by Sherry Baker

he baby was not only dangerously premature, weighing only a little more than a pound, but she was born to a woman addicted to street methadone and high on crack cocaine. At the time she delivered her child, the woman was also drunk. And she soon walked out of the hospital, disappearing back into her shadowy world of drugs and alcohol and life on the streets -- leaving her newborn deposited in the crowded neonatal unit at Grady Hospital.

The question doctors and social workers asked was obvious: If the baby survives, where will she go? Unfortunately, there was no workable answer.

"Youngsters in this situation are known as 'boarder' babies," says Donna Carson, MSW, an instructor in Emory's Department of Pediatrics. "Although medically ready to be released from the hospital, they have no place to go. Their parents may be on the streets, on drugs, or lost. Or a baby may have more care needs than their relatives are willing or able to provide and there is no available foster home."

Carson is director of Project Prevent, a federal-grant funded program that offers help to pregnant substance abusers to get them involved with prenatal care, drug treatment, and other services that lessen the likelihood of poor outcome of pregnancy. For more than 23 years, she has worked with sick infants and their families. Through her work at Grady in particular, she's seen firsthand the extent of the boarder baby problem. "More than 250 babies have boarded in the hospital over the past 11 years at a cost of more than $7 million dollars," Carson says. "There has to be a better solution."

The human cost is also staggering. She points out that many kids are sent home to dangerous environments because there is no other alternative: "Over and over, after one or two months, the child is dead, or has a skull fracture. What is the point in saving these kids only to send them to that fate?" The alternative, Carson insists, is to provide a safe, nurturing environment.

"I was deluged with thousands of phone calls," Carson recalls. "Some got involved with a mentoring program, while others helped in the long process of renovation. Over the course of several months, volunteers transformed a rented, Victorian-era house in midtown Atlanta into a home for babies, with help from Carson and fellow faculty member Sue Glover, program manager for Project Prevent. In June of 1999, "My House" received a state license as a temporary emergency shelter for medically fragile infants, the only such facility in Georgia.

One of the first babies to arrive at My House was a term infant who had severe withdrawal complications from the numerous drugs that her mother was on during pregnancy. Carson recalls how the infant screamed, her doll-sized hands squeezed into tight fists. The second day she was at My House, she stopped screaming -- she, in fact, stopped breathing. "I performed CPR and resuscitated her. She came around and was able to recover but took months to get completely through her ordeal," Carson says.

The toddler not only has healed physically but has blossomed into a healthy, bright, happy youngster who has been adopted into a loving home. Another little girl, also born addicted to drugs, left her temporary home at My House for a new life with adoptive parents who raise Tennessee walking horses in north Georgia; her adoptive mom is a Head Start teacher.

"These kids will be loved and nurtured and will have a second chance at life," Carson says. "Their future is a hopeful one."

If parents can make changes that enable them to take care of their children, they may be able to be reunited with the infants. However, if that hasn't happened after a year, the state is now mandated by federal law to make permanent plans for these toddlers so they do not linger in legal limbo with no real home and no real hope of finding adoptive parents.

"What has happened until two years ago, when the federal laws changed, is that these kids could be trapped forever in foster care. Now, by the time they are a year old, a decision has to be made. Either their family has gotten their act together or - if they haven't - the child can be adopted," says Carson. "People who want to adopt get disillusioned that there are no children available or that the wait is too long. The change in laws should make many of these children eligible for adoption at an age when there are families still willing to adopt them."

Carson, who recently completed studies to become certified as a trainer for foster and adoptive parents, is working to have My House licensed by the state as a child care agency able to make placements to adoptive and foster homes. "Then we can move kids into good homes faster, and that will free us up to take care of more babies here."

My House receives a minimum of five referrals a week from Atlanta-area hospitals that have babies with no place to go. "We accept babies based on our ability to meet their individual needs and on available space. We can care for 11 now," Carson says. "But we hope eventually to move to a larger facility so we can help more."

My House and Project Prevent also receive visits from pediatrics residents in Emory's training program, who lend a hand and learn valuable lessons in return. "They get to see real-life situations, what happens in the street," says Carson. "We take them with us on home visits, to jails. When they come here to My House, they get to see that the work done in the hospital to save these kids hasn't all been for nothing, that kids like these really do have a good chance to be OK. It helps keep them from becoming discouraged or cynical. It also helps them know the importance of getting involved in advocacy for children."

"We give the same daily care that would be provided in a home, along with the special care these kids need. They didn't have good beginnings, and most are on medication, at least when they first arrive," Carson notes. "Many are initially on heart monitors because they were premature -- we've had four that weighed slightly over a pound at birth. And some have been so physically abused, they've had special medical situations -- like one little boy who had a shunt in his head due to a skull fracture."

An Emory physical therapist visits My House weekly to evaluate the youngsters and compile developmental guidelines to help volunteers and staff. "These are based on their birth problems and their current status," Carson explains. "For example, one might have a stiff right leg, and another might not be tracking with his left eye." The development and health care of many of the My House children, until they are 4 years old, is monitored by the Developmental Continuity Clinic in Emory's Department of Pediatrics. Other children are seen by pediatricians Jane Wilkov, Deborah Pollack, and Lauren Healy, all Emory alums in private practice with DeKalb Pediatrics.

My House is supported totally by donations raised by Carson, Glover, and several volunteers. A variety of businesses, church groups, school groups, and individuals have come forward to help in this new venture. Carson says community support has been overwhelming -- including an annual fundraising Mother's Day Baby Ball and silent auction sponsored by Maggiano's Little Italy Restaurant in Buckhead. However, she adds, much remains to be done for the children. "Buying gloves, diapers, food, and all of the things you need for 11 children at a time adds up. We need a van to transport children to medical appointments and outings. And our dream is to have a permanent, rather than rented home for My House." Carson notes that My House also welcomes involvement by other pediatricians and experts in child development.

In addition, she hopes more people will consider becoming court-appointed special advocate (CASA) volunteers to work with the juvenile court system as advocates of children's rights in individual cases. A case in point: Although the laughing, handsome 1-year-old playing with a stuffed dog looks like a perfectly normal little boy, he looked nothing like that when he first arrived at My House. When he was only 2 months old, his arms, legs, ribs, and skull were fractured. His swollen head was so painful, Carson recalls, that he screamed continuously. Despite fears he would be permanently brain damaged, the boy has thrived in this nurturing, safe environment. This, says Carson, is the kind of situation where CASA volunteers can help ensure that children don't slip through the court system, that their rights are protected, and that they have a chance for a future of health and hope instead of abuse and neglect.

"We accept babies based on our ability to
meet their needs and on available space.
We can care for 11 now. But we hope to
eventually move to a larger facility,"
says Donna Carson.

Carson, who was awarded the 1999 Children's Champion Award by UNICEF and The Carter Center for her work with the intensive care nursery at Grady, Project Prevent, and My House, has been called a "one-woman revolution." She refuses to put limits on the possibilities for children who have been deemed hopeless or permanently damaged due to their medical and/or social histories. She believes , with help, most can have a bright future.

"I hope this environment can become an arena for research in infant development," Carson says. "These kids, even the ones born to drug addicts, babies that weighed a pound, are proving to be very bright, alert, and loving when they are given a second chance at a new beginning."

For more information on My House, contact Donna Carson at 404-876-4367, or visit the My House website at www.myhouseweb.org.

Sherry Baker is an Atlanta freelance writer.