Sir.—We welcomed the articles in the February 1978 Journal (132:124, 1978) concerning incest because they alert the pediatrician to a relatively common problem that tends to be handled poorly by the physician. Dr Adams' editorial raised the concern about the deleterious consequences of incestuous matings in which the risk for congenital abnormalities and mental retardation approaches 30% to 40%.
We would like to alert physicians to an observation we have made, which is that one should suspect incest when a young, unmarried mother does not clearly identify the father of her baby. The children of unmarried teenagers frequently become available for adoption. In our experience, a surprisingly large number of adopted children have autosomal recessive diseases, raising the possibility of incest. Recently, we have evaluated two unrelated, adopted children, each with two, different, rare recessive disorders, making it likely that they are the products of consanguineous or incestuous matings. In