This article describes the early history of the "boarder baby" phenomenon t
hrough the late 1980s and early 1990s. The characteristics of the recent "b
oarder baby" population and of the problem are described with particular em
phasis on the role of alcohol and drug abuse and the historical lack of coo
rdination between hospitals and child welfare agencies. Three additional to
pics are discussed in depth: (1) policies around testing mother and infants
, (2) the meaning and use of a positive toxicology screen for a newborn or
birthing mother, and (3) the identification and characterization of the vic
tim. Alternative solutions to the problem are discussed.