Considering adoption? For your child's well-being now and in the future, find out as much as you can about her origins. Going forward, you'll want to keep an eye out for any health or development challenges. Whether you're adopting domestically or internationally, here's what you need to know:

Before you bring her home
The best time to gather your child's medical history is during the adoption process. It's easier to do this if you're adopting in the U.S., but a growing number of countries, such as Korea and Guatemala, now provide extensive information. Ask about:
• Her birth mother's health, including any physical illness, chronic conditions, history of depression, or alcoholism.
• How the child compares with other kids her age. Does she eat or sleep less, or cry more? Has she been sick?
• Locating her medical records, often scattered among hospi-tals, orphanages, and foster homes. You may need to make quite a few calls to get them all.

The first few months
Aim for an initial checkup within two weeks of bringing her home (even if she's had a medical exam in a foreign country). Of course, if she's sick see a pediatrician right away; about half of adoptees have common illnesses like ear infections that need immediate treatment. She'll need a follow-up four to six weeks after her first visit.
During these early appointments, your child's vision and hearing will be checked. If she's under 4 months, expect the standard newborn screenings. Internationally adopted children will be vaccinated  -- whether or not they've already gotten shots abroad. The doctor will also screen for:
• Nutritional risks like anemia
• Lead poisoning
• Genetic abnormalities (an African-American baby, for instance, will be tested for sickle-cell anemia)
• Infectious diseases, depending on the birth mother's history and country of origin

In the future
It's not uncommon for newly adopted kids to start off behind in growth and development  -- to crawl or walk a little later than average, for example. This might be due to a lack of early stimulation, a nutritional deficiency, or, more rarely, exposure to alcohol or drugs. That's why your pediatrician will pay close attention to your child's growth pattern and milestones, especially during her first years. Fortunately, with good food, medical care, and love, most adoptees with delays catch up in a few months or a year.

"Does my child need a special doctor?"
Probably not. Just look for a pediatrician who communicates well and is willing to devote time to your family's needs. However, if your child has been seriously ill, or experienced abuse or emotional trauma, it's a good idea to seek out a doctor who has treated adopted kids with these issues. To find one in your area, check out the AAP's state-by-state directory.

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