Adoption

Overview

Adoption is a legal process where a child becomes a permanent member of a new family. For a General Practitioner (GP), adoption is not a medical condition, but the health and well-being of the adopted child and their new family are very important. Many adopted children have experienced early challenges, so they may need extra support with their health, growth, and emotional development.

Adoption affects a small but significant number of children and families each year. Most adopted children are healthy and grow well, but some need extra health monitoring.

Adoption affects children placed for adoption, their new parents, and birth families. In general practice, the main focus is on the adopted child, but parents may also need support adjusting to family life.

Symptoms

Common symptoms

• Not gaining weight or growing as expected
• Delay in developmental milestones such as sitting, walking, or talking
• Difficulty settling, sleeping, or feeding
• Signs of low mood, anxiety, or excessive irritability

Symptoms in children

• Fear or distress when separated from their new parents
• Avoiding cuddles or physical contact
• Behaving in a way that seems very young for the child's age
• Overeating or hoarding food

Symptoms in older adults

• Adoption is not an adult health condition, but adoptive parents who are older may have their own health needs as they care for a growing child. If you are an older parent, talk to your GP about keeping active and managing any long-term conditions.

Causes

Main causes

• Adoption itself is not a cause of illness, but the reasons a child enters adoption can affect their health. These may include prenatal exposure to alcohol, drugs, or infections, early neglect or trauma, and gaps in medical care or immunisations.
• A child may have an unknown medical and family history, which means doctors need to check carefully for hidden issues.

Risk factors

• Coming from institutional care such as an orphanage
• Having experienced abuse or neglect before adoption
• Being born prematurely or with a low birth weight
• Having a birth mother who had limited access to prenatal care

When to see a doctor

See a doctor urgently if:

• Contact your GP practice on the same day if your child has a sudden illness or injury, or if you notice a new and very worrying symptom.

Book a routine appointment if:

• Please book a routine appointment for any developmental concerns, sleep or feeding problems, or if you need a review of immunisations.

Diagnosis

Adoption itself is not a diagnosis. Your GP will complete an initial health assessment after the child arrives. They will review the child's medical record, ask about family history, and look for any health or developmental needs.

Tests that may be done

• Physical examination
• Height, weight, and head circumference measurement
• Vision and hearing screening
• Developmental screening tools
• Blood tests only when there is a reason, for example to check for conditions passed from mother to child

What to expect at your appointment

Your GP should share the findings with you and make a plan. If extra help is needed, they will refer you to specialist children's services, speech and language therapy, or child and adolescent mental health services.

Treatment

Most health issues in adopted children are treated with support and therapies rather than medicine. Early assessment and a supportive family environment are the most powerful tools.

Self-care at home

• Create a calm, predictable routine around meals, sleep, and bath time.
• Use positive attention and praise to build the child's confidence.
• Talk to your health visitor or GP about parenting courses or support groups.
• Keep a diary of any concerns so you can share accurate information at appointments.

Medical treatments

If your child is diagnosed with a specific condition, like asthma, another health condition, or a mental health problem, the GP will explain the treatment options. These may include watchful waiting, talking therapies, or referral to specialists. Medication is always prescribed by a doctor and tailored to the child.

When is surgery considered?

Surgery is only rarely needed for adopted children, and only for a specific physical condition like a hernia or heart problem. Your GP will refer you to a surgeon if that is the right next step.

Living with this condition

Build a sense of belonging with routines, family traditions, and photos. Help your child feel safe by being patient and consistent. Understand that the child may need time to attach to you.

Lifestyle tips

• Keep regular times for meals, play, and rest.
• Encourage outdoor physical activity every day, but at the child's pace.
• Limit screens, especially before bed, and use them together when you can.

Diet and exercise

Offer a balanced diet with plenty of fruit and vegetables, and make sure your child eats regularly. If you have concerns about weight gain, low weight, or picky eating, speak to your health visitor or GP. Daily activity helps with mood and sleep.

Mental health and emotional wellbeing

The adoption experience can affect a child's emotional health. It is also a big life change for parents. Feeling tired, anxious, or overwhelmed at times is common. It is important to speak to a professional if you or your child are struggling.

Prevention

Adoption itself is not a health condition to be prevented. However, you can help prevent some health problems by addressing early issues quickly — such as developmental delays or emotional difficulties. Good nutrition, immunisations, and a stable home all help.

Vaccines

Check that your child's immunisations are up to date. Your GP can catch up on any missed vaccines. This is especially important because some adopted children arrive with an incomplete vaccine record.

Screening programmes

Your child will have initial screening for growth, hearing, and vision. If there is a history of exposure to alcohol, drugs, or infections in pregnancy, your GP may discuss additional blood tests. These are always optional and discussed fully with you.

Complications

If left untreated

• Long-term emotional or behavioural difficulties if attachment problems are not supported
• Developmental delays if early assessments are delayed
• Missed immunisations increasing the risk of preventable infectious diseases

Long-term outlook

The outlook for adopted children is very hopeful. With the right support, most adopted children go on to form strong, loving relationships and lead healthy, fulfilling lives. The earlier problems are found, the better the outcomes.

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