutrition that they can’t even hold up their heads.

It feels so unfair that we live in a country where people literally eat so much that they negatively effect their health and overeating and obesity are huge health problems, while in other parts of the world, people are starving to death.

This article is another reminder of how blessed we truly are, and how many people are out there who are needing and waiting for help and aid.

As scary as it is to read about the affects of malnutrition and to worry about the children we are adopting, many of the experts are optimistic about childrens’ abilities to recover and catch up.

This article on malnutrition and adoption by the Erichsons, who wrote “How to Adopt Internationally” says,

Although the relationship of severe malnutrition in infancy and childhood to brain damage is a well established fact, seriously affected children are not typically selected for adoptions. Studies of severe malnutrition in infancy and childhood do show that children may experience persistent and permanent cognitive, behavioral, and social defects - the severity of the effects are impacted by the age of onset of malnutrition, the length of time of caloric deprivation, and other existing health conditions, such as premature birth and fetal alcohol syndrome (FAS).

However, the damage of even severe malnutrition may be ameliorated by the age of rehabilitation (the younger the better), better social environments, and adequate educational support. Long-term studies of malnourished children show generally good outcomes, especially if the child is adopted before the age of three years. Prospective adoptive parents with concerns about the effects of malnutrition should visit with parents who have adopted foreign children who were once in this condition.

And on Dr. Jane Aronson’s wonderful website, The Orphan Doctor, she writes about malnutrition,

“Growth failure is due to malnutrition and emotional deprivation and lack of stimulation. There must be an interplay of both. The timing, duration, and severity of malnutrition are clearly operating in concert to produce growth failure and finally developmental delay. Understanding why some children actually grow in the same environments where other children are failing is truly a mystery. Growth failure can obviously interfere with normal mental development because the brain is robbed of essential nutrients during very critical periods of growth especially in the first two years of life.
Children are very resilient and have the potential for catch-up growth. Their recovery for weight, height, and even head circumference can be stunning.
It is essential to note that cognitive assessments are much more sensitive than physical growth as a measure of recovery.”

Malnutrition and the effects thereof are one of the big “unknowns” in adoption. Malnutrition is one of the most common issues seen in newly internationally adopted children, and is common enough that it is rarely listed as a special need, unless it is severe. It is one of the areas where adoptive parents typically have to make an educated “leap of faith.”

Personally I agree with Dr. Aronson that children are resilient, and most of the children I know, even children who were in pretty dire conditions (including several of my own), end up catching up and thriving once they are home. I do however know of several children who even years after being home, struggle with learning disabilities that likely stem from early malnutrition.

I think it is smart to be optimistic, and yet remember that the risks of lasting effects from malnutrition are real, and should not be overlooked by adoptive parents.