Five-year-old Dani works on a wooden puzzle in the pediatric clinic that is part of the Center for Addiction and Pregnancy (CAP). Her mother, Krystele Kemp, 32, encourages her to keep trying, and the pieces finally fit together.
Kemp is putting the pieces of her own life together with help from this clinic at Johns Hopkins Bayview Medical Center. She was homeless, pregnant and using drugs when she found a lifeline in CAP, one of the first programs in the nation to co-locate and often integrate prenatal care, substance abuse treatment, psychiatric care and a pediatric clinic that treats children until they are 21.
Kemp took methadone and reverted once to heroin use when pregnant. After Dani was born, the infant stayed in the hospital for two weeks for treatment of neonatal abstinence syndrome—problems associated with opiate exposure before birth.
Until she was 3, Dani visited the pediatric clinic about every two months as she struggled with breathing issues. The little girl still has asthma but appears healthy, energetic and curious.
During her visit, she gives nurse Susan Berg a hug and calls her “Miss Sue.” She borrows a stethoscope from pediatrician Lauren Jansson, who founded the clinic in 1991, and listens to her own heart.
“If I’m unsure about something, I can call Miss Sue, and she’ll talk me through it,” says Kemp. “If Dani has a bad cold, I can call. It helps so much.”
The effects of prenatal drug exposure are not fully known. But Jansson says children born to parents who took drugs while pregnant have more than their fair share of medical, developmental and behavioral problems—conditions that make parenting even more challenging for mothers contending with their own difficult circumstances.
The clinic helps by treating mothers as well as their children, says Jansson. For example, clinicians help mothers find treatment for substance use or psychiatric issues if necessary. “We give up on nobody,” says Jansson. “Even if they tell us to give up on them, we don’t.”
Kemp says she always feels welcome at the clinic. “They’re always genuinely interested in what’s going on with me as a person,” she says. “There’s never an ounce of judgment. That’s the main reason I keep Dani here. They have a true passion for what they’re doing. Not just for the children, but for the adults too.”