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According to the New York Post and People.com, Nicole “Snooki” Pollizzi, is, despite her protestations, pregnant with her first child.

 “The Jersey Shore star is roughly three months pregnant, and the baby’s father is her boyfriend, Jionni LaValle, according to the paper, which also notes that as recently as Feb. 2, the diminutive reality star went on ABC’s Good Morning America and shot down stories about her being in a family way.”

 But Snooki isn’t an outlier in her baby mama drama. Pollizi, who recently began filming a reality spin-off of the Jersey Shore with costar and friend Jenni Farley in my hometown of Jersey City, NJ, is experiencing what millions of single American women will go through this year: the weighty iron wrench that a bambino throws into even the best-laid plans for life, career, relationships, you name it.

 According to recent reporting in the NYTimes, the fastest-growing group of new moms are young, single women. “More than half of births to American women under 30 occur outside marriage,” Sabrina Tavernise writes, “It used to be called illegitimacy. Now it is the new normal.”

 Only in Snooki’s case, we get to watch it play out in the tabloids. And in terms of her career, it’s a much bigger, heavier and potentially more destructive wrench. See, the 4’9” star has built her name upon her Jersey Shore antics—skipping work, flashing her panties, getting arrested—most often with the lubrication of liquor. She’s lined her pockets with endorsement deals for energy drinks and diet pills—definite no-no’s for a mommy-to-be.

 It would be easy to say that Snooki’s troubles—should this baby turn out to be true—are worlds away from those of your run-of-the-mill (read: non reality star) pregnant 24-year-old. But the truth is that her issues are just heightened versions of the same. Will she be able to provide for her child? Likely, although it depends on whether she’s hired a real-deal wealth manager or if she’s squandering her $100K an episode on leopard print and spray tans. Will her career plans survive this unexpected baby-bump in the road? If she can convince producers that her labor should be televised, then maybe. And in the end, will Snooki be a good mother?

 While the premise of the new series, rumored to be titled “Snooki and JWoww v. The World,” is still unknown, it’s easy to imagine producers thought it would follow suit: on the pair’s first weekend in Jersey City they celebrated Jenni “JWoww” Farley’s 26th birthday at O’Connell’s Bar by renting out a full floor for partying. For her part, Polizzi’s told the press that it won’t be all vodka and club-hopping this season. “We want it to be different than ‘Jersey Shore,’ so it’s not always going to the club, drinking and partying,” she told US Weekly. “It’s the first time I’m going to be on my own for real. You’ve only seen the party side of us.”

 On her own, or drinking for two? Reps for both Polizzi and 495 Productions, which produces the show in addition to Jersey Shore, did not respond to phonecalls, but given the delayed production schedule, it’s worth speculating that it was Snooki’s big news that slowed things down, not the conflicts over locations that were fed to the press. Were production assistant scrambling for set pieces to hide the bump as it grows over the six weeks of filming?

 According to the unnamed sources in Wednesday’s Post, Snooki is one step ahead of everyone, plotting to parlay the wrench of an unexpected pregnancy into (yet another) media moment: she’s allegedly brokered a deal to announce her pregnancy on the cover of US Weekly. We’ll just have to wait and see if 495 Productions and their cameras are in on the fun.

 What do you think? If Snooki told 495 bigwig Sally Ann Salsano that she was in a family way, did Salsano see red—or only dollar signs? ||||| IS THERE A TEST FOR FETAL ALCOHOL SYNDROME AT THREE MONTHS IN UTERO? Sources tell the New York Post that perpetual party girl is preggers but keeping the news under wraps so she can sell it to a tabloid. Check out What To Expect When Snooki's Expecting: The Fallout On Jersey Shore

 Jersey Shore's breakout star -- and by that we don't mean herpes -- is currently filming her spinoff series with Jenni "JWoww" Farley in Jersey City.

 Star reported several weeks ago that Snookums was pregnant, but the diminutive star with the loud persona denied those claims on GMA on Feb. 2.

 Snooki's obviously ambivalent boyfriend, Jionni LaValle, is speculated to be the father. Snooki has been practically whining during the last few months that she wants to be married, telling Ryan Seacrest in January that LaValle is "the one" and "Oh my god, I can’t wait to have guido babies.”

 God help that devil spawn.

  ||||| "FASD" redirects here. For other uses, see FASD (disambiguation)

 Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person whose mother drank alcohol during pregnancy.[1] Problems may include an abnormal appearance, short height, low body weight, small head size, poor coordination, low intelligence, behavior problems, and problems with hearing or seeing.[1][2] Those affected are more likely to have trouble in school, legal problems, participate in high-risk behaviors, and have trouble with alcohol or other drugs.[7] The most severe form of the condition is known as fetal alcohol syndrome (FAS).[1] Other types include partial fetal alcohol syndrome (pFAS), alcohol-related neurodevelopmental disorder (ARND) and alcohol-related birth defects (ARBD).[1][8] Some accept only FAS as a diagnosis, seeing the evidence as inconclusive with respect to other types.[9]

 Fetal alcohol spectrum disorders are caused by drinking alcohol during pregnancy.[1] Surveys from the United States have found about 10% of pregnant women have drunk alcohol in the last month, and 20% to 30% drank at some point during the pregnancy.[10] About 4.7% of North American women who are pregnant are alcoholics.[11] The risk of problems depends on the amount consumed and the frequency of consumption as well as when during pregnancy the alcohol is consumed.[10] Other risk factors include an older mother, smoking, and poor diet.[12][10] There is no known safe amount or safe time to drink during pregnancy.[1][13] While drinking small amounts of alcohol does not cause abnormalities in the face, it may cause behavioral issues.[11] Alcohol crosses the blood brain barrier and both directly and indirectly affects a developing baby.[14] Diagnosis is based on signs and symptoms in the person.[1]

 Fetal alcohol spectrum disorders are preventable by avoiding alcohol.[4] For this reason, medical authorities recommend no alcohol during pregnancy or while trying to become pregnant.[15][16][17] While the condition is permanent, treatment can improve outcomes.[1][3] Interventions may include parent-child interaction therapy, efforts to modify child behavior, and possibly medications.[5]

 FASD is estimated to affect between 2% and 5% of people in the United States and Western Europe.[6] FAS is believed to occur in between 0.2 and 9 per 1000 live births in the United States.[6] In South Africa, some populations have rates as high as 9%.[8] The negative effects of alcohol during pregnancy have been described since ancient times.[8] The lifetime cost per child with FAS was $2,000,000 in 2002 in the US.[6] The term fetal alcohol syndrome was first used in 1973.[8]

 Types [ edit ]

 FASDs encompass a range of physical and neurodevelopmental problems that can result from prenatal alcohol exposure.[1] The most severe condition is called fetal alcohol syndrome (FAS),[1] which refers to individuals who have a specific set of birth defects and neurodevelopmental disorders characteristic of the diagnosis.[18]

 Some accept only FAS as a diagnosis, seeing the evidence as inconclusive with respect to other types.[9] Partial fetal alcohol syndrome (pFAS) refers to individuals with a known, or highly suspected, history of prenatal alcohol exposure who have alcohol-related physical and neurodevelopmental deficits that do not meet the full criteria for FAS.[18] The subtypes of pFAS are alcohol-related neurodevelopmental disorder (ARND) and alcohol-related birth defects (ARBD).[18] In addition to FAS, pFAS, ARND, and ARBD, any other conditions believed to be related to prenatal alcohol exposure, such as spontaneous abortion and sudden infant death syndrome (SIDS), are also considered to be on the spectrum of related disorders.[18] It is unclear as of 2017 if identifying a FASD-related conditions benefits the individual.[9]

 Signs and symptoms [ edit ]

 Facial characteristics of a child with FAS

 The key of FASD can vary between individuals exposed to alcohol during pregnancy. While consensus exists for the definition and diagnosis of FAS, minor variations among the systems lead to differences in definitions and diagnostic cut-off criteria for other diagnoses across the FASD continuum. The central nervous system damage criteria particularly lack clear consensus. A working knowledge of the key features is helpful in understanding FASD diagnoses and conditions, and each is reviewed with attention to similarities and differences across the four diagnostic systems. More than 400 problems, however, can occur with FASD.[19]

 Growth [ edit ]

 In terms of FASD, growth deficiency is defined as significantly below average height, weight or both due to prenatal alcohol exposure, and can be assessed at any point in the lifespan. Growth measurements must be adjusted for parental height, gestational age (for a premature infant), and other postnatal insults (e.g., poor nutrition), although birth height and weight are the preferred measurements.[20] Deficiencies are documented when height or weight falls at or below the 10th percentile of standardized growth charts appropriate to the population.[21]

 Criteria for FASD are least specific in the IOM diagnostic system ("low birth weight..., decelerating weight not due to nutrition..., [or] disproportional low weight to height" p. 4 of executive summary),[16] while the CDC and Canadian guidelines use the 10th percentile as a cut-off to determine growth deficiency.[2][22] The "4-Digit Diagnostic Code" allows for mid-range gradations in growth deficiency (between the 3rd and 10th percentiles) and severe growth deficiency at or below the 3rd percentile.[20] Growth deficiency (at severe, moderate, or mild levels) contributes to diagnoses of FAS and pFAS, but not ARND or static encephalopathy.

 Growth deficiency is ranked as follows by the "4-Digit Diagnostic Code":[20]

 Severe: Height and weight at or below the 3rd percentile.

 Moderate: Either height or weight at or below the 3rd percentile, but not both.

 Mild: Either height or weight or both between the 3rd and 10th percentiles.

 None: Height and weight both above the 10th percentile.

