However, when Priscilla Morse saw the heart-breaking photos of the emaciated boy on Facebook last year, she knew she had to save him.
And in October last year, Priscilla was able to bring Ryan home to Nashville, Tennessee.
Now the 8-year-old has gained 6.8kg in 13 months and is making gradual improvements after being adopted by the loving family.
Morse, who own a jewellery business, said: "We adopted our first child four years ago, and I was adopted too.
"When I saw a photo of Ryan in the orphanage, I remembered my brother had similar needs and the care he needed before he died.
"I begged my husband for months if we could adopt him, I just had to look after him."
Last July, she visited Ryan for the first time to finalise paperwork, and spent two weeks bonding with the infant.
The amazing mum returned to Burgas, Bulgaria, in October that year to bring him home.
Ryan is currently seeing different specialists and awaiting an official diagnosis but is believed to have cerebral palsy and a form of dwarfism. Photos / Caters News Agency She said: "It's a beautiful country, but they don't have the funding to take care of the kids, they do the best they can.
"All he needed was a feeding tube. What was killing him was starvation.
"The first time I saw him, I walked into his room and the first thing that went through my head was that he was going to die.
"It was shocking, photos don't do it justice. He looked even smaller in real life. Sicker and more fragile.
"My index finger was the same size as his thigh."
As soon as they landed back in Nashville, Ryan was rushed to hospital.
Now the family are seeing improvements - he starting to ennunciate sounds, laugh and move more. Photos / Caters News Agency She said: "We went straight to Vanderbilt Children's Hospital, we didn't even go home to see our kids.
"The doctors hadn't seen anything like it either.
"They told me that if it had happened in America it would be national news because it was so shocking, to be starved for seven years.
"They didn't think he would make it."
At first Ryan suffered from re-feeding syndrome, which meant he had to wait until January before his body could cope with a feeding tube.
He would also swallow air to make himself feel full and regurgitate food, stopping him from getting nutrients.
Thankfully, in March after being switched from a gastrostomy tube (G-tube) to a Jejunostomy feeding (J-tube), he started to gain weight.
Now the eight-year-old has gained 15lbs in 13 months and is making gradual improvements after being adopted by the loving family. Photo / Caters News Agency His mum said: "It took months of training his body to accept food.
"He didn't trust that there was food coming in the orphanage so he had learned to regurgitate food to stay alive.
"Doctors hoped it was a behavioural thing, so they put him on a J-tube, which delivers food straight to the intestine."
When the family first got Ryan he was silent, couldn't make eye contact and his muscles were atrophied.
Now the family are seeing improvements - he is starting to enunciate, laugh and move more. He has even began feeding orally in small amounts.
Priscilla said: "It's going to take years.
"But I think he would have died if we hadn't got him.
"He's the happiest kid I've ever seen, he wakes up happy and goes to bed happy, he very rarely cries.
"Our other kids love him - he's the baby of the family."
Ryan is seeing different specialists and awaiting an official diagnosis but is believed to have cerebral palsy and a form of dwarfism.
The Morse family. Left to right: Dylan, 14, with Jack, 6, Mum Priscalla with Ryan, 8, and Dad David with McKenzie, 7. Photo / Caters News Agency Priscilla said: "We see one specialist at a time to look over one part of him.
"So far they can't pinpoint a syndrome, they have tested for all kinds of stuff, it's kind of a mystery."
She added: "I would really urge parents thinking of adoption not to overlook kids with disabilities.
"It is a struggle, you have to have a dark sense of humour.
"If you can't laugh you won't make it.
"But these kids are worth it."
The family run a Facebook page, Saving Baby Ryan , which documents his progress.
- Caters