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BABIES WHO TAKE VIAGRA

Bailey Buffalow was 18 months old before she laughed for the first time. Born three months premature, Bailey suffers from pulmonary hypertension, a rare condition in which the artery carrying blood from the heart to the lungs becomes constricted. A scan showed that the right side of her tiny heart had swollen to almost twice its normal size as it struggled to pump enough blood through the narrowing blood vessel. Even the slightest exertion--such as laughter--was too much for her. Left untreated, she would die. "I asked the doctor several times, 'Am I being inhumane to keep her alive?' " says Bailey's mother, Micah, a 23-year-old legal secretary from Albuquerque, N.M. Bailey's doctors were initially optimistic, but conventional treatments had little effect. Finally, they suggested an experimental treatment: Viagra.

"I said, 'You've got to be kidding'," Micah recalls. "Viagra, for Pete's sake--you wouldn't think of that for a little girl for any amount of reasons." But with no other option, Micah agreed, and three times a day gave Bailey a cherry-flavored syrup containing ground-up Viagra tablets. Almost immediately, Bailey's blood pressure and heart rate began to drop, and just days after beginning the treatment she laughed for the first time. Within months, the pressure in Bailey's pulmonary artery had dropped almost to normal, and her swollen heart had begun to shrink. Bailey's health will always be fragile, but if she remains stable she could be off meds in a year or so. It's hard to tell there was ever anything wrong with Bailey, now 3 years old, as she runs about playing--and laughing--with her friends, Micah says. "She couldn't sit still if her life depended on it."

The drug that's put a spring in the step of 16 million American men since its introduction in 1998 as a treatment for erectile dysfunction is itself finding new life as a therapy for the very young. In May, the most comprehensive study yet of Viagra therapy for kids with pulmonary hypertension found that after a year of treatment, the children could walk four times farther before becoming exhausted. All 14 children who participated were alive at the end of the Toronto study--unusual for a disease that normally has a 12-month mortality rate of 37 percent. Pfizer, Viagra's maker, is recruiting patients for a large-scale trial as a first step toward marketing the drug for infant use.

"From a scientific perspective, it's not nearly as crazy as it sounds," says Dr. Andrew Atz of the Medical University of South Carolina, who pioneered the use of Viagra for hypertensive babies. The same chemical messengers Viagra targets to improve blood flow in the penis are present in the heart and lungs. And since Viagra amplifies the body's chemical reaction to sexual stimulation, rather than triggering erections directly, there's no risk of the little blue pills' having sexual side effects in minors. "The way Viagra works is not that it magically gets you going," Atz says. "You have to have carnal thoughts to go along with it."

Reports of the drug's success in patients with pulmonary hypertension have fueled an explosion in "off label" prescriptions. Although hundreds of children around the country have already been treated with Viagra, Bailey's pulmonologist, Steven Abman, urges caution. "We feel the benefits outweigh the unknowns if the child's pulmonary hypertension is severe enough," he says. "But we certainly do not know the long-term complications, especially in young infants." Some parents report increased aggression in their children, and doctors are concerned that the drug may affect the developing retina, leading to problems in later life. Pfizer distances itself from the drug's off-label use. "It's not something we'd promote or endorse in any way," says Daniel Watts, a Pfizer spokesman.

Nevertheless, many parents are convinced Viagra is effective. Three-year-old Abby Sherwood, of Indianapolis, used to slump to the floor every few steps, her heart pounding, and complain that she was too tired to go on; but Viagra therapy changed everything. These days, Abby barely breaks a sweat as she pedals furiously around the house on her tricycle. Whether researchers will be able to keep pace with her remains to be seen.

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