Children Health

Why you need your adopted child's medical history

2006-01-21T21:25:00.000-08:00

In the excitement of adopting an infant or toddler, obtaining the child's medical history may not seem like a high priority. After all, the child has been alive for such a short time; how much information can there be?

Medical histories and early learning
The explosion of new information on early brain development tells us that the first two or three years of a child's life are critical in establishing the patterns of nerve connections that will be the basis for all of the child's later learning. If adverse risks factors are known at the time of adoption, parents, physician and educators can direct their efforts to try to ameliorate the effects. Thus, we know that children who are diagnosed with language delays early do far better than children diagnosed at later ages. This is not to say that a child past the age of three years is beyond hope.

Accessing your child’s information

Accessing information for a very young child is easier the closer you are to the time of birth. Newborn records are sometimes contained entirely within the mother's medical record or may be filed under the mother's name and otherwise inaccessible. Pregnancy and delivery are stressful periods; memory of those events may be quickly lost or altered. Access to birthparents and other relatives may become more difficult or impossible over time.

Records may not even exist for children adopted from foster care or from overseas. For those children, whatever information can be obtained from the most recent caregiver maybe the best and only data ever available about the child's life.

What to ask for
What information should you ask for? Be realistic; not everything will be available. And some things can't be available. For example, it's unlikely that the birthparents are old enough to have developed all the medical problems that might affect them as adults. Parents often ask about genetic evaluation when indicators suggest an inherited or acquired syndrome. Genetics testing to determine risk of adult onset diseases such as Huntington's chorea or breast cancer is not appropriate merely for the purpose of an adoption evaluation.

Finally, remember that evaluating medical records for a very young child is really a risk assessment process. If your child has experienced less than optimal conditions for growth and development, prenatally or after birth, you can be better prepared to help him or her. If your child has had optimal care, obtaining information while it is most easily accessible is still a good idea.

Try to find out the following:

• Basic description of the age, health and genetic origins of the birth parents and birth siblings. A nicety would be any known genetic conditions in the family such as diabetes or early onset heart disease.

• Description of the pregnancy, labor and delivery including maternal life-style, prenatal care, substance abuse and infectious diseases.

• Commentary on the newborn course, especially birth measurements, gestational age and any unusual symptoms or physical findings.

• Results of any lab tests such as maternal infectious diseases screening and "metabolic screening tests" such as PKU and thyroid panel.

• Record of any immunizations, hospitalizations, surgeries, transfusions, past and current medications.

• Growth and developmental milestones over time.

• Allergies and diet.

• Chronology of the child's care, i.e., how many places has she lived, for how long and was there a significant risk for abuse or neglect?

Healthy Eating

2006-01-21T21:18:00.000-08:00

Good nutrition and a balanced diet will help your child grow up healthy. Whether your kid is a toddler or a teen, you can take steps to improve nutrition and encourage smart eating habits. Five of the best strategies are:

Have regular family meals.

Serve a variety of healthy foods and snacks.

Be a role model by eating healthy yourself.

Avoid battles over food.

Involve kids in the process.

But it's not easy to take these steps when everyone is juggling busy schedules and convenience food, such as fast food, is so readily available. Here are some suggestions to help you incorporate all five strategies into your routine:

Family Meals
Family meals are a comforting ritual for both parents and kids. Children like the predictability of family meals and parents get a chance to catch up with their kids. Kids who take part in regular family meals are also:

more likely to eat fruits, vegetables, and grains

less likely to snack on unhealthy foods

less likely to smoke, use marijuana, or drink alcohol

In addition, family meals offer the chance to introduce your child to new foods and find out which foods your child likes and which ones he or she doesn't.

Teens may turn up their noses at the prospect of a family meal - not surprising because they're trying to establish independence. Yet studies find that teens still want their parents' advice and counsel, so use mealtime as a chance to reconnect. Also, consider trying these strategies:

Allow your teen to invite a friend to dinner.

