In Finland, there is an urgent need to standardize recommendations for arrival examinations for internationally adopted children including all the necessary laboratory tests.

The law on international adoption came into force in 1985. Between then and the year 2007, altogether 3300 children from abroad were adopted in Finland. Research has shown that the certifications of vaccinations are often inadequate, and almost half of the international adoptees have some medical problems. Adopted children may have infections acquired in their country of origin, e.g. intestinal parasites, hepatitis B, and tuberculosis. As many as 70% of adoptees have delayed development and 45% have retarded growth. There are many disorders that interfere with growth and development at the time of arrival, e.g. sensory problems, hypothyroidism, phenylketonuria, and anaemia. At least these health and developmental problems should be recognized at the time of entry already. Development begins to catch up immediately after arrival and progress is usually visible within two months. If growth has not started to catch up within 6 months after adoption, examinations should be initiated. Intensive follow-up is needed to monitor development, growth and attachment process during the first months after adoption.