THE tiniest victims
BABIES, TOO, SUFFER FROM THE HEROIN/OPIOID EPIDEMIC THAT IS HURTING THEIR PARENTS
ST. LOUIS — The tiny babies typically arrive at Jill Bundschuh’s foster home in Rock Hill, Mo., around dinner time. Social workers bring them on short notice, with maybe some formula and a few diapers. There are no extra onesies. No swaddling blankets. No car seats. The paperwork is usually sparse beyond a name and maybe a few clues about the baby’s first few days or weeks of life. Bundschuh knows from experience to quickly read the hospital notes before the caseworker leaves with the file.
Even when there is no medical history, this relatively new foster parent knows what to expect in the long night ahead.
The baby will constantly fidget. There can be sudden tremors in the arms and legs. The buttocks might bleed from open sores caused by runny diarrhea. The sucking reflex is off, so feeding can frustrate the baby.
Lullabies and cuddling rarely soothe the child who arches his or her back and cries in a high pitch. So Bundschuh will find a quiet spot away from the bedrooms where her husband and three boys are sleeping. She will rock the baby in her arms with his or her body vertical. Being cradled agitates the baby.
Mostly she will pace with the baby through the dark house because, in her experience, babies withdrawing from heroin, methadone, morphine or other opioids may be consoled by movement.
Bundschuh has cared for four babies in opioid withdrawal since she and her husband became licensed foster parents in Missouri two years ago. The most recent arrival came in late January — a newborn preemie. The previous baby was agitated for six months, a fairly typical course for full withdrawal.
“There would be two to three hours every night where he just screamed; he was very hard to calm,” she said.
Bundschuh made no special request to care for these cases when she signed on to be a foster parent.
Nonetheless, she has wound up on the front lines of Missouri’s opioid epidemic, which is sending children at an alarming rate to a state foster care system that is straining to serve them.
It’s not just newborns — though the system is seeing far more of them. It’s also older siblings who need care after Children’s Division investigators find severe neglect in a household disrupted by opioid addiction and the often unsafe parental behaviors that go with it.
“We are in desperate need of more foster parents for the first time in a decade and a half,” said Melanie Scheetz, executive director of the Foster and Adoptive Care Coalition of St. Louis. “We need them for both newborns and older children.”
Scheetz said foster parents need to be trained about dealing with trauma in these children:
“We had a case where two kids were found in Fairground Park behind a bridge because their mother was turning tricks for drugs. It’s just devastating for these families.”
Bundschuh received no special training on how to care for babies in drug withdrawal after being exposed to opioids in the womb or given morphine in the hospital to taper the symptoms of their withdrawal. She’s learned on her own.
Along with the risk of burnout and frustration with an inconsolable baby, there is constant worry. She knows, for example, that babies in withdrawal are at a higher risk for seizures or sudden infant death syndrome, or SIDS. If something happens, she could be legally liable.
“The first week is very exhausting because I’m constantly checking their breathing,” she said. “I didn’t go through that with my own.”
The numbers climb
Last year, more than 650 people died from opioid overdoses in the St. Louis region, more than four times the number in 2007. Recently, the Post-Dispatch chronicled the toll those fatalities are taking on the region’s families and communities.
But the epidemic is also measured in the delivery rooms of Missouri hospitals, which have seen more than a fivefold increase in the number of infants born with symptoms of opioid withdrawal in the past 10 years, according to the Missouri Hospital Association. St. Louis stood out with one of the highest rates in the state, surpassed by just two counties in rural south-central Missouri.
The number of children going into foster care in Missouri began to climb in 2012, following years of a general decline. Last year, 7,505 children entered foster care. That is a leap from 6,432 in 2013.
In the past five years, St. Louis County saw a
29 percent jump in the number of children entering foster care, peaking at 521 children last year. In St. Louis city, entries increased by more than a third. Jefferson County saw a 20 percent increase; St. Charles County, 14 percent.
The state lacks data to directly tie the spike in foster care to opioids.
But data from the St. Louis Family Court show the link.
Of the 46 children who have entered foster care in the city this year, 17 — or 39 percent — were due to drugs, either involving drug exposure to newborns, or issues of abuse or neglect because of substance abuse by parents.