Cruel Inheritance : Drug babies are becoming more common in O.C.’s home for abused children. But veiled symptoms and stereotypes may prevent detection of most addicted infants, who face a legacy of fragile health.

Baby Boy One sleeps fitfully in the shelter crib, born a slave to speed. That was a few weeks ago, and the newborn’s body continues to be racked by withdrawal. He wails inconsolably, trembles from his black curly hair to his booties, but all anyone can do is hold him.

Still he cries himself to utter exhaustion in the darkened nursery of Orangewood, the county’s home for abused and abandoned children. Here in a wing expanded last year to accommodate drug babies, lights are lowered and noise muffled because the newborn addicts are so sensitive. A special cradle rocks in wavelike motion and sounds like a mother’s womb.

“Most babies normally look at you to make eye contact, but drug babies can’t look you in the eye,” said Sandy Buckley, senior counselor of Orangewood’s nursery. “They might look at you a split second, then they have to look away, because it’s too much stimulation.”

These are drug-exposed children who have been intercepted. The vast majority go unnoticed. And that is what worries many health care and child specialists.

In Orange County last year, 281 babies--an average of 23 a month--were reported to child welfare authorities for substance exposure in the womb, and experts believe the vast majority go undetected.

“I estimate that number is no more than 20% of the substance-exposed children who exist,” said Mary Harris, a manager of the county’s Social Services Agency program that works with substance-abusing families, developmentally delayed and medically fragile children. “But overall there really hasn’t been an increase in the numbers . . . so I think there has been some progress in the population understanding the dangers of using alcohol and drugs while pregnant.”

The California Department of Alcohol and Drug Programs estimates that between 72,000 and 85,000 of the 570,366 live births in California involved prenatal drug and alcohol exposure in 1989, and the department estimates that 810,400 women of childbearing age used illicit drugs.

“Thousands of children are at risk for developmental, behavioral and learning difficulties,” according to a June, 1992, report on perinatal substance abuse by the state Child Development Programs Advisory Committee that studied the problem.

When Orangewood was built in 1985, its nursery was outfitted for 14 babies. It was unusual, then-director Bill Steiner said, to be presented with substance-exposed babies.

“But certainly,” said Steiner, who until recently ran Orangewood’s private fund-raising foundation, “over the last eight years it’s built into a major problem, and sometimes 40% of the babies in the nursery” got high in their mother’s womb.

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Despite a commonly held stereotype that drug babies are mostly born in poor or inner cities, national research shows that the problem cuts evenly through all race and class lines.

“South Orange County is no less susceptible to this happening than a downtown barrio in Santa Ana,” said Dr. Timothy Healey, a Santa Ana pediatric physical therapist and child development specialist who has been following the progress of about 370 substance-exposed children throughout Orange County.

Healey sees anywhere from five to 15 kids each week who have been exposed to drugs in the womb, and he just completed a 40-minute video guide for care givers--nurses, social workers and biological parents--of substance-exposed babies that is being used in neonatal centers throughout the country.

Detection can be tricky, especially in such places as Orange County, where cocaine is far and away the drug most abused by pregnant women, Harris said. Whereas heroin addiction often leaves a physical trail of needle tracks, cocaine use is less obvious.

“With cocaine,” Healey said, “it can be a longtime user and abuser, but it can also be an attorney. It can be anybody essentially, and so we don’t test a lot of the babies, and I definitely feel it’s underreported. And I think cocaine more so than any other drug in Orange County.”

This is why specialists in the field caution doctors not to overlook possible drug-use symptoms in the mother who comes from a well-off background and bucks the drug mom stereotype. Only a doctor can authorize a drug test for a newborn, and it needs to be drawn very soon after birth.

A mother’s acknowledgment of substance abuse during pregnancy, of course, would prompt a drug test. But there are other risk factors to look out for, specialists say, ranging from signs of unstable living conditions to a lack of prenatal care that could be viewed as avoiding drug detection.

The problem is that many health care workers have only limited exposure--a few days at most--with the mothers. Some doctors say this is why it is far better to err on the side of being overly suspicious.

At St. Joseph Hospital in Orange, where more than 5,200 babies were born last year, about one mother a month is tested, said clinical social worker Kerri Mosinski.

“It’s part of the stereotype,” said Mosinski. “If you seem to be a put-together family and you haven’t done anything strange, it probably wouldn’t be that difficult to get through the system without being tested.”

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Healey’s forte is calming the inconsolable kid. He’s magic with a baby. And it’s how he came to begin studying drug-exposed babies as he saw patterns emerging at his private practice in the 1980s.

“I think the big onset was seven years ago, because that’s when crack really began to be prevalent,” he said.

His office is visited each week by weary mothers whose children are severely irritable and cry constantly--among the most common symptoms of prenatal drug exposure.

“So I started looking at all the complications, through school age,” Healey said, “and in Orange County, it’s unfortunately a big problem.”

