Pubdate: Sat, 31 May 2003
Source: Federal Way Mirror (WA)
Contact:  http://www.fedwaymirror.com/
Details: http://www.mapinc.org/media/2077
Author: Erica Jahn

ROUGH START SMOOTHED FOR DRUG BABIES

Infants swaddled in pink or blue cotton blankets slept peacefully in their 
cribs at the Pediatric Interim Care Center in Kent as volunteers and nurses 
moved around them deftly, speaking in hushed voices.

Soft light filtered through the windows and filled the nursery rooms where 
the babies ---- 14 in all ---- slept in their blanket cocoons.

In a crib near the wall, a girl slept hooked to a respiratory monitor. She 
was given a small dose of morphine, a respiratory depressant, to ease her 
through withdrawals from heroin.

In a darkened, quiet room across the hall, a mother rocked her baby, who 
was born too sensitive to all forms of stimulus to lie in the cribs in the 
lighted rooms with the other infants.

The pediatric center opened its doors more than 10 years ago to serve as a 
haven for drug-addicted babies who no longer need hospital care, but are 
still too sick to go home. Most stay about a month to allow the drugs to 
leave their bodies and to allow their nervous systems to get accustomed to 
the stimulation babies encounter: Light, sounds, chilly air and warm baths.

Barbara Drennen, co-creator and executive director of the center, said 
staff lately have been seeing a run of babies born addicted to opiates, 
particularly oxycodone, the active ingredient in the painkiller Oxycontin.

They also see babies addicted to cocaine, methamphetamine and psychotropic 
drugs, like Prozac or Dilantin. But most of the babies who come into the 
center have been exposed to a multiplicity of drugs.

"Rarely do any of our babies have less than five drugs in them," Drennen said.

A baby born addicted to drugs like cocaine or methamphetamine withdraws 
differently than a baby born addicted to an opiate. But they all are 
hyper-sensitive to lights and sounds and tactile things like air or water 
or cloth on skin.

All the babies like to be swaddled and contained. For opiate-addicted 
babies, it keeps them from shaking.

Babies born addicted to heroin have withdrawals similar to those 
experienced by adult heroin addicts. They have body tremors which they try 
to control by making their limbs rigid.

When they can't control the shaking, they inhale and let out a broken, 
high-pitched shriek healthcare workers refer to as a cat-cry. Their bodies 
become mottled from hyperventilating and, without medication, they could 
have seizures or strokes.

Case manager Donna Ellis said heroin-addicted mothers are typically the 
most cooperative with the center because the babies' withdrawals look so 
much like their own. "They just say, `Here, fix my baby,'" Ellis said.

While the heroin-addicted babies have more obvious signs of withdrawal, the 
cocaine-or methamphetamine-addicted babies present a more long-term danger 
because they're born with a low percentage of body fat and they won't eat. 
They don't know how to suck and they don't have any appetite. "They'll drop 
a bunch of weight," Ellis said.

They're docile, sleepy babies who won't wake up to eat, and if staff 
members or their mothers wake them, they might only swallow a couple ounces 
of milk before nodding off again.

Those babies usually stay at the center a longer time because case workers 
and medical staff want to get their body weights up and make sure they're 
eating before they leave.

In addition to low body weights, though, babies born addicted to 
methamphetamine get diaper rashes that look like third-degree burns on 
their bottoms because the chemicals in meth are so caustic, they turn the 
baby's urine to acid.

But those "typical" symptoms can be inapplicable for many of the center's 
charges because most babies there were exposed to several drugs, as well as 
alcohol and cigarettes, officials said.

A baby exposed to both opiates and methamphetamine could have the cat-cries 
and tremors of a heroin baby and refuse to eat like a cocaine baby, or he 
could eat normally like a heroin baby, but not experience the tremors.

"No one can tell you what the baby will look like until he's here," Ellis 
said. "Quite often, we don't know what all the baby was exposed to."

When a baby is admitted to the center, a caseworker takes the infant's file 
to monitor how the mother interacts with the baby -- if she interacts at 
all. Last year, more babies went into foster care than went home with their 
mothers.

Drennen opened the Pediatric Interim Care Center in the early 1990s, but 
the framework on which it would be modeled started decades before in her 
own home and the home of a friend.

Drennen and Barbara Richards were foster parents for 30 years, the last 10 
of which they both began noticing weird behavior patterns and issues in the 
children they were taking.

Cocaine was becoming a big drug at the time, but the women didn't yet know 
the children they were seeing were exposed to the drug before they were born.

Both women called around to local hospitals, but they didn't find much help 
there. Hospital staffs were just as stumped, so Drennen and Richards began 
treating the children's symptoms empirically.

In the late 1980s, doctors approached Drennen to enhance what she was 
already doing in her home to care for babies born exposed to or addicted to 
drugs.

Last year, the center provided care for 151 babies. In the 12 years since 
the center opened its doors, 1,368 infants have lied in the cribs, swaddled 
in blankets, withdrawing from drugs. Fifty-one babies withdrew -- mostly 
opiates -- in the first three months of this year.

In four months, the center saved taxpayers about $2 million, according to 
center statistics. It costs about $150 a day to let the babies withdraw 
from drugs at the care center, compared to between $2,700 and $3,700 a day 
to stay in the hospital.

The center uses more than 100 volunteers who do everything from cuddle and 
swaddle the babies to clean and make sure supplies are stocked. Everything 
in the center, the cribs and blankets and tables and chairs, was donated.

Still, the center is cringing against the threat of serious state budget 
cuts from the Legislature this year. Center spokeswoman Pam Huffman said 
lawmakers could end up doing one of three things: Cut funding for the 
center entirely, put the center under the auspices of the Department of 
Social and Health Services, or fund it as a line item in the budget.

Center officials have planned for $1.11 million in revenue from public 
sources and private donations and grants. They plan to spend $1.06 million 
on continuing the program, paying salaries (social workers, nurses, nurses 
aides and office workers) and raising money. As 14 babies slowly recover 
within the comforting walls of the center, the staff is collectively 
holding its breath. "We won't know until June," Huffman said.
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MAP posted-by: Keith Brilhart