In the first 60 seconds of life, Dr. Rizwan Shah said, a newborn has to learn six new functions with perfection including breathing, keeping a heartbeat, regulating sleep and learning how to eat.

"Every newborn is so well-organized, said Shah, medical director of the Regional Child Protection Center at Blank Children's Hospital in Des Moines, Iowa. "If it is a meth-exposed baby, those skills are going to be compromised. There will be a delay in achieving these functions."

She said nurses can look to see if a baby sleeps all day, does not respond to touch or is unable to suck and swallow as signs of being exposed to methamphetamine while in the womb.

"If you are looking for missing toes, missing fingers, you will not see it," she said. "These babies will sleep for 23 hours out of 24, maybe."

A nurse in Shah's clinic said she once drew blood from a baby's heel, and the baby did not even move.

Early identification and intervention of mothers who deliver infants with prenatal exposure to meth are keys to successful treatment of both, said Shah, who spoke Wednesday at the fourth annual Wyoming Statewide Methamphetamine Awareness Conference.

Mike Phillips, spokesman for the Wyoming Medical Center, said in 2005 the hospital tested 43 babies for prenatal meth exposure, with seven coming back positive. From January through September of 2006, the hospital tested 28 babies, with one being positive for meth exposure.

If a baby tests positive, the hospital alerts the Department of Family Services.

He said the current hospital policy states the hospital tests a baby if doctors and nurses are suspicious of drug use. However, the hospital has to get the consent of the mother first.

He also said the hospital is in the process of trying to amend its policy to include drug-testing women before they deliver if they meets certain criteria and risk factors. The hospital is waiting to hear opinions from obstetricians who use the hospital.

Shah said she does not know the long-term effects of prenatal meth exposure on an infant because she has not done research on older children. However, the immediate effects can include low birth rates, a delay in development and other complications.

About 10 babies Shah has seen in her clinic have suffered strokes because of prenatal meth exposure and she said this occurs only when there is heavy meth use during labor.

She said the issue is important because of the sheer number of communities meth affects. Meth is one of the most widely used illegal drugs in the country and it affects rural areas, Shah said.

Shah said 40 percent of the time, women using meth do not seek any prenatal care at all.

For example, the mother of a boy she has seen in the clinic did not know she was pregnant until she saw blood in the bathtub because she was delivering the baby.

She said a lack of prenatal care can be a red flag to test that baby for meth and other drugs.

"That's how you make those policies," she said.

Several representatives and senators have drafted a bill that will come before the Wyoming Legislature this year that would make prenatal exposure to meth part of criminal child endangerment.

Some legislators tried to pass a similar bill early in 2006, but it was defeated.

Reach Allison Rupp at (307) 266-0534 or at allison.rupp@casperstartribune.net.