Involve your teen in meal planning and preparation.

Keep mealtime calm and congenial - no lectures or arguing.

What counts as a family meal? Any time you and your family eat together - whether it's takeout food or a home-cooked meal with all the trimmings. Strive for nutritious food and a time when everyone can be there. This may mean eating dinner a little later to accommodate a child who's at sports practice. It can also mean setting aside time on the weekends, such as Sunday brunch, when it may be more convenient to gather as a group.

Stocking Up on Healthy Foods
Kids, especially younger ones, will eat mostly what's available at home. That's why it's important to control the supply lines - the foods that you serve for meals and have on hand for snacks. Follow these basic guidelines:

Work fruits and vegetables into the daily routine, aiming for the goal of 5 servings a day.

Make it easy for your child to choose healthy snacks by keeping fruits and vegetables on hand and ready to eat. Other good snacks include yogurt, peanut butter and celery, or whole-grain crackers and cheese.

Serve lean meats and other good sources of protein, such as eggs and nuts.

Choose whole-grain breads and cereals so your child gets more fiber.

Limit fat intake by avoiding deep-fried foods and choosing healthier cooking methods, such as broiling, grilling, roasting, and steaming.

Limit fast food and other low-nutrient snacks, such as chips and candy. But don't completely ban favorite snacks from your home. Instead, make them "once-in-a-while" foods, so your child doesn't feel deprived.

Limit sugary drinks, such as soda and fruit-flavored drinks. Serve water and milk instead.

By drinking milk, kids also boost their intake of calcium, which is important for healthy bones. That means 800 milligrams (mg) a day for kids ages 6 to 8 and 1,300 mg a day after age 9. To reach the 1,300-mg goal, your child could have:

1 cup (237 milliliters) of milk (300 mg of calcium)

1 cup (237 milliliters) of calcium-fortified orange juice (300 mg of calcium)

2 ounces (57 grams) of cheese (300 mg of calcium)

1 cup (237 milliliters) of yogurt (315 mg of calcium)

1/2 cup (118 milliliters) of cooked white beans (120 mg of calcium)

How Talking to Your Child About Drugs

2006-01-21T21:12:00.000-08:00

Just as you inoculate your children against illnesses like measles, you can help "immunize" your children against drug use by giving them the facts before they are presented with the substance.

When kids don't feel comfortable talking to parents, they're likely to seek answers to their questions elsewhere, even if their sources are not reliable. If kids are not properly informed, there's a greater risk that they're going to engage in risky behaviors and experiment with drugs.

What Should I Say to My Child?
Preschool to Age 7
Before you get anxious about talking to your young children, take heart. You've probably already laid the groundwork for a discussion. For instance, when you give a fever medication or an antibiotic to your child, you have the opportunity to discuss the benefits and the appropriate use of those drugs. You are providing a context of how to use drugs in a responsible way. This is also a time when your child is likely to be very attentive to your behavior and any guidance that you provide.

This is also an ideal time to start taking advantage of "teachable moments." If you see a character on a billboard or on TV that is smoking, talk to your child about cigarettes, nicotine addiction, and what smoking does to person's body. This can lead into a discussion about other drugs and how they can potentially cause harm.

The tone of these discussions should be calm and it's a good idea to present the concept in terms that you know your child can understand. Be specific about the effects of the drugs: how they make a person feel, the risk of overdose, and the other long-term damage drugs can cause. To give your kids the facts, you might have to do a little research.

Ages 8 to 12
As your kids grow older, you can open up conversations about drugs with them by asking them what they think about drugs. If you ask the questions in a nonjudgmental, open-ended way, it is likely that you will get a more honest response from your child.

This is also a time when kids are still really willing to talk openly to their parents about touchy subjects. By establishing a dialogue at this age, you will help keep the door open as kids get older and are naturally less inclined to share their thoughts and feelings so openly with you.