 In the initial studies that discovered FAS, growth deficiency was a requirement for inclusion in the studies; thus, all the original people with FAS had growth deficiency as an artifact of sampling characteristics used to establish criteria for the syndrome.[citation needed] That is, growth deficiency is a key feature of FASD because growth deficiency was a criterion for inclusion in the study that defined FAS. This suggests growth deficiency may be less critical for understanding the disabilities of FASD than the neurobehavioral sequelae to the brain damage.[16]

 Facial features [ edit ]

 Several characteristic craniofacial abnormalities are often visible in individuals with FAS.[23] The presence of FAS facial features indicates brain damage, although brain damage may also exist in their absence. FAS facial features (and most other visible, but non-diagnostic, deformities) are believed to be caused mainly during the 10th and 20th week of gestation.[24]

 Refinements in diagnostic criteria since 1975 have yielded three distinctive and diagnostically significant facial features known to result from prenatal alcohol exposure and distinguishes FAS from other disorders with partially overlapping characteristics.[25][26] The three FAS facial features are:

 A smooth philtrum: The divot or groove between the nose and upper lip flattens with increased prenatal alcohol exposure.

 Thin vermilion: The upper lip thins with increased prenatal alcohol exposure.

 Small palpebral fissures: Eye width decreases with increased prenatal alcohol exposure.

 Measurement of FAS facial features uses criteria developed by the University of Washington. The lip and philtrum are measured by a trained physician with the Lip-Philtrum Guide,[27] a five-point Likert Scale with representative photographs of lip and philtrum combinations ranging from normal (ranked 1) to severe (ranked 5). Palpebral fissure length (PFL) is measured in millimeters with either calipers or a clear ruler and then compared to a PFL growth chart, also developed by the University of Washington.[28]

 Ranking FAS facial features is complicated because the three separate facial features can be affected independently by prenatal alcohol. A summary of the criteria follows:[20][29]

 Severe: All three facial features ranked independently as severe (lip ranked at 4 or 5, philtrum ranked at 4 or 5, and PFL two or more standard deviations below average).

 Moderate: Two facial features ranked as severe and one feature ranked as moderate (lip or philtrum ranked at 3, or PFL between one and two standard deviations below average).

 philtrum ranked at 3, PFL between one and two standard deviations below average). Mild: A mild ranking of FAS facial features covers a broad range of facial feature combinations: Two facial features ranked severe and one ranked within normal limits, One facial feature ranked severe and two ranked moderate, or One facial feature ranked severe, one ranked moderate and one ranked within normal limits.

 None: All three facial features ranked within normal limits.

 Central nervous system [ edit ]

 Central nervous system (CNS) damage is the primary key feature of any FASD diagnosis. Prenatal alcohol exposure, which is classified as a teratogen, can damage the brain across a continuum of gross to subtle impairments, depending on the amount, timing, and frequency of the exposure as well as genetic predispositions of the fetus and mother.[16][30] While functional abnormalities are the behavioral and cognitive expressions of the FASD disability, CNS damage can be assessed in three areas: structural, neurological, and functional impairments.

 All four diagnostic systems allow for assessment of CNS damage in these areas, but criteria vary. The IOM system requires structural or neurological impairment for a diagnosis of FAS, but also allows a "complex pattern" of functional anomalies for diagnosing PFAS and ARND.[16] The "4-Digit Diagnostic Code" and CDC guidelines allow for a positive CNS finding in any of the three areas for any FASD diagnosis, but functional anomalies must measure at two standard deviations or worse in three or more functional domains for a diagnosis of FAS, PFAS, and ARND.[20][22] The "4-Digit Diagnostic Code" also allows for an FASD diagnosis when only two functional domains are measured at two standard deviations or worse.[20] The "4-Digit Diagnostic Code" further elaborates the degree of CNS damage according to four ranks:

 Definite: Structural impairments or neurological impairments for FAS or static encephalopathy.

 Probable: Significant dysfunction of two standard deviations or worse in three or more functional domains.

 Possible: Mild to moderate dysfunction of two standard deviations or worse in one or two functional domains or by judgment of the clinical evaluation team that CNS damage cannot be dismissed.

 by judgment of the clinical evaluation team that CNS damage cannot be dismissed. Unlikely: No evidence of CNS damage.

 Structural [ edit ]

 Structural abnormalities of the brain are observable, physical damage to the brain or brain structures caused by prenatal alcohol exposure. Structural impairments may include microcephaly (small head size) of two or more standard deviations below the average, or other abnormalities in brain structure (e.g., agenesis of the corpus callosum, cerebellar hypoplasia).[16]

 Microcephaly is determined by comparing head circumference (often called occipitofrontal circumference, or OFC) to appropriate OFC growth charts.[21] Other structural impairments must be observed through medical imaging techniques by a trained physician. Because imaging procedures are expensive and relatively inaccessible to most people, diagnosis of FAS is not frequently made via structural impairments, except for microcephaly.

 Evidence of a CNS structural impairment due to prenatal alcohol exposure will result in a diagnosis of FAS, and neurological and functional impairments are highly likely.[2][16][20][22]

 During the first trimester of pregnancy, alcohol interferes with the migration and organization of brain cells, which can create structural deformities or deficits within the brain.[31] During the third trimester, damage can be caused to the hippocampus, which plays a role in memory, learning, emotion, and encoding visual and auditory information, all of which can create neurological and functional CNS impairments as well.[32]

 As of 2002, there were 25 reports of autopsies on infants known to have FAS. The first was in 1973, on an infant who died shortly after birth.[33] The examination revealed extensive brain damage, including microcephaly, migration anomalies, callosal dysgenesis, and a massive neuroglial, leptomeningeal heterotopia covering the left hemisphere.[34]

 In 1977, Dr. Clarren described a second infant whose mother was a binge drinker. The infant died ten days after birth. The autopsy showed severe hydrocephalus, abnormal neuronal migration, and a small corpus callosum (which connects the two brain hemispheres) and cerebellum.[34] FAS has also been linked to brainstem and cerebellar changes, agenesis of the corpus callosum and anterior commissure, neuronal migration errors, absent olfactory bulbs, meningomyelocele, and porencephaly.[34]

 Neurological [ edit ]

 When structural impairments are not observable or do not exist, neurological impairments are assessed. In the context of FASD, neurological impairments are caused by prenatal alcohol exposure which causes general neurological damage to the central nervous system (CNS), the peripheral nervous system, or the autonomic nervous system. A determination of a neurological problem must be made by a trained physician, and must not be due to a postnatal insult, such as a high fever, concussion, traumatic brain injury, etc.

 All four diagnostic systems show virtual agreement on their criteria for CNS damage at the neurological level, and evidence of a CNS neurological impairment due to prenatal alcohol exposure will result in a diagnosis of FAS or pFAS, and functional impairments are highly likely.[2][16][20][22]

 Neurological problems are expressed as either hard signs, or diagnosable disorders, such as epilepsy or other seizure disorders, or soft signs. Soft signs are broader, nonspecific neurological impairments, or symptoms, such as impaired fine motor skills, neurosensory hearing loss, poor gait, clumsiness, poor eye-hand coordination. Many soft signs have norm-referenced criteria, while others are determined through clinical judgment. "Clinical judgment" is only as good as the clinician, and soft signs should be assessed by either a pediatric neurologist, a pediatric neuropsychologist, or both.

 Functional [ edit ]

 When structural or neurological impairments are not observed, all four diagnostic systems allow CNS damage due to prenatal alcohol exposure to be assessed in terms of functional impairments.[2][16][20][22] Functional impairments are deficits, problems, delays, or abnormalities due to prenatal alcohol exposure (rather than hereditary causes or postnatal insults) in observable and measurable domains related to daily functioning, often referred to as developmental disabilities. There is no consensus on a specific pattern of functional impairments due to prenatal alcohol exposure[16] and only CDC guidelines label developmental delays as such,[22] so criteria (and FASD diagnoses) vary somewhat across diagnostic systems.

 The four diagnostic systems list various CNS domains that can qualify for functional impairment that can determine an FASD diagnosis:

 Related signs [ edit ]

 Other conditions may commonly co-occur with FAS, stemming from prenatal alcohol exposure. However, these conditions are considered alcohol-related birth defects[16] and not diagnostic criteria for FAS.

 Cause [ edit ]

 Fetal alcohol syndrome usually occurs when a pregnant woman has more than four standard drinks per day.[36] Milder symptoms have been found with two drinks per day during the early part of pregnancy.[36][37] Among those who are alcoholic about a third of children have FAS.[36]

 Evidence of harm from less than two drinks per day or 10 drinks per week is not clear.[36][38] While small amounts of alcohol do not cause an abnormal appearance, it may cause behavioral issues.[11] There is conflicting evidence regarding whether drinking by fathers before conception can cause FAS.[36]

 Mechanism [ edit ]

 Despite intense research efforts, the exact mechanism for the development of FAS or FASD is unknown. On the contrary, clinical and animal studies have identified a broad spectrum of pathways through which maternal alcohol can negatively affect the outcome of a pregnancy. Clear conclusions with universal validity are difficult to draw, since different ethnic groups show considerable genetic polymorphism for the hepatic enzymes responsible for ethanol detoxification.[39]

 Genetic examinations have revealed a continuum of long-lasting molecular effects that are not only timing specific but are also dosage specific; with even moderate amounts being able to cause alterations.[40]

 A human fetus appears to be at triple risk from maternal alcohol consumption:[41][42]

