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American Academy of Pediatrics

Adoption: Guidelines for Parents

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Adopting a child into your family can create many different emotions—from excitement and delight to concern or fear. While adopting a child is a unique and wonderful experience, it can bring special issues and challenges to your family. Read on to get a better understanding about how adoption plays a role in your child's life and how you can help your child understand his or her history of adoption.

Start at the beginning

Many parents want to know when is the best time to tell a child she is adopted. The answer is that it is never too early to talk to your child about adoption. Before age 3, include age-appropriate children's books on adoption as part of your child's reading routine. Give your child information little by little, as much as she can understand. It may take years for your child to fully understand what adoption means. These early talks will give you practice in talking about adoption. They will also show your child that it is OK to bring up the topic.

Here are some tips on how to talk about adoption in your everyday life.

Tell the story. Just as any child delights in the story of the day she was born, a child who is adopted will love to hear the details of how she came into the family. Share with your child the joy you felt at bringing her home that very first day. Talk with her about the many ways children join families—whether by adoption or birth, or in foster care or stepfamilies.

Share the memories. During the adoption process, keep a scrapbook or journal the same way an excited mother does during pregnancy. Keep track of important dates and steps in the process. Take pictures of the people and places involved in your child's earlier life. These details will help make the adoption easier for your child to understand. You may want to place pictures in your child's room to encourage her to ask questions about her adoption. If you have an open adoption, you could frame a picture of her birth parents. If she was adopted internationally, maybe frame a picture from her place of origin.

Use the words. The word adopted should become a part of your child's vocabulary early on. Find other words that everyone in your family is comfortable with. The terms birth mother and birth father are very common. Biological parents is also used frequently. Let your child know that the words mother and father have more than one meaning. A mother is someone who gives birth to a child, but a mother is also someone who loves, nurtures, and guides a child to adulthood. Being a father also can have different meanings.

Adoptive parents often tell their child she is special because she was "chosen" or that she was "given up out of love." Though the parents mean well, these statements may be very confusing to a child. Some children may feel that being chosen means they must always be the best at everything. This can lead to problems when they start to realize this is not possible. Telling your child she was given up out of love may raise questions about what love is and whether others will give her up too. Some families use the term "making an adoption plan" instead of "giving up" their child.

Don't wait. The longer you wait to talk about adoption with your child, the harder it will be. Any level of openness you can build when your child is young will help encourage her to ask more questions about her adoption as she gets older.

Ask for help. If talking with your child about adoption is difficult, talk with your pediatrician. He or she can be a valuable source of support, understanding, and resources.

Questions your child might ask

Even if you talk about adoption early and openly, at some point your child may begin to ask questions such as

  • "Did I grow in your body, Mommy?"

  • "Why did my birth mother give me away?"

  • "Did she and my birth father love each other?"

  • "What was my name before I was adopted?"

  • "What nationality am I?"

  • "Do I have brothers or sisters?"

  • "How much did it cost to adopt me?"

Be honest and open. If your child feels that you are not telling the whole story, he may look for answers somewhere else, like from a relative or friend who may not know or may not share accurate information. Show your child that you are willing to talk about the adoption. Tell him it's OK to bring it up with you.

Avoid responding with your own worries like "Why do you want to know?" or "Are you unhappy with our family?" Your child's curiosity is healthy and natural. It should not be discouraged or seen as a threat to you. Also be sure to only answer the questions the child has asked, not what you think he should know.

Don't force the issue on your child. Some children are curious from the very beginning. Others may be afraid to bring it up. The best you can do is let your child know it is OK to talk about it. When your child is ready to know more, he will ask.

Questions others may ask

Other people might ask questions that your child will not be able to answer, from innocent questions like

  • "Where did you get those big, blue eyes?"

  • "Do you look more like your mom or your dad?"

to important medical questions such as

  • "Do you have a family history of heart disease, cancer, or diabetes?"

  • "What is your ethnic background?"

Questions from strangers can be tricky. You do not have to tell everyone your child is adopted. However, if a question comes up about differences in appearance or ethnicity, offer a simple but honest explanation. When you are proud of your child's identity, she too will learn to appreciate her own value. Be aware that your attitude about adoption will show in your answers. How you respond can set an example as to how your child may choose to answer these questions in the future. Also, let your child know that she does not have to give specific answers to strangers if she does not feel comfortable. It is her choice to share whatever information about her adoption that she chooses. It is fine for children to learn that information about their adoption is theirs to share over time.

International adoptions

Parents who adopt children from other countries need to be aware of the special medical needs their child may have. Your pediatrician recommends the following:

  • Immunizations should meet US standards.

  • Tests for infectious diseases (such as HIV, hepatitis B and C, syphilis, tuberculosis, and parasites) and nutritional disorders (such as lead poisoning, anemia, rickets, and iodine deficiency), even if testing was done in another country before the adoption.

  • Vision, hearing, and developmental (such as language) assessments.

