How Do We Get Good Parents For The Babies Of The `90s?

March 20, 1989|By Joan Beck.

Marissa is almost 2 years old. She can`t roll over or sit up yet in her hospital crib. Her mother is dying of AIDS on another floor of the hospital and is rarely well enough to visit the forlorn little girl, who also has AIDS. Marissa has been improving a little since she started getting the drug AZT. She`s almost well enough to go home; but there is no home.

From 10,000 to 20,000 children will be infected with the AIDS virus, HIV, by 1991, according to the Centers for Disease Control. Most will have been infected during pregnancy or at birth by mothers who acquired the infection from sharing drug needles or having sex with partners carrying HIV.

AIDS babies, like Marissa, are stacking up in urban hospitals. Even when they are well enough to go home-at least for a while-there is often no one at home to care for them. Foster homes are hard to find-in part because some foster families are afraid of infection but also because it hurts to love and care for a child who will almost certainly die.

Identical twins, Lynn and Chrystal, were born premature, addicted to heroin and an unidentified street drug. They cried inconsolably, had violent convulsions and frantic tremors, and were difficult to feed and hold. But after about nine months of intensive, tasking care, they were able to go home with their mother, who had been getting therapy, support and help in learning how to care for them.

A few months later, the mother returned the children, sick and cold, to the therapeutic center where they had lived most of their lives. They may eventually move into a foster home.

About 11 percent of babies born in the United States inherit drug problems from a drug-abusing mother. No one yet knows how many of them will have permanent damage. Many of them have mothers who cannot care for them because of drug and other problems and fathers who are unidentified, drug-addicted or absent.

Add to this aching toll an estimated one million more children who are seriously abused or neglected by their parents and who need the help of social resources, if not a foster home.

So great is this problem it may be necessary to turn to therapeutic institutional care for youngsters because enough foster homes cannot be found, says Dr. Sally Provence, in Zero to Three, the Bulletin of the National Center for Clinical Infant Programs (source of the cases described above). Provence`s 1960s research on the harmful effects of institutionalizing babies and young children played a big role in replacing group homes with foster parents.

But good institutional care, even for infants, may be better than a series of short-term foster placements or prolonged hospitalization, especially now that caregivers know more about the specifics of good child development, Provence says.

This is not a plea for more foster parents (although they are urgently needed). Nor is it a plug for Provence`s sad and reluctant conclusion. It is a reminder that no matter how great our resources and how hard we try, social workers and doctors and nurses and government and society and money and earnest effort cannot make up completely to small children what they lack when they do not have healthy, loving, good parents.

There`s an echo of the same message in the Public Health Service statistics released last week, noting that between 1970 and 1986, births to unmarried women more than doubled. Sixteen percent of the white babies born in 1986 had no legal father, nor did 61 percent of the black infants.

Family supports, feminist rhetoric, welfare checks, nutrition programs, subsidized housing, Medicaid and day care can all help. But none can come close to substituting for what a good father does for a child.

The message repeats, in another variation, in the much-reported differences between children of the urban underclass who may start school not knowing their own last name and suburban 5-year-olds who can read and do easy computer programming. No matter how good the inner-city school, it can`t make the educational playing field level for these children.

How do we get good, healthy, on-the-job parents for the babies of the 1990s? How do we persuade teenagers to grow up themselves and build a stable marriage before they have babies they cannot parent well? How do we keep young people from risking AIDS and substance addiction so their children won`t be born damaged or dying? How can we get them to put forth the effort to help their children learn during the critical years before they start school?

The answers must go beyond the familiar statistics and facile excuses of poverty, racism and prejudice. (They were all worse in 1960, when single-parent families were fewer and drug-damaged babies rare.) They must include more than ``a national policy on children`` or more day care or more government programs and spending. They must get at the heart and soul of who we are and what kind of people we are willing to make of ourselves for the good of our children. That`s why it`s so hard.