Adopted children constitute approximately two percent of the United States’ childhood population, but are disproportionately represented in mental health settings, where they make up an estimated four to fifteen percent of the population. Science suggests that for those adopted at birth, this discrepancy may be due in part to their abrupt removal from the biological parents. We are now beginning to understand the importance of the bonding that takes place in utero and the infant’s awareness at birth. This article suggests three changes to the infant adoption process to align it with scientific knowledge. First, all adults involved in the adoption need to be educated on the unique mental health needs that adopted children may have as a result of their transition from one family to another. Second, the infant adoption placement process should be changed from an event to a process to make the shift from one family to another more gradual. Finally, we need a sea change in the cultural beliefs surrounding adoption to make access to information and contact with biological parents the norm rather than the exception.