Adopting an older child

Adopting an older child can have challenges as well. An older child may bring both positive and negative experiences from his past into your family. He may have lived in a number of foster homes, each affecting him in some way. He may have lived with one or both birth parents for a time. There may be a history of abuse. He may have been separated from siblings. Many factors could have affected your child's life before he came to your home. The following are some suggestions that will help you deal with them:

Learn as much as you can about your child's background and that of his birth parents. The adoption agency can help you gather as much information as possible. Learning about your child's past may help you be more aware of what lies ahead.

Keep a connection to your child's past. It is important that your child feel connected in a positive way to the life he had before coming to your home. If possible, keep in touch with someone he knew, like a grandparent, relative, friend, or neighbor. Put together a "life book" by collecting mementos and photos of your child's previous home and school and people he was close to. These things will be important to your child over time.

Don't be afraid to seek help. Love can work wonders for most children; however, in some cases, love may not be enough. Adoptive parents should understand that an older child with mild or serious problems may need professional help to resolve issues.

Don't blame yourself. An older child may rebel against his new family. This anger is usually because of the child's past experiences. These problems are not your fault. Remind yourself that you are part of the solution as you help your child work out his issues. Most of all, be patient.

Talk with your pediatrician. He or she may be able to help or suggest counselors or support groups.

Searching for birth parents

While it may be painful for you to think or talk about your child's past, many adopted children get to a point where they want to know where they came from and why they were placed for adoption.

As your child gets older, make sure she knows where to look for information about the adoption. It is a good idea to keep copies of your child's adoption papers and share them with her at an appropriate time. She may want to look them over in private or read through them with you, or she may never want to see them at all. But it is important that she have the choice.

At some point your child may begin thinking about searching for her birth family. Some states have programs available to help adults who were adopted get information about their adoption. Only a few states have open records. Check with your state government to find out about the laws concerning adoption records.

Birth mothers and fathers also may conduct searches to reconnect with a child placed for adoption. Many have gone on to raise other children and may feel a need for information or be very concerned about the well-being of the child they placed for adoption years earlier.

It is important for you to consider the possibility that the birth parents may one day play a role in your child's life. An open and loving relationship with your child will help you face these issues. Search and reunion can bring pain and joy for everyone involved. Each child, no matter what age, needs the continuing love and support of her adoptive family.

Open adoptions

An open adoption is when there is contact between birth parents and adoptive parents during the adoption process. This can mean simply exchanging names and addresses or, in fully open adoptions, the birth parents may have ongoing communication with or even visit the adoptive family and child.

In an open adoption, your young child may not understand the relationships between the 2 sets of parents. While there are fewer secrets in an open adoption, there may be just as many difficult questions. It is important to address the issues mentioned in this brochure and provide your child with the guidance and support he needs.

The gift of each other

Raising a child who is adopted can present unique challenges. If the child misbehaves, gets into trouble, or has problems at school, it is tempting to blame her history of adoption. The fact is, all children sometimes misbehave or get into trouble. It is possible your child's problems have nothing to do with adoption at all. They may simply be a normal part of growth.

As your child grows, she is influenced by family, the community, friends, school, and society in general. She is also influenced by the genes passed to her from her birth mother and father. There is no research that can tell us which is more important, but we know that both are powerful. Adoption is an important part of who your child is, but keep in mind that many other factors will affect who she becomes.

Helping your child accept the fact that she is unique, yet just like everyone else, may not sound easy, but it is important to try. Talking openly and truthfully with your child about her history of adoption, her birth parents, and her feelings is the key. Adoption gives both you and your child a tremendous gift—the gift of each other. With love, honesty, and patience, you and your child will form a relationship that is as deep and meaningful as any bond between a parent and child.

For more information

There are many quality resources available to find out more about adoption. The following are just a few:


Adopting the Hurt Child: Hope for Families With Special-Needs Kids by Gregory C. Keck and Regina M. Kupecky (Pinon Press, 1998)

The Adoption Triangle by Arthur D. Sorosky, Annette Baran, and Reuben Pannor (Corona, 1989)

Being Adopted: The Lifelong Search for Self by David M. Brodzinsky, Marshall Schechter, and Robin Marantz Henig (Anchor, 1993)

Birthmothers: Women Who Have Relinquished Babies for Adoption Tell Their Stories by Merry Bloch Jones (Chicago Review, 1993)

How It Feels to Be Adopted by Jill Krementz (Knopf, 1988)

Journey of the Adopted Self by Betty Jean Lifton (BasicBooks, HarperCollins, 1995)

Let's Talk About It: Adoption by Fred Rogers (Paper Star, 1998)

Raising Adopted Children by Lois R. Melina (HarperCollins, 1998)

Real Parents, Real Children by Holly van Gulden and Lisa M. Bartels-Rabb (Crossroad, 1995)

Talking With Young Children About Adoption by Mary Watkins and Susan Fisher (Yale University Press, 1995)


  • Adoptive Families Magazine

  • 800/372-3300


  • American Adoption Congress (AAC)

  • 202/483-3399


  • Child Welfare League of America (CWLA)

  • 202/638-2952


  • North American Council on Adoptable Children (NACAC)

  • 651/644-3036


Please note: Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of the resources mentioned in this publication. Phone numbers and Web site addresses are as current as possible, but may change at any time.

Copyright © 2007 American Academy of Pediatrics, Updated 5/07

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