Dec. 4, 2008 -- As if unemployment numbers weren't enough, the story of an infant in Florida really hit the country as a sign we are in desperate economic times: Five-month-old La'Damian Barton almost died Monday from watered-down formula because his mother tried to cut costs.
Child care and poverty advocates say poor families have always had to make dangerous decisions to cut back. Now, with the economy in trouble, experts say more families are likely to try cutting doctor visits or skipping their own meals so the children can eat.
Phyllis Harrison of Yonkers, N.Y., a member of Community Voices Heard, an organization of low-income people working to improve their communities in New York city and state, said occasionally skimping, or watering things down is nothing new.
"When the milk ran out?" she said. "Well, you have to dilute the milk with water. You've got to do what you have to do."
She, herself, has five kids, 13 grandchildren, and receives welfare assistance. She also baby-sits for her neighbor while their family is out working for welfare benefits.
"It's like, every month, because over the week, they don't give you enough milk to last you the month," said Harrison. "I've been taking care of this baby since May. During that time we had to go to the pantry because the food from WIC ran out."
WIC is a federally run program to help subsidize the nutrition of women, infants and children up to age 5. WIC helps, but it's not meant to provide all food.
Like Harrison and her neighbors, La'Damian Barton's mother also relied on WIC. Also like Harrison, she ran out of formula by the end of the month.
Nancy Cauthen, deputy director of the National Center for Children in Poverty (NCCP) in New York, said she hopes this is an extreme, but she can't be sure.
"We can't always quantify these kinds of things," she said. "In general, there are the kinds of things we know happen and the kinds of things we worry about."
Making Tough Family Choices
Cauthen said even the kinds of "things" the NCCP knows happen aren't very encouraging.
"We know, when families are running out of money for food, that parents will tend to cut back on their own meals before they'll cut back on their own children's," said Cauthen.
However, when it comes to health care, Cauthen said everybody in the family usually suffers. If parents lose their jobs, they often lose their health insurance. Then, parents don't take their children for checkups, possibly missing vital red flags for developmental problems.
"If that baby isn't getting ... checkups, you can think about how that can snowball," said Cauthen.
In the Florida case, doctors discovered that Barton was 4 pounds underweight.
Cauthen said parents also often wait until a child gets really sick before seeing a doctor.
"Waiting to go to the doctor until something is serious ... that can turn a cold into bronchitis in the emergency room," she said.
Even if parents have jobs, Cauthen said a bad economy can cause children's health to suffer.
"We know that people lose jobs if they don't show up because they need to take a kid to the doctor," said Cauthen. "So, sometimes parents will send their children to school sick. And, of course, that just exposes other children."
With a bad economy, Cauthen said, "parents are going to be more fearful than before to not show up."
Denise Bonitto, Harrison's neighbor in Yonkers, knows she can't afford to lose too many days at work or she'll lose her welfare benefits.
"I get up every morning, and I deal with seniors at the senior citizen center," said Bonitto.
For 20 hours a week, Bonitto, 46, feeds seniors their meals and plans activities for them.
"I enjoy the work, but at the same token, I wish I could get a paycheck for it," said Bonitto. "I have to work for my 'outgoing needs' welfare check."
Trying to Make It On Welfare
Bonitto said she gets $147 every two weeks for her "outgoing needs."
The money is meant to cover non-food costs for herself, her 16-year-old daughter and her grandchild. But Bonitto extends that money for a fourth person in the household: her 22-year-old son who has cerebral palsy and seizures.
"What they give us is ridiculous. They're bringing back slavery, to say it in a polite way," said Bonitto. "If you've got to be at work from 9 to 2, how are you supposed to find a job?"
When the WIC benefits run out for Bonitto's family, she, too, goes to the food pantry. But even that can require referrals from the Salvation Army or forms from the welfare office, she said.
"We're barely making it," said Bonitto.
To help herself, Bonitto joined the Community Voices Heard.
"We fight for low-income families; we're fighting to save our homes," she said.
Bonitto also finds assistance with her neighbor, Harrison.
"Phyllis baby-sits for me and my daughter; we're all on DSS," she said.
Agencies that track child care say relying on neighbors and friends to watch children is a sure sign of a recession.
"We are getting reports from all around the country of people making the decision basically to save money by taking children out of child care," said Linda Smith, executive director of the National Association of Child Care Resource and Referral Agencies in Arlington, Va.
"They can't not make the rent payment, they have to make the utilities, so what can they do? Take the children out of child care," said Smith. "The question is then: Where do they go?"
Smith's organization has been able to track some trends of child care when kids are pulled out of day care: Grandparents watch more children, as do relatives, neighbors and friends.
More worrisome to Smith is the decision to take rotating day and night shift work so that one parent is always at home.
"But if the parent's sleeping during the day, what care is the child getting? Is the child just parked in front of the TV?" asked Smith.
What Smith and the National Association of Child Care Resource and Referral Agencies cannot be sure of is the quality of care children are receiving.
"If they're a school age child, they're probably going home after school," she said. "If they're preschool aged, they're probably bouncing around from neighbors to friends, to anyone who will take them."
Of course, Smith said some of this care might be quality. But some may not.
"The biggest predictor in good child outcomes is consistency with a relationship, with a caregiver," said Smith. "We, as a nation, need to stand back and look at this and say, 'What is the view of the child?'"
The Associated Press contributed to this report.