 The placenta allows free entry of ethanol and toxic metabolites like acetaldehyde into the fetal compartment. The so-called placental barrier is of almost no barrier with respect to ethanol. The developing fetal nervous system appears particularly sensitive to ethanol toxicity. The latter interferes with proliferation, differentiation, neuronal migration, axonic outgrowth, integration, and fine-tuning of the synaptic network. In short, all major processes in the developing central nervous system appear compromised. Fetal tissues are quite different from adult tissues in function and purpose. For example, the main detoxicating organ in adults is the liver, whereas the fetal liver is incapable of detoxifying ethanol, as the ADH and ALDH enzymes have not yet been brought to expression at this early stage. Up to term, fetal tissues do not have significant capacity for the detoxification of ethanol, and the fetus remains exposed to ethanol in the amniotic fluid for periods far longer than the decay time of ethanol in the maternal circulation. The lack of significant quantities of ADH and ALDH means that fetal tissues have much lower quantities of antioxidant enzymes, like SOD, glutathione transferases, and glutathion peroxidases, resulting in antioxidant protection being much less effective.[ citation needed ]

 Diagnosis [ edit ]

 Because admission of alcohol use during pregnancy can stigmatize birth mothers, many are reluctant to admit drinking or to provide an accurate report of the quantity they drank. This complicates diagnosis and treatment [22] of the syndrome. As a result, diagnosis of the severity of FASD relies on protocols of observation of the child's physiology and behavior rather than maternal self-reporting. Presently, four FASD diagnostic systems that diagnose FAS and other FASD conditions have been developed in North America:

 The Institute of Medicine's guidelines for FAS, the first system to standardize diagnoses of individuals with prenatal alcohol exposure; [16]

 The University of Washington's "The 4-Digit Diagnostic Code", which ranks the four key features of FASD on a Likert scale of one to four and yields 256 descriptive codes that can be categorized into 22 distinct clinical categories, ranging from FAS to no findings; [20]

 The Centers for Disease Control's "Fetal Alcohol Syndrome: Guidelines for Referral and Diagnosis", which established consensus on the diagnosis FAS in the U.S. but deferred addressing other FASD conditions; [22] and

 and Canadian guidelines for FASD diagnoses, which established criteria for diagnosing FASD in Canada and harmonized most differences between the IOM and University of Washington's systems.[2]

 Each diagnostic system requires that a complete FASD evaluation includes an assessment of the four key features of FASD, described below. A positive finding on all four features is required for a diagnosis of FAS. However, prenatal alcohol exposure and central nervous system damage are the critical elements of the spectrum of FASD, and a positive finding in these two features is sufficient for an FASD diagnosis that is not "full-blown FAS".

 While the four diagnostic systems essentially agree on criteria for fetal alcohol syndrome (FAS), there are still differences when full criteria for FAS are not met. This has resulted in differing and evolving nomenclature for other conditions across the spectrum of FASD, which may account for such a wide variety of terminology. Most individuals with deficits resulting from prenatal alcohol exposure do not express all features of FAS and fall into other FASD conditions.[16] The Canadian guidelines recommend the assessment and descriptive approach of the "4-Digit Diagnostic Code" for each key feature of FASD and the terminology of the IOM in diagnostic categories, excepting ARBD.[2]

 Thus, other FASD conditions are partial expressions of FAS. However, these other FASD conditions may create disabilities similar to FAS if the key area of central nervous system damage shows clinical deficits in two or more of ten domains of brain functioning. Essentially, even though growth deficiency and/or FAS facial features may be mild or nonexistent in other FASD conditions, yet clinically significant brain damage of the central nervous system is present. In these other FASD conditions, an individual may be at greater risk for adverse outcomes because brain damage is present without associated visual cues of poor growth or the "FAS face" that might ordinarily trigger an FASD evaluation. Such individuals may be misdiagnosed with primary mental health disorders such as ADHD or oppositional defiance disorder without appreciation that brain damage is the underlying cause of these disorders, which requires a different treatment paradigm than typical mental health disorders. While other FASD conditions may not yet be included as an ICD or DSM-IV-TR diagnosis, they nonetheless pose significant impairment in functional behavior because of underlying brain damage.

 Fetal alcohol syndrome [ edit ]

 The following criteria must be fully met for an FAS diagnosis:[2][16][20][22]

 Growth deficiency: Prenatal or postnatal height or weight (or both) at or below the 10th percentile[21] FAS facial features: All three FAS facial features present[28] Central nervous system damage: Clinically significant structural neurological, or functional impairment Prenatal alcohol exposure: Confirmed or Unknown prenatal alcohol exposure

 Fetal alcohol syndrome (FAS) is the first diagnosable condition of FASD that was discovered. FAS is the only expression of FASD that has garnered consensus among experts to become an official ICD-9 and ICD-10 diagnosis. To make this diagnosis or determine any FASD condition, a multi-disciplinary evaluation is necessary to assess each of the four key features for assessment. Generally, a trained physician will determine growth deficiency and FAS facial features. While a qualified physician may also assess central nervous system structural abnormalities and/or neurological problems, usually central nervous system damage is determined through psychological, speech-language, and occupational therapy assessments to ascertain clinically significant impairments in three or more of the Ten Brain Domains.[43] Prenatal alcohol exposure risk may be assessed by a qualified physician, psychologist, social worker, or chemical health counselor. These professionals work together as a team to assess and interpret data of each key feature for assessment and develop an integrative, multi-disciplinary report to diagnose FAS (or other FASD conditions) in an individual.

 Partial FAS [ edit ]

 Partial FAS (pFAS) was previously known as atypical FAS in the 1997 edition of the "4-Digit Diagnostic Code". People with pFAS have a confirmed history of prenatal alcohol exposure, but may lack growth deficiency or the complete facial stigmata. Central nervous system damage is present at the same level as FAS. These individuals have the same functional disabilities but "look" less like FAS.

 The following criteria must be fully met for a diagnosis of Partial FAS:[2][16][20]

 Growth deficiency: Growth or height may range from normal to deficient[21] FAS facial features: Two or three FAS facial features present[28] Central nervous system damage: Clinically significant structural, neurological, or functional impairment in three or more of the Ten Brain Domains[43] Prenatal alcohol exposure: Confirmed prenatal alcohol exposure

 Fetal alcohol effects [ edit ]

 Fetal alcohol effects (FAE) is a previous term for alcohol-related neurodevelopmental disorder and alcohol-related birth defects.[1] It was initially used in research studies to describe humans and animals in whom teratogenic effects were seen after confirmed prenatal alcohol exposure (or unknown exposure for humans), but without obvious physical anomalies.[44] Smith (1981) described FAE as an "extremely important concept" to highlight the debilitating effects of brain damage, regardless of the growth or facial features.[45] This term has fallen out of favor with clinicians because it was often regarded by the public as a less severe disability than FAS, when in fact its effects can be just as detrimental.[46]

 Alcohol-related neurodevelopmental disorder [ edit ]

 Alcohol-related neurodevelopmental disorder (ARND) was initially suggested by the Institute of Medicine to replace the term FAE and focus on central nervous system damage, rather than growth deficiency or FAS facial features. The Canadian guidelines also use this diagnosis and the same criteria. While the "4-Digit Diagnostic Code" includes these criteria for three of its diagnostic categories, it refers to this condition as static encephalopathy. The behavioral effects of ARND are not necessarily unique to alcohol however, so use of the term must be within the context of confirmed prenatal alcohol exposure.[47] ARND may be gaining acceptance over the terms FAE and ARBD to describe FASD conditions with central nervous system abnormalities or behavioral or cognitive abnormalities or both due to prenatal alcohol exposure without regard to growth deficiency or FAS facial features.[47][48]

 The following criteria must be fully met for a diagnosis of ARND or static encephalopathy:[2][16][20]

 Growth deficiency: Growth or height may range from normal to minimally deficient[21] FAS facial features: Minimal or no FAS facial features present[28] Central nervous system damage: Clinically significant structural, neurological, or functional impairment in three or more of the Ten Brain Domains[43] Prenatal alcohol exposure: Confirmed prenatal alcohol exposure;0

 Alcohol-related birth defects [ edit ]

 Alcohol-related birth defects (ARBD), formerly known as possible fetal alcohol effect (PFAE),[44] was a term proposed as an alternative to FAE and PFAE[49] The IOM presents ARBD as a list of congenital anomalies that are linked to maternal alcohol use but have no key features of FASD.[16] PFAE and ARBD have fallen out of favor because these anomalies are not necessarily specific to maternal alcohol consumption and are not criteria for diagnosis of FASD.[47] The Canadian guidelines recommend that ARBD should not be used as an umbrella term or diagnostic category for FASD.

 Exposure [ edit ]

 Prenatal alcohol exposure is determined by interview of the biological mother or other family members knowledgeable of the mother's alcohol use during the pregnancy (if available), prenatal health records (if available), and review of available birth records, court records (if applicable), chemical dependency treatment records (if applicable), or other reliable sources.

 Exposure level is assessed as confirmed exposure, unknown exposure, and confirmed absence of exposure by the IOM, CDC and Canadian diagnostic systems. The "4-Digit Diagnostic Code" further distinguishes confirmed exposure as High Risk and Some Risk:

 High Risk: Confirmed use of alcohol during pregnancy known to be at high blood alcohol levels (100 mg/dL or greater) delivered at least weekly in early pregnancy.

 Some Risk: Confirmed use of alcohol during pregnancy with use less than High Risk or unknown usage patterns.

 Unknown Risk: Unknown use of alcohol during pregnancy.

 No Risk: Confirmed absence of prenatal alcohol exposure.

