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Statement on International Adoption: Committee to Advise on Tropical Medicine and Travel.

International adoption medicine is a new field that is changing constantly due to the different countries and circumstances from which children are adopted into Canada. Although this document is evidence-based when possible, much of the published literature does not apply to current situations given the dynamic nature of international adoption medicine. With the exception of the Bucharest Early Intervention Project (1), all known published literature in international adoption is based on descriptive studies or expert opinion (e.g. grades B/C III). The reader is directed to recent comprehensive reviews on international adoption (2-4) and infectious diseases in international adoption (5,6) for more information. 
 
Over the past 10 years, Canadians have adopted over 20,000 children from other countries (7). These children are a unique group of travellers and can have unique medical issues related to growth and developmental delay, attachment disorders, long-term institutionalization, prenatal and postnatal exposure to toxins and drugs, variable immunity to vaccine preventable diseases, and exposure to infectious diseases. In addition, the process of international adoption may require a medical practitioner to make judgments on specific circumstances in which they may have little experience or knowledge.