When children end up at hospitals alone because their parents are dead, critically injured or in jail, the burden of their care and well-being falls upon a network of medical professionals, volunteers and social workers.

Just this month, local hospitals have had to grapple with such situations twice.

Noah King, 4 months old, is in critical but stable condition at Children's Hospital after police arrested his mother, Amber Brewington, 21, of Tennessee, for injecting him with salt water. His father has not been charged in this incident but has a history of assault.

A newborn boy whose mother was killed when he was sliced from her womb in Wilkinsburg was taken to West Penn Hospital last week by his alleged abductor.

Efforts by hospitals and social workers ensure that although a child might not have a parent in crying distance, there are plenty of hugs, cuddles and laps to go around.

"We don't just go up and change a baby's diaper. You talk to them, you stroke them," said Dr. Janet Squires of Children's Hospital's Child Advocacy Center, which works with Allegheny County's Office of Children, Youth and Families. "Many times a volunteer will just be asked to come in and hold a baby."

Children's Hospital has volunteers, a department of child life dedicated to helping children cope with their hospital stays, playrooms and a visitors program.

At West Penn, "babies in the neonatal unit received very close, around-the-clock attention from the nursing staff, attention that is further heightened in cases when a mother is unable to participate in the care of the child," said Dan Laurent, spokesman for the West Penn Allegheny Health System.

If only one parent is out of the picture and the other parent is fit, willing and able to be a caregiver, CYF "often takes a back seat to that parent," said Bruce Noel, the agency's intake manager.

But if there is no suitable parent or guardian available, CYF becomes involved.

"In cases where a baby is delivered at the hospital and for some reason the mom and dad are not able to be legal guardians, a family member wishing to assume that responsibility engages the hospital's legal department to get the process rolling," Mr. Laurent said.

CYF would have to decide how quickly to approach a juvenile court judge to take custody. Urgent situations, such as emergency surgery, might speed up the process.

Once CYF has custody, the court will oversee the child's medical care and direct contact with extended family.

Although those extended family members might not have custody of a hospitalized child whose parents are out of the picture, they are welcomed as part of an important web of people providing nurturing and support.

"We don't want to be confrontational," Dr. Squires said. "We welcome families. Extended families are often needed to help children."