 Confirmed exposure [ edit ]

 Amount, frequency, and timing of prenatal alcohol use can dramatically impact the other three key features of FASD. While consensus exists that alcohol is a teratogen, there is no clear consensus as to what level of exposure is toxic.[16] The CDC guidelines are silent on these elements diagnostically. The IOM and Canadian guidelines explore this further, acknowledging the importance of significant alcohol exposure from regular or heavy episodic alcohol consumption in determining, but offer no standard for diagnosis. Canadian guidelines discuss this lack of clarity and parenthetically point out that "heavy alcohol use" is defined by the National Institute on Alcohol Abuse and Alcoholism as five or more drinks per episode on five or more days during a 30-day period.[50]

 "The 4-Digit Diagnostic Code" ranking system distinguishes between levels of prenatal alcohol exposure as high risk and some risk. It operationalizes high risk exposure as a blood alcohol concentration (BAC) greater than 100 mg/dL delivered at least weekly in early pregnancy. This BAC level is typically reached by a 55 kg female drinking six to eight beers in one sitting.[20]

 Unknown exposure [ edit ]

 For many adopted or adults and children in foster care, records or other reliable sources may not be available for review. Reporting alcohol use during pregnancy can also be stigmatizing to birth mothers, especially if alcohol use is ongoing.[22] In these cases, all diagnostic systems use an unknown prenatal alcohol exposure designation. A diagnosis of FAS is still possible with an unknown exposure level if other key features of FASD are present at clinical levels.

 Confirmed absence of exposure [ edit ]

 Confirmed absence of exposure would apply to planned pregnancies in which no alcohol was used or pregnancies of women who do not use alcohol or report no use during the pregnancy. This designation is relatively rare, as most people presenting for an FASD evaluation are at least suspected to have had a prenatal alcohol exposure due to presence of other key features of FASD.[20][22]

 Ten brain domains [ edit ]

 A recent effort to standardize assessment of functional CNS damage has been suggested by an experienced FASD diagnostic team in Minnesota. The proposed framework attempts to harmonize IOM, 4-Digit Diagnostic Code, CDC, and Canadian guidelines for measuring CNS damage vis-à-vis FASD evaluations and diagnosis. The standardized approach is referred to as the Ten Brain Domains and encompasses aspects of all four diagnostic systems' recommendations for assessing CNS damage due to prenatal alcohol exposure. The framework provides clear definitions of brain dysfunction, specifies empirical data needed for accurate diagnosis, and defines intervention considerations that address the complex nature of FASD with the intention to avoid common secondary disabilities.[43]

 The proposed Ten Brain Domains include:[43]

 The Fetal Alcohol Diagnostic Program (FADP) uses unpublished Minnesota state criteria of performance at 1.5 or more standard deviations on standardized testing in three or more of the Ten Brain Domains to determine CNS damage. However, the Ten Brain Domains are easily incorporated into any of the four diagnostic systems' CNS damage criteria, as the framework only proposes the domains, rather than the cut-off criteria for FASD.[51]

 Differential diagnosis [ edit ]

 The CDC reviewed nine syndromes that have overlapping features with FAS; however, none of these syndromes include all three FAS facial features, and none are the result of prenatal alcohol exposure:[22]

 Prevention [ edit ]

 The only certain way to prevent FAS is to avoid drinking alcohol during pregnancy.[47][52] In the United States, the Surgeon General recommended in 1981, and again in 2005, that women abstain from alcohol use while pregnant or while planning a pregnancy, the latter to avoid damage even in the earliest stages (even weeks) of a pregnancy, as the woman may not be aware that she has conceived.[15] In the United States, federal legislation has required that warning labels be placed on all alcoholic beverage containers since 1988 under the Alcoholic Beverage Labeling Act.

 There is some controversy surrounding the "zero-tolerance" approach taken by many countries when it comes to alcohol consumption during pregnancy. The assertion that moderate drinking causes FAS is said to lack strong evidence and, in fact, the practice of equating a responsible level of drinking with potential harm to the fetus may have negative social, legal, and health impacts.[53] In addition, special care should be taken when considering statistics on this disease, as prevalence and causation is often linked with FASD, which is more common and causes less harm, as opposed to FAS.[54]

 Treatment [ edit ]

 There is no cure for FASD, but treatment is possible. Because CNS damage, symptoms, secondary disabilities, and needs vary widely by individual, there is no one treatment type that works for everyone.

 Medication [ edit ]

 Psychoactive drugs are frequently tried on those with FASD as many FASD symptoms are mistaken for or overlap with other disorders, most notably ADHD.[55]

 Behavioral interventions [ edit ]

 Behavioral interventions are based on the learning theory, which is the basis for many parenting and professional strategies and interventions.[48] Along with ordinary parenting styles, such strategies are frequently used by default for treating those with FAS, as the diagnoses oppositional defiance disorder (ODD), conduct disorder, reactive attachment disorder (RAD) often overlap with FAS (along with ADHD), and these are sometimes thought to benefit from behavioral interventions. Frequently, a person's poor academic achievement results in special education services, which also utilizes principles of learning theory, behavior modification, and outcome-based education.

 Developmental framework [ edit ]

 Many books and handouts on FAS recommend a developmental approach, based on developmental psychology, even though most do not specify it as such and provide little theoretical background. Optimal human development generally occurs in identifiable stages (e.g., Jean Piaget's theory of cognitive development, Erik Erikson's stages of psychosocial development, John Bowlby's attachment framework, and other developmental stage theories). FAS interferes with normal development,[56] which may cause stages to be delayed, skipped, or immaturely developed. Over time, an unaffected child can negotiate the increasing demands of life by progressing through stages of development normally, but not so for a child with FAS.[56]

 By knowing what developmental stages and tasks children follow, treatment and interventions for FAS can be tailored to helping a person meet developmental tasks and demands successfully.[56] If a person is delayed in the adaptive behavior domain, for instance, then interventions would be recommended to target specific delays through additional education and practice (e.g., practiced instruction on tying shoelaces), giving reminders, or making accommodations (e.g., using slip-on shoes) to support the desired functioning level. This approach is an advance over behavioral interventions, because it takes the person's developmental context into account while developing interventions.[citation needed]

 Advocacy model [ edit ]

 The advocacy model takes the point of view that someone is needed to actively mediate between the environment and the person with FAS.[47] Advocacy activities are conducted by an advocate (for example, a family member, friend, or case manager) and fall into three basic categories. An advocate for FAS: (1) interprets FAS and the disabilities that arise from it and explains it to the environment in which the person operates, (2) engenders change or accommodation on behalf of the person, and (3) assists the person in developing and reaching attainable goals.[47]

 The advocacy model is often recommended, for example, when developing an Individualized Education Program (IEP) for the person's progress at school.[55]

 An understanding of the developmental framework would presumably inform and enhance the advocacy model, but advocacy also implies interventions at a systems level as well, such as educating schools, social workers, and so forth on best practices for FAS. However, several organizations devoted to FAS also use the advocacy model at a community practice level as well.[57]

 Public health and policy [ edit ]

 Treating FAS at the public health and public policy level promotes FAS prevention and diversion of public resources to assist those with FAS.[47] It is related to the advocacy model but promoted at a systems level (rather than with the individual or family), such as developing community education and supports, state or province level prevention efforts (e.g., screening for maternal alcohol use during OB/GYN or prenatal medical care visits), or national awareness programs. Several organizations and state agencies in the U.S. are dedicated to this type of intervention.[57]

 The US Centers for Disease Control estimates 3 million women in the United States are at risk of having a baby with FASD, and recommended that women of child-bearing age should be on birth control or abstain from drinking alcohol as the safest way to avoid this.[58]

 Prognosis [ edit ]

 Primary disabilities [ edit ]

 The primary disabilities of FAS are the functional difficulties with which the child is born as a result of CNS damage due to prenatal alcohol exposure.[59] Often, primary disabilities are mistaken as behavior problems, but the underlying CNS damage is the originating source of a functional difficulty,[60] rather than a mental health condition, which is considered a secondary disability.

 The exact mechanisms for functional problems of primary disabilities are not always fully understood, but animal studies have begun to shed light on some correlates between functional problems and brain structures damaged by prenatal alcohol exposure.[47] Representative examples include:

 Functional difficulties may result from CNS damage in more than one domain, but common functional difficulties by domain include:[47][48][56][60] Note that this is not an exhaustive list of difficulties.

 Secondary disabilities [ edit ]

 The secondary disabilities of FAS are those that arise later in life secondary to CNS damage. These disabilities often emerge over time due to a mismatch between the primary disabilities and environmental expectations; secondary disabilities can be ameliorated with early interventions and appropriate supportive services.[59]

 Six main secondary disabilities were identified in a University of Washington research study of 473 subjects diagnosed with FAS, PFAS (partial fetal alcohol syndrome), and ARND (alcohol-related neurodevelopmental disorder):[47][59]

 Mental health problems: Diagnosed with ADHD, Clinical Depression, or other mental illness, experienced by over 90% of the subjects

 Disrupted school experience: Suspended or expelled from school or dropped out of school, experienced by 60% of the subjects (age 12 and older)

 Trouble with the law: Charged or convicted with a crime, experienced by 60% of the subjects (age 12 and older)

 Confinement: For inpatient psychiatric care, inpatient chemical dependency care, or incarcerated for a crime, experienced by about 50% of the subjects (age 12 and older)

 Inappropriate sexual behavior: Sexual advances, sexual touching, or promiscuity, experienced by about 50% of the subjects (age 12 and older)

 Alcohol and drug problems: Abuse or dependency, experienced by 35% of the subjects (age 12 and older)

 Two additional secondary disabilities exist for adults:[47][59]

 Dependent living: Group home, living with family or friends, or some sort of assisted living, experienced by 80% of the subjects (age 21 and older)

 Problems with employment: Required ongoing job training or coaching, could not keep a job, unemployed, experienced by 80% of the subjects (age 21 and older)

 Protective factors and strengths [ edit ]

 Eight factors were identified in the same study as universal protective factors that reduced the incidence rate of the secondary disabilities:[47][59]

