occasion.

Sadly, this infant -- born prematurely and drastically underweight -- was already addicted to heroin so his birth was only the start of a long, painful struggle of withdrawal and perhaps recovery.

Daniel is one of Bermuda's most innocent victims of drug and alcohol abuse.

Many other children never have a chance of being born due to pregnancy complications related to their mother's substance abuse.

Consultant paediatrician and head of nurseries at King Edward VII Memorial Hospital, Dr. Stephen West, has lost count of how many drug-addicted babies he has treated in Bermuda's hospitals.

He recalled up to five have been born here in a single month -- a significant figure considering the average number of babies delivered per month hovers around 65.

"Are we catching all the mums using drugs during pregnancy? I don't think so,'' he said.

"This is probably just the tip of the iceberg because unless the mother tells her doctor about her drug or alcohol abuse, in Bermuda we are constrained in identifying these babies.'' In the US, doctors have the power to screen babies without the consent of a mother who is suspected of drug abuse, so effective treatment can begin.

But Dr. West said that in Bermuda the legal rights of the mother prevented such urine tests being carried out on the infant without her consent.

He said it was vital that mothers who dabbled with drugs should be made aware of how their actions could permanently maim or retard their babies.

Her drug or alcohol use put her at higher risk of suffering from a stillbirth, a miscarriage, a premature birth or having a baby with brain-damage or limb defects.

Children born to drug-addicted mothers also had eight times more chance of dying from Sudden Infant Death Syndrome, he said.

"A baby whose mother was addicted to heroin also has to go through the painful process of withdrawal, which can take months,'' he said.

"During that time symptoms include incessant crying, profuse vomiting and intractable diarrhoea.

"Unfortunately alcohol can cause many of the same problems including those withdrawal symptoms, birth defects and mental retardation.'' He said the most important thing was that pregnant woman worried about their use of drugs or alcohol inform their doctor so treatment can be started for both mother and child as early as possible to lessen permanent damage.

But it is not only such dire actions as using heroin or cocaine while pregnant that could cause serious harm to an unborn child.

Drinking can cause birth defects Medical experts now warn that even drinking a small amount of alcohol during pregnancy can be enough to cause birth defects and mental retardation.

"Sometimes a pregnant woman will have just a few alcoholic drinks a week and her baby will suffer diminished mental capability or not be developed properly'', the programme manager at Bermuda's hospital-based Substance Abuse Unit, Joanne Dill, explained.

"That is permanent damage. But then another woman may drink a much greater amount during her pregnancy and her baby will be fine.

"The point is that doctors haven't determined a safe level of alcohol consumption so it is important for a pregnant woman to avoid it all together.

Also it seems different women are affected in different ways.'' Mrs. Dill said often defects in infants were not obvious at birth, particularly with babies whose mothers had used cocaine.

"The birth will go OK so the mother might think she has got off scot-free but the child will often end up having behavioural problems like hyperactivity,' she said.

Graphic file name: WESTMUG Dr. Stephen West -- Seen too many addicted babies.

JOANNE DILL -- Alcohol has varying effects on pregnant mothers and their babies.

TENDER CARE -- King Edward VII Memorial Hospital's neonatal unit coordinator Mrs. Gaynell Hayward displays the equipment which can mean the difference between life and death for newborn babies already addicted to drugs or alcohol because of their mother's substance abuse during pregnancy.

DRUGS DGS