THE UNIVERSITY OF WASHINGTON ALUMNI MAGAZINE

Part Three: No Such Thing as a "Risk Free" Baby

Although detecting medical problems after the adoption is imperative, most of Bledsoe's work, and the trickiest part, occurs before parents ever meet their adopted children. Each week Bledsoe reviews between 10 and 20 sets of records for prospective parents. Since medical standards and procedures vary from country to country, she must interpret medical terminology that the average pediatrician is unfamiliar with.

"You have to take everything on the medical record seriously, but everything is also suspect," Bledsoe says. In many cases records are missing, inaccurate, or simply false. Often vaccinations have been given incorrectly or ineffectively. Bledsoe does what she can to fit together the available jigsaw pieces into a picture of the child's health.

The best news is that with experience comes knowledge. "The more we do it, the more we know what to look for," Bledsoe says. For example, she knows that fetal alcohol syndrome is prevalent in the former Soviet Union and that Chinese orphans may have low dietary iodine and develop hypothyroidism.

If measurements of a child's height, weight and head circumference over a period of time are provided, pediatricians can plot a growth chart to gauge normal development. A growth chart provides great clues, but you have to know what to look for, Bledsoe explains.

"You should use a growth grid appropriate to the child's ethnic background," she explains. Chinese heads, for example, are smaller than Caucasians'. Growth patterns plotted on the wrong chart might seem to indicate problems where none exist. "What I always worry about is a family turning down a child on the basis of incorrect information," Bledsoe says.

Families looking into adoption are asked if they will consider a child with serious illnesses, such as AIDS or cancer, birth defects, or retarded physical, mental or emotional development. Some parents chose these harder-to-place children, as Bledsoe and Johnston did. Their son, Sean, has a cleft palette, requiring several operations to correct.


Adoption medicine specialist Dr. Julie Bledsoe (left) examines little Paige Lockridge as her mother, Terrie, looks on. Photo by Mary Levin.

And then there's the reverse situation-when people believe they're adopting a healthy child only to discover there are unexpected problems.

"People live in constant fear of that," Bledsoe acknowledges. "I explain very clearly up front that I'm going to do my best job to tell them what I think the health of the child is. But there are certain things that we can't know because we don't have that information. We can be wrong either way. I try to prepare people for the worst-case scenarios."

An important fact for prospective parents to face is that no child comes with a guarantee. "It's not nice to hear that-but birth isn't risk-free, either," remarks Bledsoe. "At some point, you just have to take the leap."

Even with the built-in uncertainties of adoption, most end happily, Bledsoe says.

"One study, sponsored by the Joint Council on International Children's Services, interviewed more than 700 families who had adopted internationally through agencies all over the country. The survey found that 90 percent of the parents felt they were with the child they were meant to be with-and that's all comers, even people whose children have major medical problems," Bledsoe says. "Those are pretty good statistics. It speaks to the fact that bonding between a parent and child goes beyond an illness."

University of Minnesota pediatrician Dana Johnson, who founded Minnesota's adoption medicine clinic, agrees. "All children come with problems. Institutionalized children just come with different ones," he says. "Most families are happy."


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