 Living in a stable and nurturing home for over 73% of life

 Being diagnosed with FAS before age six

 Never having experienced violence

 Remaining in each living situation for at least 2.8 years

 Experiencing a "good quality home" (meeting 10 or more defined qualities) from age 8 to 12 years old

 Having been found eligible for developmental disability (DD) services

 Having basic needs met for at least 13% of life

 Having a diagnosis of FAS (rather than another FASD condition)

 Malbin (2002) has identified the following areas of interests and talents as strengths that often stand out for those with FASD and should be utilized, like any strength, in treatment planning:[48]

 Music, playing instruments, composing, singing, art, spelling, reading, computers, mechanics, woodworking, skilled vocations (welding, electrician, etc.), writing, poetry

 Participation in non-impact sport or physical fitness activities

 Epidemiology [ edit ]

 FASD is estimated to affect between 2% and 5% of people in the United States and Western Europe.[6] FAS is believed to occur in between 0.2 and 9 per 1000 live births in the United States.[6] The lifetime cost of an individual with FAS were estimated to be two million USD in 2002.[6] Drinking any quantity during pregnancy, the risk to give birth to a FAS is about 1,5%, and to a FASD about 15%. Drinking large quantities, defined as 2 standard drinks a day, or 6 standard drinks in a short time, give a 50% risk to a FAS birth.[64]

 Australia [ edit ]

 FASD among Australian youth is more common in indigenous Australians.[65] The only states that have registered birth defects in Australian youth are Western Australia, New South Wales, Victoria and South Australia.[66] In Australia only 12% of Australian health professionals are aware of the diagnostics and symptoms of FASD.[65] In Western Australia, the rate of births resulting in FASD is 0.02 per 1000 births for non-Indigenous Australians, however among indigenous births the rate is 2.76 per 1000 births.[66] In Victoria, there have been no registered FASD related births for indigenous Australians, but the rate for the general population in Victoria is 0.01-0.03 per 1000 births.[66] There have been no dedicated FASD clinics within Western Australia, but there are also no nationally supported diagnostic criteria anywhere in Australia.[67] Passive surveillance is a prevention technique used within Australia to assist in monitoring and establishing detectable defects during pregnancy and childhood.[66]

 History [ edit ]

 From the 1960s to the 1980s, alcohol was commonly used as a tocolytic, a method to stop preterm labor. The method originated with Dr. Fritz Fuchs, the chairman of the department of obstetrics and gynecology at Cornell University Medical College.[68][69] Doctors recommended a small amount of alcohol to calm the uterus during contractions in early pregnancy or Braxton Hicks contractions. In later stages of pregnancy, the alcohol was administered intravenously and often in large amounts. "Women experienced similar effects as occur with oral ingestion, including intoxication, nausea and vomiting, and potential alcohol poisoning, followed by hangovers when the alcohol was discontinued."[70] Vomiting put the mother at a high risk for aspiration and was "a brutal procedure for all involved." [68] Because the alcohol was being given intravenously, the doctor could continue giving the treatment to the mother long after she had passed out, resulting in her being more intoxicated than would otherwise be possible. Such heavy intoxication is highly likely to contribute to FASD.[68]

 Historical references [ edit ]

 Anecdotal accounts of prohibitions against maternal alcohol use from Biblical, ancient Greek, and ancient Roman sources[71] imply a historical awareness of links between maternal alcohol use and negative child outcomes.[33] For example, in the Bible, Judges 13:4 (addressed to a woman who was going to have a baby) reads: "Therefore be careful and drink no wine or strong drink, and eat nothing unclean" (ESV). In 1725 British physicians petitioned the House of Commons on the effects of strong drink when consumed by pregnant women saying that such drinking is “…too often the cause of weak, feeble, and distempered children, who must be, instead of an advantage and strength, a charge to their country.”[72] There are many other such historical references. In Gaelic Scotland, the mother and nurse were not allowed to consume ale during pregnancy and breastfeeding (Martin Martin). Claims that alcohol consumption caused idiocy were part of the Teetotalism's message in the 19th century,[73] but such claims, despite some attempts to offer evidence, were ignored because no mechanism could be advanced.[74]

 The earliest recorded observation of possible links between maternal alcohol use and fetal damage was made in 1899 by Dr. William Sullivan, a Liverpool prison physician who noted higher rates of stillbirth for 120 alcoholic female prisoners than their sober female relatives; he suggested the causal agent to be alcohol use.[75] This contradicted the predominating belief at the time that heredity caused intellectual disability, poverty, and criminal behavior, which contemporary studies on the subjects usually concluded.[47] A case study by Henry H. Goddard of the Kallikak family—popular in the early 1900s—represents this earlier perspective,[76] though later researchers have suggested that the Kallikaks almost certainly had FAS.[77] General studies and discussions on alcoholism throughout the mid-1900s were typically based on a heredity argument.[78]

 Prior to fetal alcohol syndrome being specifically identified and named in 1973, only a few studies had noted differences between the children of mothers who used alcohol during pregnancy or breast-feeding and those who did not, and identified alcohol use as a possible contributing factor rather than heredity.[47]

 Recognition as a syndrome [ edit ]

 Fetal Alcohol Syndrome was named in 1973 by two dysmorphologists, Drs. Kenneth Lyons Jones and David Weyhe Smith of the University of Washington Medical School in Seattle, United States. They identified a pattern of "craniofacial, limb, and cardiovascular defects associated with prenatal onset growth deficiency and developmental delay" in eight unrelated children of three ethnic groups, all born to mothers who were alcoholics.[79] The pattern of malformations indicated that the damage was prenatal. News of the discovery shocked some, while others were skeptical of the findings.[80]

 Dr. Paul Lemoine of Nantes, France had already published a study in a French medical journal in 1968 about children with distinctive features whose mothers were alcoholics,[81] and in the U.S., Christy Ulleland and colleagues at the University of Washington Medical School had conducted an 18-month study in 1968–1969 documenting the risk of maternal alcohol consumption among the offspring of 11 alcoholic mothers.[82] The Washington and Nantes findings were confirmed by a research group in Gothenburg, Sweden in 1979.[83] Researchers in France, Sweden, and the United States were struck by how similar these children looked, though they were not related, and how they behaved in the same unfocused and hyperactive manner.[83]

 Within nine years of the Washington discovery, animal studies, including non-human monkey studies carried out at the University of Washington Primate Center by Dr. Sterling Clarren, had confirmed that alcohol was a teratogen. By 1978, 245 cases of FAS had been reported by medical researchers, and the syndrome began to be described as the most frequent known cause of intellectual disability.

 While many syndromes are eponymous, i.e. named after the physician first reporting the association of symptoms, Dr. Smith named FAS after the causal agent of the symptoms.[84] He reasoned that doing so would encourage prevention, believing that if people knew maternal alcohol consumption caused the syndrome, then abstinence during pregnancy would follow from patient education and public awareness.[84] At the time, nobody was aware of the full range of possible birth defects from FAS or its rate of prevalence.[84] Over time, as subsequent research and clinical experience suggested that a range of effects (including physical, behavioral, and cognitive) could arise from prenatal alcohol exposure, the term Fetal Alcohol Spectrum Disorder (FASD) was developed to include FAS as well as other conditions resulting from prenatal alcohol exposure.[84] Currently, FAS[16][44][79] is the only expression of prenatal alcohol exposure defined by the International Statistical Classification of Diseases and Related Health Problems and assigned ICD-9 and diagnoses.

 See also [ edit ] ||||| Snooki Talks Drinking on 'Ellen': 'Why Did I Wake Up in a Garbage Can?'

 Email This Nicole "

 Polizzi, who was

 The reality star-turned-author, whose book, 'A Shore Thing,' hit shelves yesterday, Nicole " Snooki " Polizzi has a well-documented history of having a darn good time, and in an interview with Ellen DeGeneres, the 'Jersey Shore's' littlest lush admits that she may occasionally overdo it.Polizzi, who was fined $500 for disorderly conduct in September following an alcohol-fueled beach outing, confesses that episodes of over-imbibing used to happen as often as once a month.The reality star-turned-author, whose book, 'A Shore Thing,' hit shelves yesterday, told DeGeneres , "I want to remember my night and sometimes I just don't." She went on to admit, "I don't want to be a role model."

 While her hard-partying ways have been the source of great amusement for 'Jersey Shore' viewers, Snooki says that living with reckless abandon is not always as fun as it may seem."It sucks," she says. "You're like, 'What did I do? Why did I wake up in a garbage can?'" |||||

– Let's hope Snooki sorta planned that baby she's reportedly carrying (stop giggling). Because if she didn't, that fetus has to be nearly swimming in booze by now. While Forbes is concerned about what's to become of the diminutive reality star's "brand," others are worried about the drinking habits of the pregnant 24-year-old, who seems to spend very few minutes sober on Jersey Shore. "Is there a test for fetal alcohol syndrome at three months in utero?" wonders crabbygolightly.com. "Quick, word association test," demands studybreaks.com, "because all that comes to mind" for the pregnant "diva of debauchery" is "fetal alcohol syndrome"—a leading cause of mental retardation. The reported pregnancy poses problems for Snooki and JWoww's spin-off, and for Jersey Shore, where the cast spends "approximately 97.2% of their time being absolutely trashed," notes studybreaks. Snooki has some qualms about her hard-partying ways, once telling Ellen DeGeneres: "I want to remember my night, and sometimes I just don't. It sucks. You're like, 'What did I do? Why did I wake up in a garbage can?'"


News article:

A young Pleasant Grove mother has been indicted after authorities say her newborn baby girl was born addicted to heroin and had to spend one month in an Intensive Care Unit while she went through withdrawals.

