One of the attractions of adapting the film for author John Irving was that he wanted his son, Colin Irving, to play Wally Worthington. However, as the development process took over a decade, eventually his son was too old for the part and was not known enough to be considered for it in any event. However, the role of Major Winslow did ultimately provide Colin Irving a part in the film.
John Irving subsequently wrote two novels - 'Until I Find You' (2005) and 'Last Night In Twisted River' (2009) which feature characters who win the 1999 Academy Award for Best Adapted Screenplay that Irving won for this movie. Irving also wrote a nonfiction book, My Movie Business: A Memoir, about his experience with and opinions on his books that have become movies, with a particular focus on The Cider House Rules.
The orphan that gets into the pie dough and eats all of it and is shown throwing up all over the orphanage is named 'Steerforth'. Steerforth is the name of one of the main character's friends in the Charles Dickens book "David Copperfield" which Homer reads to the children in their bedroom.