Healey says the numbers of reported drug-exposed infants are misleading, because it is sometimes very difficult to detect cocaine symptoms, which tend to vary from jittering and severe eating disorders to severe neurological complications.

“Then there are some children where we don’t see those symptoms until about six weeks of age,” Healey said, “and oftentimes the child is already at home. So you run into a different set of circumstances.”

Without the ability to test the child, diagnosis comes solely from the symptoms. Healey said some women eventually disclose that they snorted a line here or there in their pregnancy, although others flat-out deny it, and a few spin fantastic tales of how something was slipped into their burger at a wild barbecue.

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Foster mother Kathy Harvey has cared for numerous drug babies, and nobody had to tell her that they were exposed to something dangerous before birth.

“There are children that will never walk, I’ve had children that will never be potty trained,” she said sadly.

Harvey is currently caring for a baby girl, the youngest of five children born on heroin to the same mother. It is a harrowing way to start life.

“She was born addicted to heroin. She’s been through tremors, she’s been through her withdrawals, probably the stiffness of her legs is a result of the heroin, even the asthma maybe. She was a month old when we got her.”

Now 6 months old, “she’s showing some asthma symptoms, her muscle tone is a little tight, she’s a very poor suck-swallower, takes her an hour to finish a four-ounce bottle,” Harvey said with a heavy sigh. “But I think she’s going to be OK. Socially she’s real alert and responsive. But she’s not rolling over yet, not holding herself up as high on her tummy. But I think that will come.”

The baby’s siblings were all taken from their addict mother. The oldest is 15. Relatives have two children, one has been adopted and two are in foster care.

“Most of the (biological) mothers have loved their children the best they could,” she said, “but it was just that they were addicted to drugs and it was stronger than them.”

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Long-term effects of drug exposure, Healey said, may not fully surface until the child begins playing with other children or reaches preschool age and learning disabilities emerge.

Some researchers, however, believe that only a small fraction of babies exposed to cocaine in the womb develop medical problems later (although those that do may have devastating and outrageously expensive conditions).

Dr. Ira J. Chasnoff, president of the Chicago-based National Assn. for Perinatal Addiction Research and Education, has done research indicating “other factors including the environment that can have as big an impact after the fact as the prenatal effect,” NAPARE spokeswoman Nancy Lodl said. Healey disagrees and believes that such research does not follow a prenatally exposed child’s progress long enough. He believes that such students need to be observed at least into the second and third grade, “where abstract learning becomes more critical, where we’re asking more of a child’s nervous system.”

More noticeable by school age may be attention deficit disorders, an inability to sort out information, and an increase in hearing troubles in which they perceive sounds incorrectly and language is affected. Healey said drug-exposed children have more difficulty moving from activity to activity in the classroom and may react “horribly” to having to put one assignment aside for another.

Most important, he says, are the greater number of prenatally drug-exposed children who later suffer sensory overload, in which they cannot filter incoming messages, the light, the child next to him tapping his foot, or an activity in the front of the classroom. Something as simple as seasonal classroom decorations “may entirely overload this child’s system,” Healey said.

“And the importance of that is that until we get a good understanding of how all this is affecting the child, we continue to treat it behaviorally, so they get labeled in a sense as disruptive or bad children when, in fact, our approach is to understand the physiology and block out the stimulus.” Even more lasting, he fears, are the esteem problems that arise from casting such children as problems instead of acknowledging they are victims and need different care. They may grow up to become substance abusers themselves, perpetuating a cycle that deserves breaking.

“We need to remember that (substance abuse) is an illness, not a sin,” Healey adds, “and with children who were innocent victims, they had no choice.”

Facts on Drug Babies

Nationally there are an estimated 554,400 to 739,200 infants each year prenatally exposed to illicit drugs, which does not include alcohol.

More than 20% of infants admitted to intensive care units in California are drug-exposed; delivery and neonatal hospital costs for infants born substance-exposed average about $36,000 per child.

Care for the first five years of a substance-affected baby’s life is $63,000 per patient.

If Orange County takes custody of a drug-exposed baby, it costs from $8,000 to $12,000 a year to keep the child in a foster home, not including costs of government agency and court personnel.

In what could be termed prevention costs, Orange County pays $500,000 a year to the operators of Heritage House, the county’s only residential treatment program for mothers and children. That’s a daily fee of about $54 per person for rehab of 24 women and children.

Sources: National Assn. of Perinatal Addiction Research and Education, American Family Physicians, California Journal

Drug Baby Symptoms

Common symptoms in infants with cocaine exposure. * Severe irritability. * Difficulty feeding. * Excessive crying. * Poor sleep/wake cycles. * Chafing of skin on the knees and elbows from flailing. * Vulnerability. If held in a position that makes them feel unprotected, they may arch their backs, their hands flying up in a defensive posture as though they are trying to ward off a blow. * Sensitivity. Bright light and moderate noise, certain textures such as grass or stuffed animal fur, prove far too stimulating. Source: St. Josephs Hospital video “Caregivers Guide to Drug-Exposed Infants.”