Getting Ready to Bring Your Child Home

Our adoption agency gave Andrew and me a list of American Academy of Pediatrics pediatricians who performed pre-adoption consultations. Before we adopted, I called several to see how easy it was to reach them and how quickly they returned my call. I wanted to make sure I felt comfortable talking with a doctor I'd never met before. A few weeks after I selected our doctor, we got a call from the agency — we were matched! The agency wanted us to review the baby's medical information and make our decision within a day. I was glad I had a doctor to reach out to. She called us back within a few hours, and she helped us make an informed decision.

— Gwen, mother of Hannah, a domestically adopted child

As a physician, I've been trained to always be ready for anything, and this trait is also a natural part of my personality. I like to prepare and plan so I know what's going to happen before it does. Of course, life doesn't always work like this, but I still believe that a certain degree of preparation for most situations can help relieve our anxieties. At least it helps relieve mine!

The Value of a Pre-adoption Consultation

While a pre-adoption consultation is not a required part of the adoption process, most adoption agencies recommend that prospective parents talk with a pediatrician who has expertise in adoption. The American Academy of Pediatrics posts a list of adoption medical specialists on its Web site (www.healthychildren.org/English/tips-tools/findpediatrician/ Pages/Pediatrician-Referral-Service.aspx). These pediatricians will review any medical records, photos, and video files of your child, and they will answer any questions you have. Please keep in mind, however, that no pediatrician will tell you whether a child is "right for you" or whether you should "accept the referral." Pediatricians who perform pre-adoption consultations want to help you make an informed decision. And they might talk about some aspects of adoption that are difficult to hear — for example, the risks of early childhood trauma and how much a birth mother's prenatal history may affect a child's life. Again, these physicians are sharing their professional opinions based on their own experiences. You don't have to agree with what the physician says, but do take note. Feel free to ask lots and lots of questions and to ask for further clarification if you don't understand an answer.

Any pediatrician who assists families during the pre-adoption period might offer a range of different services and will understand the importance of being available quickly. Some offer a onetime medical record review. Others will maintain ongoing contact during the pre-adoption period and will continue to answer your questions. If you are traveling, some will help you prepare as you get ready, and some will also provide the option for you to contact them during your trip. You will want to ask your physician about response time and to clarify with your physician expectations about what services are included and for what length of time. Most, but not all, pediatricians charge a fee for their adoption consultations. Some pediatricians who perform pre-adoption consultations also perform the recommended comprehensive post-adoption evaluation (see Chapter 3). And some of these physicians will provide ongoing primary care for your child.

Even if you have adopted before or you are an experienced parent, I recommend you establish a relationship with a pediatrician who is familiar with adoption.

What Parents Ask Me About Adoption

I always tell all parents — whether they've adopted or not — that there are no "stupid" questions. If you don't know something and you want an answer, just ask. You are doing your job as a parent. Some parents have no idea what to ask during these pre-adoption consultations, and that's OK. Even a question such as "How much should I feed her the first day?" is a great question. Here are my answers to pre-adoption questions that I'm often asked.

She looks so healthy in the picture. Is she going to be OK?

"Is my child going to be OK?" is the crucial question. I wish I could always tell parents that their child is going to be healthy. The reality is that no one can offer that type of reassurance. For all the reasons you'll read about later in this book, it is impossible to guarantee — or know — that any child is going to be healthy, even if the child's medical records indicate that that might be the case. When a child develops a medical condition or a mental health concern, pediatricians often don't know the reason. Adopted children are at greater risk of certain conditions that can affect a child's overall health, which we discuss in later chapters. Our job, as pediatricians, is to provide the support and education to ensure that every child receives appropriate medical care.

Do you recommend we meet our child's birth mother?

If you have an opportunity to have an open adoption, I would recommend you do. An open adoption establishes a foundation of honesty about everyone's life circumstances. It reduces the association of shame and guilt that used to be so much a part of what adoption meant. These days, most people are highly supportive of open adoptions. Your child will want — and need — to know about her birth family, and her birth family may want to know about her as well. While circumstances at some future point might make regular contact difficult, meeting your child's birth mother (and father) and finding out as much as you can now will be very helpful in the long run.

I'm adopting from foster care. Can I talk with you about the preplacement visits?

Yes, you can ask questions about anything that comes up during preplacement visits. Your physician may also have some questions for you about what you have observed. Preplacement visits are a wonderful way to help you and your child establish some continuity and will help as she transitions from a foster home to your home.

What should I bring on the trip?

Nowadays, it often doesn't matter whether you are traveling to the next state or around the world to adopt. You can usually get what you need right where you are. But since I believe in my "be prepared" motto, here are several items that I recommend you always have handy.

Food

Food is critical! Depending on how old your child is, you may have to prepare baby formula, so always have some extra with you. You do not need to use...