Even if your question doesn't immediately result in a discussion, you've gotten your kids thinking about the issue. If you show your kids that you're willing to discuss the topic openly and hear what they have to say, they might be more willing to come to you for help in the future.

News items, such as steroid use in professional sports, can be springboards for casual conversations about current events. These discussions can provide your children with information about the risks of drugs.

Ages 13 to 17
At this age, your kids are likely to know other kids who use or abuse alcohol or drugs. They are also likely to have friends and peers who drive. It's important to talk about the dangers of driving under the influence on your kids. Talk about the legal issues - jail time and fines for driving under the influence - and the possibility that they or someone else might be killed or seriously injured.

It's a good idea to set up a written or unwritten contract on the conditions of going out or using the car. You can promise to pick your kids up at any time (even 2:00 AM!) without asking questions if they call you when the person who drove has been drinking or using drugs.

The contract can also detail other situations: For example, if you find out someone has been drinking or using drugs in your car while your kids are driving, you may want to suspend driving privileges for 6 months. If you discuss all of this at the beginning, there will be no surprises and they will be clear about your expectations.

Laying Good Groundwork
No parent, child, or family is immune to the effects of drugs. Some of the best kids can end up in trouble, even when they have made an effort to avoid it, and even when they have been given the proper guidance from their parents.

However, certain groups of kids may be more likely to use drugs than others. Kids who have friends who use drugs are likely to try drugs themselves. Kids who may be feeling socially isolated for one reason or another may turn to drugs. So it's important to know your child's friends - and their parents. Be involved in your children's lives. If your child's school runs an antidrug program, get involved. You might learn something! Pay attention to how your kids are feeling and let them know that you are available and willing to listen in a nonjudgmental way. Recognize when your kids are going through difficult times so that you can provide the support they need or seek additional care beyond what you can provide.

A warm, open family environment, where kids are encouraged to talk about their feelings, where their achievements are praised, and where their self-esteem is bolstered will encourage kids to come forward with their questions and concerns. When kids are censored in their own homes, they go elsewhere to find support and answers to their most important questions.

Tips vitamins for children's health

2006-01-21T21:01:00.000-08:00

Before You Buy Children's Vitamins
What You Need To Know

Most children do not need supplental vitamins or minerals. According to the American Academy of Pediatrics, 'a diet based on the Food Guide Pyramid provides adequate amounts of all the vitamins' a child needs. Still, there are situations where children's vitamins are necessary, especially if your child is a very picky eater or has a poor diet. Vegetarians also need vitamins to meet all of their nutritional needs.

According to new AAP recommendations, exclusively breastfed infants should receive 200 IU of Vitamin D each day. Older children who don't drink at least 500ml (about 17 ounces) of Vitamin D fortified milk will also need Vitamin D supplements if they don't get regular sunlight exposure.

Iron
Children and adolescents need the mineral iron to prevent anemia. Those most at risk of iron deficiency are infants who are not given extra iron after six months of age (usually in the form of an iron fortified infant cereal), and babies who drink low-iron formula, cow's milk or goats milk. Good sources or iron include meats, fish, legumes, and fortified foods, such as breads and cereals. Adolescent girls are also at risk of anemia once they begin having their periods.

* Flintstones Children's Chewable Multivitamin, Tablets, plus Iron
* Poly-Vi-Sol Vitamin Drops With Iron
* Pokemon Children's Multiple Vitamin with Iron, Chewable Tablets
* Fer-In-Sol Iron Supplement Drops
* Feosol Tablets and Caplets

Calcium
Calcium is another important mineral, and it is necessary for healthy bones and teeth. Children who drink milk and eat dairy products, such as yogurt, ice cream and cheese, usually get enough calcium from their diet. Children with milk allergies or who just don't like milk are a little more of a challenge to meet these requirements, but it is still easy if you find other foods high in calcium, such as calcium fortified orange juice. Vitamins, even those with extra calcium, generally only have about 200mg, or 20% of daily requirements, so you usually also need to supplement these vitamins with foods labeled 'High in Calcium'.

