Sunday, November 09, 2008 11:57 AM
Subject: Melamine issue
Dear parents and adoption advocates:
I've been waiting to post on this topic until an official statement
(forthcoming) is released by the American Academy of Pediatrics. At the
same time, I'm receiving almost daily emails and calls, so I wanted to let
people know what the official word is (so far) about children potentially
exposed to melamine prior to adoption. Currently there is no consensus.
Some docs are advocating testing every child that ever lived in China, others are testing only children with symptoms. The AAP Section on Adoption and Foster Care, along with nephrologists who specialize in the care of kidneys, are looking at evidence based medicine to arrive at a consensus.
I've attached a website for the freshly minted statement created by the American Society of Pediatric Nephrology (in conjunction with input from several national adoption specialists, the intl society of nephrologists; physicians & public health officials in China; WHO and CDC representatives). The statement may be accessed by looking at the ASPN website (http://www.aspneph.com/) and clicking on the melamine statement.
A few observations of the recommendations:
1. For ASYMPTOMATIC children who may have been exposed - they are
suggesting no screening.
2. For SYMPTOMATIC children (see the article for a list of symptoms)
- further assessment is suggested. Some docs are just doing blood and
urine, others doing a renal ultrasound also.
3. They are suggesting focusing on children exposed to formula in
2007 & 2008
4. Interestingly... at least in animals... females seem to be less
impacted than males.
I will share the statement from the AAP when available with these groups. This is not cut and dried, as various medical specialists are recommending different approaches. The bottom line: if your child has symptoms (as described in the table), then it makes more sense to pursue a workup. My suggestion is to call your child's health care provider, reference the website, and help the physician to learn more about this (as all of us are). Although I am far from an authority on this issue, you may share this email without my permission, with the caveat that a child's physician should make the final call on what is appropriate for each child.
Debbi Borchers, M.D.
Adoption pediatrician in Cincinnati area
Adoptive mom of three from China (last one adopted 2000, so I'm not
doing anything for my three)
| Important Recommendation from American Academy of Pediatrics for China Adoptive Families |
| Information received from WACAP:
16 October 2008 Dear Families, |
| In recent months you’ve most likely heard about the infant
formula tainted with Melamine in China. According to reports from China,
this tainted formula has resulted in some babies developing kidney
stones, and in a few extreme cases, experiencing kidney failure. I know
we are all saddened by this situation, and by the suffering of Chinese
children and their families.
|
| We are writing today to advise you that WACAP recently has heard
from three families whose children were diagnosed with kidney stones.
Two of these children joined their families as early as 2005. WACAP
immediately contacted Dr. Dana Johnson, an adoptive medicine specialist
at the University of Minnesota’s International Adoption Medical
Clinic, to seek a recommendation for families who’ve adopted from
China. Dr Johnson consulted with the section on Adoption and Foster Care
of the American Academy of Pediatrics and advised us of the following:
"...the consensus is to do urinalysis and BUN/Creatanine on all
children adopted from China from 2005 onward and if abnormal, get a
renal ultrasound."
|
| We know this information comes as a surprise and may be upsetting.
We will continue to monitor the situation carefully and advise you of
any further recommendations from the American Academy of Pediatrics. As
we continue to place many children from China, especially children with
special needs, we will continue to be in contact with the CCAA as well
regarding this issue. We are sending this e-mail to all families who
have adopted from China since January 2005 for whom we have an e-mail
address. If you know of other families that may benefit from this
information, please feel free to forward this on.
|
| Best wishes,
Elizabeth Rose and the WACAP team |
| --------------------------------------------------------- |
| Note to parents: If your child falls in this age range, this is important but not emergency response information. Call you pediatrician during normal business hours to schedule an appointment to have your child tested. - Jim Weaver FCC Webmaster |
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