THE BABY in the blue jumper is crying in his crib.
A pacifier is stuck uncomfortably under his head, and there is no mother to lift him up and move it out of the way. A nurse working with the eight "boarder babies" finally hears the cry of this one 3-month-old among the many cries in the room and comes over to pluck the pacifier away so the baby can sleep.
This is the second-floor Boarder Babies unit at D.C. General Hospital. Most of its tiny wards are children of crack addicts who have abandoned them at birth. At this holiday time, the room is filled with stuffed animals and small toys. Twice a week a therapist comes to work with the children. The toys and the therapist's time have been donated by Washingtonians overwhelmed at the horror of these lonely little lives.
But the true horror coming to life at D.C. General may not be the obvious abuse and abandonment of crack babies but the desperate, empty lives later forced on them when their mothers or grandmothers take them out of the hospital.
"We are coming to see that it is not being born to a crack mother that dictates a poor outcome for a child," said Michal Young, a neonatologist at D.C. General. "What damages these children is the situation they go home to where they are not cared for, where they are ignored, where they are left alone and don't get love. That is what cripples these children."
The good news is that doctors at D.C. General now think crack babies are not permanently damaged by the drug abuse they sustain while in the mother's womb. Aside from some delays in development, doctors believe most of the problems are temporary. The bad news, the doctors say, is that crack babies can suffer permanent damage from bad homes.
"One of the children came back with the mother last month," said Regina Milteer, a pediatrician at D.C. General. "And we could see the speech delay, social delays. But it wasn't because of the crack. This child had little human interaction. With these babies, we are finding they are not being talked to, stimulated, because mom is too busy taking care of her business, drugs and whatever. She is not into mothering.
"The 3-year-old I saw, his mother was on crack when he was born and she is still on crack. That child does not talk, does not make eye contact, is not potty-trained. The only reason I saw him was he had pneumonia and they brought him here. He had to stay here for a week. In that week alone, he started to change. He would repeat sounds I made. He began to smile . . . . Then the woman took him back to that crack house."
Deborah Anzelone, director of the infant development program at D.C. General, finds crack babies generally to be nervous children. Some are slow to use language, and others show delays in developing fine motor skills, such as picking up small toys. "Home is the major impact on these children and in most cases their homes seem to be adding problems" for them, she said.
Anzelone took home a crack baby -- whom she is in the process of adopting -- and found the child improving in all areas in just two months.
"This child is showing very nice attachments, showing himself to be very bright, and is very interested in our 5-year-old-daughter," said Anzelone. "What we still see after two months is behavioral evidence of the mother's drug use -- the nervousness, the excitability. We do a lot of soothing activities, not a lot of roughhousing you might do with a boy baby. We do swinging and rocking."
The unsettling idea that a public hospital may be a happier and more nuturing place for a crack baby than the mother's home is disturbing enough, but it appears to shed light on similar problems affecting a growing number of simply poor children in Washington and across the nation.
"We are losing two generations of children," said Ann Chisholm, who heads the public affairs office of D.C. General. "The pediatricians are seeing more and more malnourished children, and that means mothers are not using available resources, food stamps, to even feed the children properly. And then we see the kids with drug problems and the ones who come in with gunshot wounds from the violence out on the street."
In 1986, a nationwide survey of Americans under 18 found that of all the problems facing the country, crime and violence was their greatest concern: 37 percent worried about it often and 43 percent sometimes. By 1989, those numbers had changed to 49 percent and 38 percent.
Part of the worry may have to do with increasing poverty among young people, even before the inevitable effects of the current economic downturn. Almost one in five American children under age 18 lives in poverty; for those under age 6, the rate is one in four. In the last 10 years, the number of white children in poverty has grown by 25 percent, so that now roughly 15 percent are poor. (The rates for Hispanic and black children are 36 and 44 percent, respectively.) Among children in female-headed families, 55 percent now live in poverty. For black children in female-headed households, the figure is about 67 percent.
"Single mothers are under more stress and in some cases are falling apart because they are at an economic disadvantage in supporting a child," said Harriette P. McAdoo, a professor of social work at Howard University. "The heavy load on the mothers comes down on the child. We see it in the violence among children, the problems in schools, the drugs, the drive-by shootings."
The most heart-wrenching story of the past year may have come from Elizabeth, N.J., where a divorced 24-year-old mother couldn't find day care for her 5-year-old daughter while she worked a second job as a department store sales clerk. The mother drove to the shopping mall and left the girl in her car, clad in pajamas and comforted by a stuffed animal, a flashlight and a doughnut. Adding to the stress that many of today's children face is what psychologists call the "mean world syndrome." From watching the repeated showings of murders on TV news as well as facing bullying and threats on the streets, they come to believe that brutality and crime are a constant threat to them.
"They live and breathe this poverty every day in ways that were not imaginable in our homes just 10 or 20 years ago," said Margie Wilbur, executive director of the Crimestoppers Club, which has 800 D.C. children as members. "It's the drugs, the moms on drugs, the moms who are so young they don't know how to raise kids, the dads who have deserted them. It is violence in the schools, on television. The fear of getting beat up over some sneakers. They live under circumstances we don't want to see. I shudder when I see what these children go through to live."
Juan Williams writes frequently for Outlook on politics and social issues.