* Calcium Gummy Bears
* Herbasaurs Calcium for Kids
* Flintstones Children's Chewable Multivitamin, Tablets, plus Calcium
* Scooby-Doo! plus Calcium, Chewable Tablets

Fluoride
Most children get enough fluoride to build healthy teeth if they are drinking fluoridated water, either from tap water in a city that adds fluoride to the water, or bottled water that also has added fluoride. Since too much fluoride can cause staining of your child's teeth, talk with your Pediatrician or Dentist before giving your child fluoride supplements.

* Poly-Vi-Flor

Infant's Multivitamins
Multivitamins for infants are available as drops and usually contain Vitamin A, Vitamin C, and Vitamin D. They may also have added iron (see above) and other vitamins and minerals, such as thiamine, riboflavin, niacin, pyridoxine, Vitamin B12, and Vitamin E.

* Tri-Vi-Sol Drops
* Poly-Vi-Sol Drops
* Gerber Vitamin Drops

Children's Multivitamins
Multivitamins for older children are usually given as a chewable tablet. Finding your child's favorite character may make taking vitamins easy and fun.

* Centrum Kids Chewable Vitamins
* Flintstones Children's Chewable Multivitamin
* Pokemon Children's Vitamins
* Bugs Bunny Children's Vitamins
* Scooby-Doo! Complete Multivitamin / Multimineral Supplement, Chewable Tablets

2006-01-21T04:20:00.000-08:00

Adopting Children in Indonesia

Government of Indonesia Requirements for Adoption

Foreign citizens wishing to adopt a child in Indonesia must fulfill a variety of requirements set out by the Government of Indonesia. The Department of Social Affairs has appointed a few agencies through which all foreign adoptions must be channeled. In Jakarta the designated agency is Yayasan Sayap Ibu. Below are listed the steps which foreign nationals must follow in order to adopt in Indonesia.

1. Contact the orphanage (in Jakarta Sayap Ibu Foundation, Jalan Barito II/55, Tel. 722-1763) and tell them you are interested in adopting an Indonesian child. You will be asked to meet with a social worker for an interview regarding your motivation and suitability. The basic requirements that adoptive parents must meet are as follows:

Prospective adopting families must be between the ages of 25 and 45. (husband 45 years, wife 40 years).
The couple must have been married for at least 5 years.
The couple must have been residents of Indonesia for a minimum of 2 years and have a permit issued by the local regent and from their embassy in Jakarta.
Couples can be either childless, have their own natural children, or have previously adopted an Indonesian child.
If a child from another country has been adopted previously, the foundation will not agree to an Indonesian child being placed with the family.
The couple should believe in God. Both parents must be able to appear in Court.

2. If the Sayap Ibu Foundation determines that you are suitable, you will have to submit the following paperwork, which will then be forwarded to the Department of Social Affairs.

Marriage Certificate which has been authenticated by the Indonesian Embassy in the country of issuance.
Birth Certificate of both parents which has been authenticated as above.
B irth certificate of previous children, authenticated as above.
Letters from close relatives of both prospective adoptive parents stating that they approve of the prospective parents’ desire to adopt an Indonesian child.
Health statement for husband and wife by a medical practitioner at an Indonesian government hospital.
Statement from an Indonesian government hospital gynaecologist regarding involuntary childlessness
Income statement
Good condust certificates from the Indonesian police for both husband and wife
Family photos and photos of the home and surroundings
Three photos each of husband and wife
Statement from the adoptive parents that they will contact the Indonesian Embassy at future areas of residence (with meterai/official stamp)
Statement of motivation for adopting an Indonesian child (with meterai).
Statement of domicile from the U.S. Embassy in Jakarta an dfrom the local regent (RT/RW/Lurah/Camat).
Work Permit
Photocopies of husband's and wife's passports and KIMS.
A letter from the U.S. Embassy in Jakarta stating that the child will be allowed to enter the United States after the adoption is granted, and that under U.S. adoption legislation an adopted child becomes a child of the adoptors as if he/she had been born to them in marriage

NOTE: All documents in English must be translated into Bahasa Indonesia (the national language) by a sworn translator in Indonesia (Sayap Ibu Foundation will assist).

