Problems of Drug Babies Studied at UCI : Medicine: The agonies of the “very needy” infants whose mothers had taken illegal drugs attracted the attention of two assistant professors of pediatrics.

Cheryl Milford, a psychologist at UCI Medical Center, insists that she did not want to be known “as the lady who works with drug babies.”

Neither did pediatrician Lynn Hunt, whose main job at the university hospital is running the normal newborn nursery.

But slightly more than a year ago, both women found themselves drawn to the plight of some of the medical center’s babies.

Some were born prematurely--their mothers’ labor triggered months early when they took methamphetamines or cocaine. These underweight infants had trouble sleeping and swallowing and, Milford said, their tiny limbs would twitch.

Others showed signs of withdrawal from heroin or other opiates--constant high-pitched crying, fast breathing, faster heart rates. And they squirmed constantly, acting “so wiggly in their cribs,” Hunt said, “that they would skin their chins, skin their knees.”

The sight of these “very needy babies” worried Milford and Hunt, both assistant professors of pediatrics. Both had been reading medical literature on a growing national problem--babies born to women who took illegal drugs in pregnancy. But now, Milford said, UCI’s nursery had them, too.

Estimates of these so-called “drug babies” vary widely, with reports of from 13,000 to 375,000 such children born throughout the country last year. In Orange County, hospital officials estimate that at least 1,248 drug-exposed children were born here last year, with nearly a third of these at UCI.

“We really started counting them in the fall of 1988,” said Mary Harris, who chairs a county committee for high-risk children. “In the 10 years I’ve been here, we have always had a small but steady stream of heroin babies. But this was a real change in the special needs”--drug-exposed babies who were more critically ill than the heroin babies.

Concerned about these children, Milford and Hunt, in March, 1989, began following their progress in a special section of UCI’s pediatric clinic called the HOPE Clinic. (HOPE is an acronym for High Risk Outcome of Perinatal Exposure.)

And not only did they track the babies’ health and development, but they also offered mothers and foster parents classes in caring for these often-difficult children.

In 14 months, the clinic has blossomed from a small operation that evaluated several babies a month to one that handles 60 children a month, from birth to 2 years of age.

Considered the only comprehensive program for “drug babies” in Orange County, it received its first grant recently when county supervisors approved $265,060 in federal funds to cover costs from March through September. Until now, it had been quietly underwritten by UCI’s College of Medicine--including $80,380 for the first three months of 1990.

Milford and Hunt say they are seeking other grants, including one from the National Institute of Health, so they can follow as many as 500 children up to the age of 5. But new grants or not, they promise to run the clinic long past September.

County officials also want the clinic to continue. Len Foster, the county Health Care Agency’s division manager for Adult and Child Health Services, called the grant “a beginning.” Right now, Foster said, this still-growing clinic is only “scratching the surface of the needs.”

Around the country, medical researchers are just beginning to study drug-exposed babies. Although six clinics, including ones at UC San Diego and UCLA, work with drug-exposed children, so far researchers have not studied these children after age 2, Milford said.

“Are all these kids going to be learning disabled? We don’t know,” she said. “In good numbers, the cocaine babies have not hit schools.”

Often a foster parent calls the clinic with concerns about a child’s behavior. “They ask: ‘Is this the drugs? Is this normal development?’ ” Milford said. “Prospective adoptive parents want a guarantee that this child isn’t going to be an ax murderer.”

Milford and Hunt say their clinic will accept a child born at any Orange County hospital if medical records document an exposure to illegal drugs before birth.

Their clinic also requires that a child weigh more than 3 1/2 pounds at birth and not have major medical complications. Most of the children are wards of juvenile court, being cared for by foster parents, but lately, Milford said, more are coming with biological mothers--”courageous women” who have kicked their drug habit and gotten their children back.

Of the clinic’s 60 patients, 50% have tested positive for cocaine at birth, 20% for amphetamines and 30% for opiates, Hunt estimated. In addition, many of these infants’ mothers smoked cigarettes and drank alcohol throughout their pregnancy.

For all that, Hunt said, “we are finding these kids are not retarded.” Tiny babies may be irritable and have frequent tremors the first few months, but often they improve, she said.

Some of the newborns who test positive for illegal drugs at birth look fine--like “cute, adorable, little babies,” Milford said. And some of the toddlers seem like “the most charming, wonderful child you should ever see.”

But Milford cautions mothers and foster parents that they “shouldn’t believe the child will always be like that.”

Even the most normal-looking of these children may have “subtle vulnerabilities,” Hunt said. “The fact that they don’t have the shakes doesn’t mean they won’t be intellectually delayed.”

For example, as Milford and Hunt study babies 18 and 24 months old, they have discovered that some of their toddlers are hyperactive and do not play appropriately.

A normal toddler might take a doll and try to feed it--”play with things in a meaningful way,” Hunt said.

But “substance-exposed children don’t make those connections. They might use the doll as a battering ram and wipe all the toys off the table.”

The more they learn, Hunt and Milford said, the more they are convinced that babies exposed before birth to illegal drugs are “high-risk” children. They hope to continue monitoring them--to learn what damage their mothers’ drug abuse did or did not do--at least until kindergarten.