 A Jefferson County grand jury on April 15 indicted 21-year-old Alexandra Nicole Laird, according to court records made public Tuesday. She was initially arrested May 1, 2015 and has remained free on bond since then.

 Laird on March 29, 2015 gave birth to a baby girl at UAB Medical West, court records show. Routine newborn testing performed on the day the baby was born turned up positive for opiates and amphetamines, both controlled substances. The baby on April 6, 2015 was transferred to Princeton Baptist Medical Center where she received treatment for the withdrawals.

 Pleasant Grove police Lt. Danny Reid said Laird later admitted to detectives that she used heroin one to two times a week for at least five months of her pregnancy. Because of the severity of the baby's illness, Reid sought, and received, an enhanced charge of chemical endangerment of a child against Laird, which is a Class B felony.

 Laird does not have custody of her daughter. "You won't know you've truly victimized this child until much later in life when she has trouble in school, trouble functioning,'' Reid said.

 She also faces an unrelated drug possession charge after she was arrested again less than two months after her daughter's birth. In that case, she and a man were pulled over during a traffic stop in Tarrant, records show. The man she was with was arrested on an outstanding warrant. A search of the vehicle turned up 38 hydrocodone pills. Neither Laird nor the man claimed ownership of those pills.

 In an affidavit claiming hardship to qualify for a court-appointed attorney, Laird said cleans houses for a living and is self-employed. In those records, she listed her monthly living expenses at $450 and her monthly disposable income at $50. Her only possessions of value, she wrote, is a television and bed valued at a combined $200.

 Laird is set to be in court on the child endangerment charge in July. ||||| WASHINGTON (Reuters) - President Barack Obama on Friday signed into law a measure that pledges greater efforts to protect drug-dependent newborns and assist their parents.

 A sign marks the entrance to the Neonatal Therapeutic Unit at Cabell Huntington Hospital, where staff members have acted to treat an alarming number of drug-dependent newborns, in Huntington, West Virginia, October 19, 2015. REUTERS/Jonathan Ernst

 The Comprehensive Addiction and Recovery Act also stresses drug treatment and overdose prevention to help stanch the nation’s heroin and opioid drug epidemic.

 Obama said in a statement that 78 Americans die from opioid overdose every day, and noted that the legislation included only modest steps to address the epidemic.

 “I am deeply disappointed that Republicans failed to provide any real resources for those seeking addiction treatment to get the care that they need,” Obama said. “In fact, they blocked efforts by Democrats to include $920 million in treatment funding.”

 The bill was passed nearly unanimously by both the House of Representatives and the Senate.

 Efforts to enforce provisions to protect newborns and help their parents come in response to a Reuters investigation last year titled “Helpless & Hooked.”

 The new law requires that the federal government and every state follow a 2003 law that was routinely ignored. That law called on states to require hospitals and social services to report, track and assist drug-dependent newborns and their families.

 Reuters found that no more than nine states were following that requirement. Most children born to addicted mothers, including many mothers who were taking prescribed methadone, were not being reported by hospitals as required by law. Often, that was because medical workers feared involving child protective services, as the existing law requires. When cases were reported to social services, Reuters found, efforts to protect the child and help the parents often were limited.

 The failures came at a cost. Reuters found more than 110 babies since 2010 died under preventable circumstances after being sent home to families ill-equipped to care for them. Experts said far more children have likely died but gone uncounted.

 The new law promises a non-punitive approach that includes “safe care plans” aimed at keeping newborns at home with their parents, who will receive additional help.

 “This is a step forward for vulnerable babies who, due to an opioid dependency, will begin their lives facing enormous challenges,” said Senator Bob Casey of Pennsylvania, the ranking Democrat on the Senate subcommittee on children and families. “Reuters’ initial reporting shined a light on a darkness that had enveloped far too many lives. There is much more work to do but this is a genuine step forward.”

 Representative John Kline, a Minnesota Republican who chairs the House Committee on Education and the Workforce, which initiated the measure, said it will track state actions.

 “These reforms are an important part of our broader efforts to combat the nation’s opioid epidemic and provide these vulnerable families a better chance at a brighter future,” Kline said in a statement.

 In 2013, the latest year with nationwide hospital reporting, 27,315 babies were diagnosed with newborn drug withdrawal syndrome, a five-fold increase from a decade earlier.

 Reuters found that one drug-dependent baby was born on average every 19 minutes in the United States. Some suffer shaking, crying and feeding problems as they battle withdrawal.

 Senator Ron Wyden of Oregon, the ranking Democrat on the Senate Finance Committee, said the broader addiction law was “no more than a half measure” without more funding. Wyden has co-sponsored a measure setting aside money for substance abuse treatment for parents in danger of losing their children. It passed the House but stalled in the Senate.

 Jim Greenwood, a former Pennsylvania congressman who championed the 2003 law, said the deaths Reuters revealed represent “a national disgrace and glaring failure at the federal, state and local level to implement Plans of Safe Care for infants.” Greenwood, now president of a Washington, D.C.-based biotechnology group, applauded the new measure “to improve the health and safety of these babies and their families.”

 Stephen Patrick, an assistant professor of pediatrics at Vanderbilt University and leading researcher on the condition, said the new law is “good news” but added: “Wish there was funding that came with it.” ||||| A young Pleasant Grove mother indicted earlier this year after her newborn baby girl was born addicted to heroin is pregnant again and back behind bars on another child endangerment charge.

 Police today obtained a formal warrant against Alexandra Nicole Laird, 21, and a Jefferson County judge ordered her jailed without bond until the baby's birth. She is estimated to be between 18 to 20 weeks pregnant.

 "I'm doing my damndest to try to prevent any further damage to this child, since it's obvious the mother doesn't seem to care,'' said Pleasant Grove police Lt. Danny Reid.

 A Jefferson County grand jury on April 15 indicted Laird on the first charge. She was initially arrested May 1, 2015 and had remained free on bond since then. Laird on March 29, 2015 gave birth to a baby girl at UAB Medical West, court records show. Routine newborn testing performed on the day the baby was born turned up positive for opiates and amphetamines, both controlled substances. The baby on April 6, 2015 was transferred to Princeton Baptist Medical Center where she received treatment for the withdrawals.

 In that case, Reid said Laird later admitted to detectives that she used heroin one to two times a week for at least five months of her pregnancy. Because of the severity of the baby's illness, Reid sought, and received, an enhanced charge of chemical endangerment of a child against Laird, which is a Class B felony.

 Laird does not have custody of her daughter. "You won't know you've truly victimized this child until much later in life when she has trouble in school, trouble functioning,'' Reid said at the time of Laird's indictment.

 She also faces an unrelated drug possession charge after she was arrested again less than two months after her daughter's birth. In that case, she and a man were pulled over during a traffic stop in Tarrant, records show. The man she was with was arrested on an outstanding warrant. A search of the vehicle turned up 38 hydrocodone pills. Neither Laird nor the man claimed ownership of those pills.

 In late August, Laird was arrested again for failure to appear in court. A condition of her previous child endangerment charge required her to not commit any other crimes while out on bond, which Reid said she did when she failed to show up for a court hearing. She then went before a judge who revoked her bond and administered a court-ordered drug test, which was positive.

 She was remanded to jail in the Bessemer Cutoff on Sept. 8. It was then she admitted to using heroin three times a day, Reid said, and admitted to being pregnant which authorities confirmed with a pregnancy test.

 Reid went before Jefferson County Circuit Judge David Hobdy today and argued for no bond, claiming that the unborn baby's life is in danger of continued heroin exposure.

 "This is a sad case, no matter how you look at it, as the mother's heroin addiction is more compelling to her than the health and welfare of this unborn child,'' Reid said. "But make no mistake, sad or not, law enforcement will hold this mother accountable and vigorously defend and protect the well being of the child, who is innocent of all of this and simply struggling for life."

 Bessemer Cutoff District Attorney Bill Veitch agreed. "The whole thing is just sad,'' Veitch said. "Very sad." |||||
What is a shorter version of the above article?

– In what police describe as "a sad case, no matter how you look at it," an Alabama judge has ordered a suspected drug addict to remain behind bars until she gives birth to her second child. Authorities say Alexandra Nicole Laird, 21, gave birth to a baby girl who tested positive for opiates in March. She later admitted to using heroin one or two times a week for most of her pregnancy and was charged with chemical endangerment of a child, says Pleasant Grove Police Lt. Danny Reid. In the months that followed, she was charged with drug possession and failure to appear in court, reports AL.com. Jailed last week, she told officers she was again pregnant and using heroin daily, Reid says. "I'm doing my damndest to try to prevent any further damage to this child, since it's obvious the mother doesn't seem to care,'' Reid told a judge Tuesday, securing a second child-endangerment charge against Laird, who is believed to be 18 to 20 weeks pregnant. "You won't know you've truly victimized this child until much later in life when she has trouble in school, trouble functioning,'' he told Laird at an earlier hearing. Laird does not have custody of her 1-year-old daughter, who spent a month in the ICU after birth for withdrawals, reports AL.com. In a sign of America's opiate epidemic, Reuters previously reported that one drug-addicted baby is born every 19 minutes, according to 2013 numbers. (Addicts have died from withdrawal in jail.)


Here is a news article: Michael Vickers, a veterinarian and rancher in Falfurrias, Texas, says he won’t let outside militia onto his property and he doesn’t think such groups will be trusted by most area landowners. (Dominic Bracco II/Prime/FTWP)

 Gun-carrying civilian groups and border vigilantes have heard a call to arms in President Trump’s warnings about threats to American security posed by caravans of Central American migrants moving through Mexico. They’re packing coolers and tents, oiling rifles and tuning up aerial drones, with plans to form caravans of their own and trail American troops to the border.

