PEDIATRICIAN TREATS TINIEST TRAGEDIES

The Babies Hurt Worst by the Meth Their Moms Took Begin Life 'Basically in
Shell Shock,' Rizwan Shah Says.

Many of Iowa's smallest meth addicts are brought to Blank Children's
Hospital in Des Moines, where they meet with a sweet-talking woman whose
smile belies the countless tragedies she's seen.

Pediatrician Rizwan Shah is a nationally recognized expert on treating
children whose mothers took drugs while pregnant.

On this day, she calmly watches as a nurse runs two of her patients,
7-month-old Lukas and his brother, 3-year-old Jacob, through a series of
tests and examinations. Shah is watching for trouble with their mental and
physical development.

The boys' parents sit nearby, hoping the family's luck will continue to
hold. The mother, a central Iowa woman named Renee, smoked meth throughout
her first pregnancy and for the first six months of her second. She often
smoked in front of Jacob as he grew into toddlerhood. That was before she
went into treatment last year, before she was arrested on drug charges,
before state child-welfare workers stepped in with urine tests to make sure
she kept her promise to change.

The young mother can't explain why she kept smoking crank while pregnant.
Like so many women, she worried about what would happen, but couldn't stop.
"I wasn't thinking straight - I was just so messed up," she says.

Shah says that so far, the boys appear to be doing relatively well.

Lukas, the baby, hasn't begun to babble, which the doctor finds a bit
worrisome. "Grunting sounds are not considered words," she says. "But "bah"
and "dah" are."

The speech issue could be nothing, she says. "He's an awfully nice and calm
kid - tremendous."

Jacob, the older boy, has good coordination and vocabulary. He has trouble
getting to sleep and can be prone to tantrums. How much of that is being a
3-year-old, and how much stems from the meth that flowed through his
system? It's too early to tell, but Shah is optimistic. For one thing, he's
never shown the excruciating sensitivity to touch often seen in meth
babies. "I was looking at a kid yesterday, and you could not touch his feet
without him kicking and screaming," she says.

The worst-off babies suffer strokes before birth and wind up with permanent
brain damage. Many spend their first few weeks of life sleeping up to 23
hours a day. "They're basically in shell shock," Shah says. Later, they
become jittery and have a hard time staying asleep. Some will have learning
disabilities, which can be eased if identified early.

Many children also face significant danger posed by meth use in their
homes. They're exposed to fumes from people making or smoking the drug, and
they're often neglected. Some of the most dramatic cases make headlines: A
Des Moines baby drowns in a bathtub while her drug-using father sleeps in
the hall; a California 3-month-old dies after drinking meth-laced breast
milk from his mother. But most of the other cases are behind the scenes.

Deb Rohlfs, a Webster City counselor who deals with some of the families
Shah treats, sees children trying to grow up the best they can. She recalls
an addict's 5-year-old who went to stay with his grandmother. All he knew
how to eat was breakfast cereal, because he could pour it into a bowl by
himself.

"Every meth addict will tell you, "I always took care of the kids, even
when I was using," " Rohlfs says. "But you can't. You come down off meth,
and you sleep for two days."

Authorities are moving more aggressively to take children out of harm's
way. About 70 percent of the meth babies Shah treats are placed in foster
care. Half of those wind up being permanently separated from their parents.

Others, like Lukas and Jacob, have parents who stick with treatment and
sobriety because they can't bear to lose their kids.

Renee fears people think families like hers are hopeless, but she says they
can be redeemed if they seek and accept help.

"So far, we've been really blessed," she says. "We must have an angel up
there."