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Pediatrician for baby exposed to drugs in utero

Berkeley Parents Network > Reviews > Health & Medical > Pediatricians > Pediatrician for baby exposed to drugs in utero


March 2005

Hello, I am adopting a child through the county and he was exposed to Methamphetamines. He was in Foster Care the first year of his life and had a terrific FosterMom who did everything over and beyond the call of duty for our son. He is thriving and progressing well. Definitely developmentally where he should be talks fluidly and has been since he came to us he is now 3 years old. I would love to find a Pediatrician who has a wealth of knowledge about Drug Exposed children for him. Someone who takes HealthNet HMO and part of Alta Bates. I will travel to get the BEST CARE for my son. I live in El Cerrito. I also have a Biological Daughter so she would be going to this Doctor as well.
Desperately Seeking An Awesome Doctor


Dr. Petra Landman with the Pediatric Medical Group is wonderful. I do not know if she has any specific knowledge of drug exposed babies but I find her approachable, caring and willing to research whatever she needs to give your children the BEST CARE. Good luck.

Other advice:

I too have recently adopted a wonderful baby boy through Alameda County who was exposed to drugs (same, meth) in utero. He is doing very well and shows no signs of any delays. I understand your concerns and am interested in hearing the responses of others, but I have to say I am distressed with your choice of words ''Drug Baby...''. I know that's a quick and easy description of what you are looking for, but I would like to suggest another way to describe his history. He was exposed to drugs in utero. He is not a drug baby - he never used drugs. To me this is the same as using words like ''real mother'' ''given up for adoption'' instead of birth mother and forever mother and an adoption plan. Yes, they are only words, but words are powerful. another concerned mother


This is a very new area in medicine for docs. Substance abuse issues are given short shrift in medical school and residencies. I have friends who are pediatricians who are not at all interested in drug issues which they think are ''adult problems'' even though often first use of a drug/tobacco start in pre- teens or teens.

That said, there are newly forming groups of clinicians ( lawyers, social workers, docs etc) in different regions of the state who are responsible for coordinating care for kids that are believed to have been exposed to amphetamines in their family of origin and who have become wards of the state. How to reach them? I would call the Haight Ashbury Free Clinic at 415-565-1904, ask for Richard Seymour and ask him for the name and phone contact for the lady lawyer from San Diego who they invited to speak last year at their 37th Anniversary Conference. She was great and is right at the heart of getting these groups off the ground in different regions of the state. Ask her what's going on in the Bay Area and what local pediatricians have identified themselves as interested in following exposed kids.

If that fails, you could always contact the Calif. Soc. of Addiction Medicine 415-243-3322 and ask them if they have ANY pediatrician members. If they have one in LA ( for example) call him or her and ask if they know any pediatricians in the Bay Area with this interest.

As you can see, word of mouth will be important in finding a referral.

Good luck Dr. Jean Marsters


Just want to add this info FYI, which is intended to be reassuring, not simply provocative:

I was diagnosed AD/HD in 1997 and when I unexpectedly got pregnant in 1998 I was taking a very high dose (120 mg. time released) of amphetamines (dexedrine). I made the decision in consultation with my doctors and a geneticist at Kaiser to continue the meds throughout the pregnancy and through two years of breastfeeding--and had a very easy pregnancy and super-healthy 8+ lb baby who is now a bright, well-adjusted, HEALTHY kid, despite the fact that I was 37 and very overweight prenatally. Because I wanted my decision to be useful--given the total dearth of information about ''risk'' to the baby of such meds available at the time--I signed up to be studied by the UCSD teratogen data bank which the geneticist referred me to. They sent an MD researcher up when my daughter was born in 1999 who gave her a thorough exam at 1 week and pronounced her perfect (at which point he was informed that the exposure for which he'd been testing was amphetamines and he was deeply surprised--underlining the reason for blind studies, to guard against researcher bias). They're sending another researcher in a few weeks to do extensive IQ and aptitude testing now that my daughter is nearly 6 (once again, the testers will not know about the amphetamine exposure until they have completed their evaluation).

