Adoption and hospital admission in Port Moresby, Papua New Guinea.

We report a study of adopted children admitted to the children's wards of Port Moresby General Hospital, Papua New Guinea over a 5-month period in 2000. The proportion of hospitalized children known to be adopted was almost three times that in the children's outpatients department. Gastroenteritis and neonatal sepsis were more common causes of admission in adopted children than in the general paediatric hospital population. Admitted adopted children were lighter and shorter than the controls with no difference in weight-for-height, suggesting that stunting is the predominant nutritional problem among adopted children. These differences were even more marked in children with diagnoses other than gastroenteritis. Thirty-three (82.5 per cent) of the adopted children had ever been bottle fed compared with 11 (13.75 per cent) of the controls (p = 0.029). Twelve (30 per cent) children had been adopted because of neglect or abandonment. The biological mothers of seven of these children had died, and two children had been bought for cash. Biological mothers were more likely than the adoptive or control mothers to be single and less than 20 years of age. Knowledge of formal adoption procedures was very poor. The present study therefore shows that adoption in Papua New Guinea is not without risk and it is important that adoption should be recognized as having the potential for serious adverse effects on the child's well-being, especially since adoption is likely to become even more prevalent as the HIV epidemic continues. Consideration needs to be given to protection of the rights of children at high risk of adoption.