NEWBORN OUTCOMES: "CRACK BABIES"

Newborn Outcome:
     °Decrease in birth weight and head circumference
     °Symmetric pattern of growth retardation-depressed fat stores        and lean body mass
     °Increase fetal metabolism and thus cause depletion of fetal        nutrient stores, leading to fetal malnutrition
     °Postneonatal exposure to cocaine has been reported via        breast feeding, by direct ingestion, and by passive inhalation

 

 

• Exposed to the drug in the womb and born addicted to crack cocaine, this child experiences severe withdrawal symptoms. Conservative estimates suggest that at least 11 percent of all newborns in the United States today were exposed in the womb to one or more illicit drugs. The number is even higher in urban areas. Birth and hospitalization of a normal newborn cost approximately $2,000. Birth and hospital care of a crack exposed neonate, with round-the-clock nursing, monitors, blood and urine tests, high-tech equipment and social service evaluations, costs $11,000. Who pays the bill? The government, since crack-addicted mothers are unlikely to carry insurance.

• Prenatally drug -exposed newborns cry more frequently than unexposed babies. This 'at-risk' baby suffering though moderate to severe withdrawal, was hard to console. Typically, these children, when held, tend to arch their backs, pull away and cry until they exhaust themselves. Experts note that these behaviors interfere with child-parent bonding. "The worst problem in working with these babies is that they have the jitters," says Nancy Shatz, a San Francisco General nurse who works extensively with prenatally drug-exposed newborns. "They cry because they are in pain and suffering," she observes. "They don't even like to be touched.

• Danny B, one day old, is a crack addict. Swaddled in his soft hospital blankets, he spends each moment of his new life struggling through painful drug withdrawal. Delivered prematurely at San Francisco General Hospital, Danny suffers from low birth weight and smaller-than-normal head size. He rubs his face against the sheets in his isolette until the end of his nose is red and chapped. He furls his brow and continually yawns, sneezes and cries. Danny's high, shrill cry is different from that of other babies in the nursery. "The cry is high-pitched, and sounds so urgent," explains Liza Fernandez, acting head nurse at San Francisco General Hospital's nursery. "Drug-exposed children cry louder and more often than normal newborns."

 

The Parent Child Intervention Program is a preschool in East Palo Alto, California, established specifically to help prenatally drug-exposed youngsters. Teachers try to provide a carefully monitored and highly structured environment for the students. Here, a teacher's instructional aide, Inga Garland, intervenes to control a child who has just kicked a classmate. Teachers report that cocaine-exposed children are unable to deal with many different stimuli at once and tend to act out aggressively or withdraw completely when overstimulated.

Many may recall that "crack babies," or babies born to mothers who used cocaine while pregnant, were written off by many a decade ago as a lost generation. They were predicted to suffer from severe, irreversible damage, including reduced intelligence and social skills. It was later found that this was a gross exaggeration.

*Most crack-exposed babies appear to recover quite well.*

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