Our first pediatrician at Kaiser, a young resident, was (in accord with conventional wisdom) VERY concerned about the drug exposure and it was clear she was examining my infant for signs of developmental compromises. She grilled me at each visit about my choice to medicate while breastfeeding, although she couldn't offer any evidence for her sense that my daughter had been or would be harmed; the Doc's fears apparently included sleeping too little, sleeping too much, inadequate weight gain, motor problems, etc. (of course I too was alert for problems, but I knew from my psychopharmacologist that the incredibly short half-life for amphetamines meant they would be out of my brain and breastmilk very rapidly should I become concerned about the baby's health and development). Of the pediatrician's concerns, perhaps my baby's sleep (a lot, and deeply, thank heaven!, which continues to this day) was the ''fault'' of the medication; at any rate, it was the only observable ''side effect''. Gee, if it could be proven that babies sleep BETTER when their moms do speed...

At about 4 months, my daughter was seen by our pediatrician's supervisor when the assigned doc was running late, and he gave the baby's development an unreservedly enthusiastic A-plus. He'd left the room before I realized he hadn't grilled me about the dexedrine, and I chased him down to ask why (simple: he hadn't read the chart, and didn't expect to see something that wasn't there!). I was gratified that he acknowledged--like his UCSD counterpart--that he would have been biased had he known he was examining a ''drug baby.''

I feel compelled to mention along the same lines that one OB/GYN at Kaiser--I normally saw a nurse-practitioner--was strongly opposed to my remaining on medication while pregnant, and was utterly convinced that I was at risk for pre-eclampsia since she ''knew'' stimulants raise blood pressure. Her stern disapproval/judgementalism and lack of diplomacy had me in tears and indeed may have contributed to BP readings AT THE HOSPITAL in excess of my typical 110/60 BP. At her behest I was placed on a ''preterm birth prevention program'' which entailed home monitoring of my blood pressure twice a day for the final two months of pregnancy and a daily phone call from a nursing team to record my readings. I still have those logs (which are hell to keep for an ADD person, even on medication!) and fondly recall the hilarity with which the nurses from the monitoring service began to treat our daily encounters once they realized my BP was persistently healthy.

Two observations for those of you who are adoptive parents of meth-exposed babies: first, it makes sense that it would be hard to isolate the drug's effects on fetal and postnatal development from either the contaminants found in street drugs or the other environmental, nutrition and other health issues facing meth ''abusers'' (especially IV users), so unless there have been unpublicized studies in the past few years there is no hard evidence (indeed, no scientifically significant proof at all!) of meth exposure's risks. Since it turns out the initial scare stories about cocaine-exposed babies 15 years ago turned out to be wildly overblown, we should not take at face value the ''intuitive'' concerns of parents or doctors about the effects of drug exposure.

Second, I offer this (unsubstantiated) hypothesis: many meth users are (unfortunately and unconsciously) self-medicating undiagnosed ADD-spectrum brains, so since ADD has a genetic component one might expect to see ADD traits in babies born to these moms REGARDLESS of maternal drug use. I remember reading several years ago that there were studies showing a higher incidence of diagnosed ADD among adoptees than among non-adoptees--which might be accounted for by high rates of ADD, diagnosed or not, among the birth mothers AND FATHERS whose parental rights are terminated or relinquished following unplanned pregnancies (impulsivity and risk taking being particular challenges for those of us who are wired that way). I suggest that a good pediatrician for your possibly at-risk kids would be one who is willing to sort out her assumptions from her actual observations about your kid's health/development/behavior. A pediatrician's convenient location and a well-run office (and a personal style that is comfortable for YOU to deal with) perhaps should outweigh ''experience'' with ''drug babies'' so long as she is capable of researching suspected drug-linked behavior IF IT IS ACTUALLY OBSERVED.

Jenny


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this page was last updated: Mar 22, 2005


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