Dear Folks:
        To add to the discussion of substance use, abuse, and parenting:  a local
pediatrician, Hallum Hurt, did a study looking at the aftermath of cocaine use
in pregnancy. (I know she presented the findings locally, but don't know if
they were published. Kay Hoover would probably know.) She found that poverty
and an impoverished life made neurobehavioral problems in those children, not
that they had been exposed prenatally to cocaine.
        On a similar note, there is the study (Dreher, Nugent and Hudgins  Pediatrics
1994; 93: 254-260) where the researchers were looking at the neurobehavioral
effects of prenatal marijuana exposure on neonates in Jamaica. The better
developmental scores (autonomic stability, quality of alertness, and self-
regulation) were in the infants exposed to marijuana! The suggestion was that
the cultural positioning, social and economic characteristics of the mothers
using marijuana  promoted neonatal development.
         In the United Kingdom, mothers and care providers are told that pregnant
women may ingest less than 10 units of alcohol per week, as long as the units
are not ingested all in the same day but rather spread out over a number of
days.  A unit is clearly defined:  half pint of ordinary beer, 1/4 pint of
strong beer or lager, 1 small glass of wine, 1 single measure of spirits, 1
small glass of sherry. This information is published in a leaflet from the
MIDIRS and the NHS Centre for Reviews and Dissemination series called Informed
Choice. The recommendation is based on "the best available research evidence"
(from the pamphlet for professionals) and the citations are given.
        To say this in the USA in a childbirth class would be, putting it mildly,
politically incorrect!
        This is such a complex subject, and one so vulnerable to opinion and
judgement.
        Warmly, Nikki Lee RN, MSN, Mother of 2, IBCLC, ICCE, CST