When all the above listed paperwork is in, the Department of Social Affairs can authorize the Sayap Ibu Foundation to release the child to you, provided that you have been residing in Indonesia a minimum of two and a half years. At this point you are considered to be the child's foster parents. The fostering period must last a minimum of 6 months before the adoption can be finalized in court. An Indonesian social worker will come to your home at least once to interview you.
After you have completed the requisite 6 months of foster parenting, fulfilled the three year residency requirement, and have delivered all the necessary paperwork, a Court date will be set. The Court hearing will officially establish that you are the child's adoptive parents.
Approximately 2 weeks after the Court hearing approving your adoption, you will receive the official court adoption document.
With that document in hand, you can now apply for your child's Indonesian passport. The child will not be able to depart Indonesia, or be issued a U.S. visa, until he/she has a passport. With that document Indonesian passport be issued a US visa

Requirements for an Indonesian Passport include::

The child's birth certificate.
Copies of both parents' passports and residence/work permits.
Copy of the court adoption decree.
Letter of domicile from parents' lawyer stating that it is for the child's passport
Affidavit from the US Embassy that the child will not become an American citizen automatically upon adoption.
Rp 50,000 processing fee.

2006-01-21T04:11:00.000-08:00

Polio - Update

Background

Although the polio virus was eliminated from the Americas in 1994, the disease still circulates in Asia and Africa, paralyzing the world’s most vulnerable children. In a continually shrinking world, polio, like many other vaccine-preventable diseases remains only a plane ride away. The Global Polio Eradication Initiative, started in 1988. That year, an estimated 350,000 children were paralyzed with polio worldwide; in 2004, polio cases had fallen to just over 1,200 cases globally.

Polio is transmitted through the fecal-oral route, although there is some evidence that oral-to-oral transmission is possible. The virus is killed by regular household disinfectants and standard hygiene protocols can prevent transmission. The Virus affects the nervous system of a patient, and can lead to a flaccid paralysis of the legs while sensation remains intact.

Recent cases in Indonesia

There have been several confirmed cases of “wild” Polio in Indonesia in the area of Sukabumi in west Java. All patients were children from poor social background, who did not start or complete a vaccination series as recommended by the WHO.

Polio vaccination

The vaccination against Polio started in 1955, the vaccine breakthrough was driven by Jonas Salk and his team of scientists at the University of Pittsburgh with a monovalent (single type) oral vaccine. From then the vaccine has further evolved to a trivalent vaccine effective against all 3 know types of Polio, until 1987 the introduction of an injectable vaccine marked the start of a new era.

Although rare, vaccination associated paralytic Polio (VAPP) is a side effect that occurred in the US in 5-10 cases annually during the time of exclusive use of oral polio vaccine. This includes adults over the age of 18, who have a higher risk of VAPP than small children.

Recommendations

Independent of any cases of Polio in the country, every child and adult in Indonesia should have received a full series of 4 vaccinations against Polio. A person who did not have a full set of Polio vaccine is advised to complete this, it is not necessary to repeat the whole series if a previous vaccination had been incomplete and only one injection had been missed. An incomplete oral vaccination schedule (OPV) can be completed by injection (IPV).

Booster vaccination of adults or children who have already completed a full series of 4 injections in the past is not recommended. It is recommended to use the injectable vaccine IVP for any new full vaccination of adults and children. The minimum time between injections must be 4 weeks, it is currently recommended to follow the rapid 2 month schedule for the firs 3 injections, although the routine schedule for children proposes a 2 / 4/ 18 month program, with a 4th booster before the age of 5. Adults should follow the 0 / 1 / 2 month schedule with a further booster sometime after one year.