Madonna has flown to Blantyre, Malawi, to celebrate the first anniversary of the Mercy James Centre for Pediatric Surgery and Intensive Care, named after one of her adopted daughters.

And the international superstar - who has adopted four Malawian children and is mother to a biological son and daughter too - took to Instagram to post a shot of her proudly standing with her entire brood on Monday.

Madonna, 59, previously adopted David and Mercy, both 12, from Malawi as well as five-year-old twin sisters Esther and Stella, the Daily Mail reports.

The musician - who is currently working on her 14th studio album - also has 21-year-old daughter Lourdes Leon with actor Carlos Leon, 52, and 17-year-old son Rocco Ritchie with director Guy Ritchie, 49.

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The Centre the brood were visiting is named after Mercy James, who looked pretty in a black and white sun dress for the occasion.

Madonna addressed the press at a conference for the Centre's anniversary, as she was shown around the building to see the work being done.

Madonna visits the Mercy James Centre for Pediatric Surgery and Intensive Care in Blantyre, Malawi. Photo / AP
Madonna visits the Mercy James Centre for Pediatric Surgery and Intensive Care in Blantyre, Malawi. Photo / AP

The American Life singer wore a blue and white striped dress, with red detailing, and a sun hat.

The gauze hat was cream and she wore her blonde locks in plaited pigtails, which fell gracefully to her shoulders.

The singer added a plethora of chains to her neck to round off the look, and small hooped earrings.

She kept her make-up fresh with just a light dab of rose to her pout.

The Impressive Instant songstress later changed into scrubs, to visit some of the children under the care of the Centre.

Her other children looked smart for the event, with David in a black sweater and white shirt and Lourdes in a miniskirt with a black top and a cardigan.

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The young twins looked adorable in matching sundresses and yellow cardigans.

US singer Madonna speaks to the press at a news conference in Blantyre, Malawi. Photo / AP
US singer Madonna speaks to the press at a news conference in Blantyre, Malawi. Photo / AP

Son Rocco wore a black hoodie and jeans as he slung his arm around sister Mercy.

The family - who have had their estrangements in the past - looked like a closely knit unit as the cuddled up to one another and smiled for a snap, posing under painted tree.

Madonna captioned the image: "Tree of Life - Mercy James Pediatric Hospital - One Year Later! #everythingislove #malawi"

The Candy Shop star was seen ahead of her trip cycling in London with family and friends.

She wore a white sweatshirt reading "i love my kids" in lowercase black print on it, making a statement that was only echoed in her snap from Malawi.

Madonna also took to social media on Thursday and shared an adorable clip of herself singing along with daughter Stelle.

They sang a duet repeating the lyrics, "Everything is love" with filters adding animal ears and noses - the same hashtag Madonna used to caption the snap from the Mercy James Centre.