Crack comes to nursery

More and more cocaine using mothers are bearing afflicted infants. Numerous reports that appeared in 1980s showed that cocaine use by pregnant women could cause serious physical and mental impairment to their newborns. It was another warning that the snowy white drug was not as harmless as some believed. Since then the situation has only changed for the worse. Despite wide-spread publicity many pregnant women underestimate the extent of the problem. There are women who would not smoke and would not drink but they can’t stay away from cocaine.

Cocaine is a powerful stimulant drug that has become increasingly popular and available in the United States. Smoking cocaine results in short periods of intense euphoric feelings, during which energy and self-esteem are enhanced and anxiety is decreased. However, within hours of use cocaine rebound effects result in anxiety, exhaustion and depressive feelings. The dependent person has to take cocaine repeatedly to avoid these “crash” rebound effects. Because of cocaine’s low molecular weight and its water and lipid solubility it readily crosses the placenta and the fetal blood brain barrier.

The growing number of women are using crack, the cheap purified form of cocaine that plagues American’s inner cities and has spread into middle class suburbs. More than 100.000 babies born in the US annually are believed to have been exposed to cocaine or other drugs during the critical period of fetal development. Doctors found that cocaine like heroin and alcohol could be passed from the user-mother to the fetus with disastrous results.

As doctors see more and more crack-damaged infants – many of them premature – a clear picture of the effects of the drug is emerging. It is not a pretty one. Because a mother’s crack binge triggers spasms in the baby’s blood vessels the vital flow of oxygen and nutrients can be severely restricted for long periods. Fetal growth including head and brain size may be impaired, strokes and seizures may occur and malformations of the kidneys, genitals, intestines and spinal cord may develop. If cocaine dose is large enough, the blood supply can be cut so sharply that the placenta may tear loose from uterus, putting mother in danger and killing the fetus. In this way even one “fit” of crack can irreparably damage the fetus. At birth the babies display obvious signs of crack exposure – tremors, irritability and lethargy that may belie the seriousness of the harm done. These symptoms may disappear in a week or more but the underlying damage remains.

Cocaine-exposed neonates have been found to have lower birth weight, smaller head circumference, inferior visual and auditory orienting skills, poorer motor abilities, decreased consolability and more abnormal reflexes.

Because there is no specific treatment for cocaine babies doctors must work with mothers. Parenting programs are teaching women how to handle the baby’s long bouts of inconsolable crying and unresponsiveness. But such programs are usually designed for motivated women with some financial resources.

Note: an inner city –

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