 “We’ll observe and report, and offer aid in any way we can,” said Shannon McGauley, a bail bondsman in the Dallas suburbs who is president of the Texas Minutemen. McGauley said he was preparing to head for the Rio Grande in coming days.

 “We’ve proved ourselves before, and we’ll prove ourselves again,” he said.

 McGauley and others have been roused by the president’s call to restore order and defend the country against what Trump has called “an invasion,” as thousands of Central American migrants advance slowly through southern Mexico toward the U.S. border. Trump has insisted that “unknown Middle Easterners,” “very tough fighters,” and large numbers of violent criminals are traveling among the women, children and families heading north on foot.

 [Migrant caravan: What Trump’s threats sound like to the Central Americans trudging north]

 The Texas Minutemen, according to McGauley, have 100 volunteers en route to the Rio Grande who want to help stop the migrants, with more likely on the way.

 “I can’t put a number on it,” McGauley said. “My phone’s been ringing nonstop for the last seven days. You got other militias, and husbands and wives, people coming from Oregon, Indiana. We’ve even got two from Canada.”

 Asked whether his group planned to deploy with weapons, McGauley laughed. “This is Texas, man,” he said.

 And yet, the prospect of armed vigilantes showing up beside thousands of U.S. troops — along with Border Patrol agents, police officers and migrants — is considered serious enough that military planners have issued warnings to Army commanders.

 According to military planning documents obtained by Newsweek, the military is concerned about the arrival of “unregulated militia members self-deploying to the border in alleged support” of U.S. Customs and Border Protection.

 [Army assessment of migrant caravans undercuts Trump’s rhetoric]

 The assessment estimates that 200 militia members could show up. “They operate under the guise of citizen patrols,” the report said, while warning of “incidents of unregulated militias stealing National Guard equipment during deployments.”

 The military report provided no further details about the alleged thefts.

 Manuel Padilla Jr., the top Border Patrol official in the agency’s Rio Grande Valley sector, the nation’s busiest for illegal crossings, said he has not issued any instructions to agents in the field or to landowners whose properties are adjacent to the river. But he plans to meet with community members in the coming week, he said, to address their concerns.

 “We don’t have any specific information about the militias,” said Padilla, reached by phone along the border. “We have seen them in the past, and when things start getting really busy, we have to make sure to let the community know they’re out there.”

 “But they’re doing that on their own,” Padilla said.

 [Trump vows to block asylum seekers in caravan but offers few details]

 McGauley said that in addition to weapons and camping gear, his group will have night-vision goggles and aerial drones with thermal sensing equipment, capable of operating in darkness. He emphasized that the group would report any suspicious activity to authorities and would heed any instructions from Border Patrol agents or military personnel.

 Several landowners in the area said they do not want the militias around.

 Michael Vickers, a veterinarian and rancher who lives an hour north of the border in Falfurrias, said that he will not let militia members from outside the area onto his property and that he doubts most area landowners would trust outsiders.

 “They are a bunch of guys with a big mouth and no substance to them,” said Vickers, a Republican who heads the 300-strong Texas Border Volunteers. The group doesn’t call itself a militia, although it patrols ranchland to intercept migrants who hike through the brush to attempt to avoid Border Patrol checkpoints. The group uses ATVs, night-vision goggles, spotlights and trained dogs.

 “People on the [Rio Grande] have been calling us,” Vickers said. His group is in a “holding pattern,” he said, adding, “We can have 100 volunteers in a hot area in four to eight hours.

 “We’ve already talked to a bunch of landowners who wanted to know if we’ll be operating if the Border Patrol can’t be there to keep their property from being vandalized and their crops from being messed up.”

 “We’re ready to move,” he said.

 [South Texas county faces wave of migrant deaths]

 Others in South Texas are less enthusiastic.

 Lucy Kruse, 96, said immigrants often stop on her property as they walk through the bush country, sometimes breaking into a small cabin to sleep. Her family’s ranch lies amid the thorny mesquite brush, cactus and tawny dry grass 80 miles north of the border.

 As the migrant caravans head north, she and other landowners in the area worry that the number of trespassers walking through their ranches will increase dramatically. But many say the militias coming to the area also pose a threat.

 “I will not let militia on my land,” Kruse said. “They’re civilians stepping into a situation where the Border Patrol is supposed to be in control and make decisions. They could damage property or harm workers. I would guess they would be trigger-happy. If they shot someone, they might just say the person they shot was reaching for a gun.”

 Joe Metz, 80, lives in what looks like a pastoral tropical paradise near Mission, a town of 84,000 in the Rio Grande Valley. Tall, green sugar cane grows beside the wide river, and citrus trees dot the sandy small hillocks away from the banks.

 The Rio Grande is less than a mile from Metz’s living room window, and a section of border wall crosses his property. He has watched for years as border-crossers ford the river and walk onto his land, their first step on American soil. The wall has slowed the flow significantly, he said, but between 50 and 100 people a day still cross through the farm next door.

 He worries that the caravan, which includes many women and children, will surge through the area, but he doesn’t want armed vigilantes on his farm.

 “The militia just needs to stay where they are,” said Metz, a Republican. “We don’t need fanatical people. We don’t need anybody here with guns. Why do they have guns? I have dealt with illegals for 30 years, and all of them have been scared, asking for help. The militias need to stay up north where they belong. We have no use for them here. They might shoot someone or hurt someone.”

 [Trump on throwing rocks at the border: Military will consider that a threat]

 The heir to the state’s largest and most influential ranch said he thinks the militias could pose a threat of their own. Stephen J. “Tio” Kleberg, who has lived most of his life on the 825,000-acre King Ranch outside of Kingsville, said he will allow federal and state law enforcement and the military onto his property, which is larger than the state of Rhode Island, but he won’t let private militia beyond the gates.

 “I don’t think they have a governing body,” he said. “They are independent and not authorized by anybody. It could lead to individuals taking action without someone in authority supervising. I think that could be dangerous.

 “I think if the [caravan members] get across the river, they need to be caught and sent back,” said Kleberg, who wears a bushy handlebar mustache and chews an unlit cigar.

 “Once they get on U.S. soil, they need to be stopped and detained. We don’t have enough Border Patrol, ICE and Highway Patrol to handle them. If we get 2,000 or 3,000 people, we will need the military,” Kleberg said.

 Correction: In a prior version of this story, Texas rancher Stephen J. “Tio” Kleberg said he would allow private militias onto his property to confront migrants crossing into the United States illegally. Subsequent to publication, Kleberg said he misunderstood the questions he was asked and requested that his comments be amended to reflect that he will not allow militia groups onto his ranch. ||||| As President Donald Trump directs thousands of troops to the U.S.-Mexico border in a show of military force against an approaching caravan of migrants from Central America, preliminary intelligence assessments are preparing for encounters with a litany of groups from unregulated militias to transcontinental criminal organizations, according to documents obtained by Newsweek.

 In a powerpoint presentation from Saturday, the Joint Force Land Component Commander Threat Working Group prepared an intelligence assessment for Pentagon officials as they begin to carry out Operation Faithful Patriot, the interagency operation with the Department of Defense and led by the Department of Homeland Security, that started Tuesday.

 The presentation is marked as “UNCLASSIFIED//FOUO//LES,” meaning, the documents are for official use only and are law enforcement sensitive. Newsweek obtained the operational planning documents earlier this week from two different Defense Department sources that have direct knowledge of U.S. Northern Command's mission on the southern U.S. border.

 The documents take a detailed look at the four-point of entry locations spread across the southwest border and assesses where the caravan might travel. Two areas of concern to U.S. intelligence officials involving points of entry and transcontinental criminal organizations is the point of entry in Brownsville, Texas, where the Rio Grande River is located between Matamoros, Tamaulipas, Mexico, and the San Ysidro point of entry, separating San Diego, California from Tijuana, Mexico.

 The assessment underscored news reports that combatant commanders might encounter unregulated militia members along the southern border in alleged support of U.S. Customs and Border Protection agents.

 “Estimated 200 unregulated armed militia members currently operating along the southwest border. Reported incidents of unregulated militias stealing National Guard equipment during deployments. They operate under the guise of citizen patrols supporting CBP [Customs and Border Protection] primarily between POEs [Points of Entry],” according to the documents.

 The documents go onto highlight historical protests that support immigrants crossing the U.S. border. Those protests in some cases have shut down points of entry controlled by Customs and Border Protection, but the assessment concludes that protests are “normally peaceful unless extreme right or left groups attend.”

 Militia groups and far-right activists have already announced plans to make their way to the U.S.-Mexico border with the aim of preventing caravan members from entering the country.

 With the caravan still hundreds of miles away, it is unclear how many militia members will turn up. Among groups determined to help fortify the border, are members of the Minuteman Project.

 Historically, Minutemen were once known as civilian colonists who organized to form self-trained militia groups during the American Revolution. Today, however, the Minuteman Project is an activist organization, which was founded in August 2004 by Jim Gilchrist and Chris Simcox and describes itself as a “citizen’s Neighborhood Watch on the southern border.”

 Minutemen Project National Political Director Howie Morgan told Newsweek on Wednesday that the organization hoped to have its members out in full force at the border before the coming caravans arrive.

 “We believe our nation is under attack by foreigners who refuse to accept the rule of law on how to become a citizen in the United States,” Morgan said.

 Asked whether he believes that applies to migrants who arrive at official ports of entry at the border to make asylum claims through the U.S.’s long-standing legal process, Morgan said he believed Central Americans should make those claims “in their own country.”

 “Instead of following the rules, they are using our nation’s laws as a shortcut to get in front of the line,” Morgan claimed.

 To obtain asylum through the U.S.'s affirmative asylum process, however, asylum seekers must be "physically present in the United States," according to the U.S. Citizenship and Immigration Services Agency. Asylum seekers also are eligible to apply for asylum regardless of how they arrived in the country or what their current immigration status is.

 On Monday, the Minuteman Project issued a call to action, asking “Minutemen and Minutewomen” to “converge on the U.S.-Mexico border immediately to support U.S. law enforcement and military organizations already there.”

 “Your presence is needed along the 2,000-mile border from San Diego, California to Brownsville, Texas at any time for the next 90 days,” the organization said in a statement issued on its website.

 Morgan said he was not sure how many Minuteman members would arrive at the border in the weeks ahead. However, he said he hoped to see people come out in “thousands,” but said that may be unlikely given that the government has already made strong efforts to fortify the southern border.

 Of those who do arrive, Morgan said that members have been warned to follow the rule of law and focus their efforts on reporting migrants to Border Patrol authorities. However, he did say that he expected members would be armed.

 “We understand how dangerous the border can be and we certainly want to ensure that all of our volunteers are safe,” he said. “If they are entitled and in an area where it is legal to carry guns, it is their right to do so,” he said.

 On Wednesday, Trump announced that his administration could send as many as 15,000 troops to the southern border in anticipation of the thousands of migrants currently making their way to the U.S. with several caravans departing from Honduras and El Salvador.

 Applauding the Trump administration’s controversial crackdown on immigration, the Minuteman Project spokesperson said that while the organization is “always looking to have a better security and immigration program in the United States,” Trump has “shown he is fighting to keep those efforts moving in the right direction.”

 In its call to action for supporters to make their way to the southern border, the Minuteman Project tells members: “Remember, defending your nation’s sovereignty and its heralded stature as ‘a nation of laws’ does not make you a racist, a bigot, a xenophobe, a Nazi, a fascist… or any of the various epithets commonly used by our adversaries to falsely deface our patriotic virtue.

 “The real fascists and xenophobes are those who openly hate us because we love our country just as we love our families and our communities,” the message continued.

 It also warns members not to speak with news outlets, reminding them that “most newspaper reporters” will be “hostile to your presence on the border,” aside from Fox News, and One America News. ||||| .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... ..........

 Copyright © 2018 Albuquerque Journal

 COLUMBUS, N.M. – When the two men with a self-described militia showed up last week offering Columbus Mayor Ezequiel Salas help protecting the border, the conversation was brief and polite.

 “I told them, ‘We have a good relationship with Mexico, with our little sister village Palomas,” said Salas, referring to the community just across the border.

 “A lot of people who never come here, they have a misunderstanding. They hear things that are not true.”

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 While rumors and heated rhetoric about a crisis on the border contribute to rising tensions, border communities are caught in the middle.

 In Columbus, home to about 1,600 residents, the mayor and other villagers were perplexed by the arrival of a small band of men with the Patriots of the Constitution militia. The men said they were there scouting locations to prepare for the migrant caravan from Central America slowly making its way through Mexico toward the southwest border.

 The number of those in the caravan has dwindled from about 7,000 to 3,500 people. President Donald Trump announced this week that he planned to deploy 15,000 troops to the border to meet the caravan he referred to as an “invasion” and he vowed to set up tents to hold Central Americans who he said will likely be denied asylum and be deported. Troops could arrive this weekend to support U.S. Border Patrol agents. The caravan appears headed for Texas. A previous caravan’s final destination was California.

 Along this quiet stretch of New Mexico borderland, some residents expressed concern about armed militias making their way to the border.

 “They should not be patrolling the border if they were not sent by the federal government,” said Martin Garcia, a Columbus resident, as he watched over farmworkers picking red chile in a field that borders Mexico. “If the U.S. wants to send soldiers, that’s fine.” On another farm along the border, two men in their 20s in a pickup truck said the only militia members they had seen “were two old men with guns.”

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 Richard Puntasecca, the driver, said the militiamen asked if they could set up tents for volunteers, but the farmer who owned the property said no.

 ‘Stop the bad guys’

 At a hotel in town Wednesday, a few members of the militia rested and waited for nightfall to patrol the border. One of their trucks in the parking lot had an “ISIS hunting” decal on the bottom of the windshield.

 As one of the militiamen paced in front of the hotel, smoking and talking on his phone, another sat in a chair on the second-floor balcony holding binoculars.

 They were spurred to action by news of thousands of Central American migrants in a caravan headed for the border, said Jim Peyton, a 71-year-old retired Detroit police officer.

 Peyton drove 1,355 miles from Jasper, Ala., where he now lives, to Columbus.

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 “We’re only armed for self-defense,” he said. The goal of the militia is to “stop the bad guys.” He declined the Journal’s request to photograph him.

 Peyton said he and his second in command checked in with U.S. Customs and Border Protection as soon as they arrived in Columbus, as well as with the mayor.

 “We’re here to assist when possible,” he said. “We don’t have the authority to touch, corral, interfere. That would be illegal because we are not authorized to do so.”

 Peyton said Border Patrol asked that the group stay north of Highway 9 to avoid confusion when agents are tracking footprints and other traffic from illegal border crossers. “We are aware a group of people have arrived in New Mexico with the goal of ‘patrolling’ the border but they are not working in conjunction with the Border Patrol,” according to a statement from the El Paso Border Patrol sector, which includes all of New Mexico.

 “For any individuals coming to observe the border, we ask the public to report any illegal activity they witness to the appropriate law enforcement agency and allow those enforcement professionals to perform those duties without interfering,” the U.S. Border Patrol advises.

 Extra eyes, ears

 The militia will serve as extra eyes and ears near the border and notify Border Patrol dispatch if they spot illegal crossings or smuggling, according to Peyton.

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 Peyton said he is spending a lot of his time on the phone calming fears about the caravan.

 “A woman from Florida was in tears calling me, thought she was going to die,” he said.

 “They’re taking this as they’re going to knock on their door and blow their brains out. That’s not going to happen.”

 Social media call

 Patriots of the Constitution put out a call via social media Oct. 23 for “A FULL DEPLOYMENT OF EVERY ABLE BODY U.S. CITIZEN to Head to the U.S. Southern Border and Link up with other U.S. Citizen Groups whom are making a Stand to Secure our Border from a Mob of Migrating Immigrants.” The organization is among patriot militia groups committed to defending the Constitution and, in some cases, the border.

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 There are volunteers ready to help in Arizona, California and Texas, according to Peyton.

 “It was reported to us this was a soft spot, but so far we have not seen much of anything. But, then again, the caravan hasn’t really arrived and there’s a second one coming up,” he said.

 The U.N. Refugee Agency providing assistance in Mexico said many of those traveling in the caravan are families with “babies and toddlers.”

 Peyton believes the caravan is a “Trojan horse” hiding ISIS, MS-13 and cartel gang members, as well as Nigerians and Venezuelans. He would not say how many militia members were in Columbus, but several people in the village said it was less than a handful of volunteers.

 Caravan a ‘decoy’?

 David Miller, 59, drove from Alamogordo with his dog Snow after hearing a call for volunteers to patrol the border at a biker rally.

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 “He got down here, his truck broke down,” Peyton said. “We had to go find him, tow his truck in.”

 “It’s my country,” Miller said. “If we’re getting invaded, shouldn’t we help?”

 Miller called the migrant families in the caravan a “decoy” for gang members trying to sneak into the country.

 “They’re not coming for ice cream and cake,” he said.

 Miller is doing odd jobs in Columbus to earn money to get his truck repaired. But for now, he and his lab mix are stranded near Pancho Villa State Park.

 The park’s museum includes a “remembrance” for the Americans who gave their lives defending the village when the Mexican revolutionary Pancho Villa crossed the border with a band of his men and raided Columbus in 1916.

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 David Ferguson, 79, and his wife parked their RV in Pancho Villa State Park. The snowbirds escaped winter in Michigan for sunny southern New Mexico.

 Ferguson said he is not worried about the caravan or staying so close to the border.

 “Albuquerque is a lot more dangerous than this place ever thought of being,” said Ferguson, though he acknowledged that he had never visited.

 As tensions rise over the arrival of the migrant caravan, which is not expected to cross the border at Columbus, Mayor Salas tried to dispel misperceptions about his hometown.

 “Don’t be fearful,” he said. “We’ve lived here for years. We have good relations (with Mexico). We work together.” |||||
A summary of this is?

– Troops headed for the US-Mexico border aren't just aiming to help prevent migrant entry—they have unregulated militias and criminal organizations on their minds, too. According to planning documents obtained by Newsweek, the Department of Defense is aware of nearly 200 armed militias already operating along the southwest border. "Reported incidents of unregulated militias stealing National Guard equipment during deployments," reads an intelligence assessment for the Pentagon by the Joint Force Land Component Commander Threat Working Group. "They operate under the guise of citizen patrols supporting CBP [Customs and Border Protection] primarily between POEs [Points of Entry]." The documents analyze four points of entry including one in Brownsville, Texas, and another in the San Ysidro district of San Diego, Calif. The assessment jibes with media reports that militia members are already heading for the border, the Washington Post reports. They include the Texas Minutemen, who apparently have 100 armed volunteers going to the Rio Grande. "I can’t put a number on it," says Shannon McGauley, who leads the group. "My phone’s been ringing nonstop for the last seven days." Meanwhile, members of another group—the Patriots of the Constitution militia—arrived last week in Columbus, New Mexico, per the Albuquerque Journal. Yet the military planners expect the migrant caravan to reduce in size and contain "no terrorist infiltration," per the documents. They also say the migrants could trigger a "balloon effect" on smuggling if traffickers take advantage of the diversion. (While providing troops, the Pentagon refused one request from Trump.)