Infant of a substance using mother
IUDE; Intrauterine drug exposure; Maternal drug abuse; Maternal substance use; Maternal drug use; Narcotic exposure - infant; Substance use disorder - infant
Maternal substance abuse may consist of any combination of drug, chemical, alcohol, and tobacco use during the pregnancy.
While in the womb, a fetus grows and develops due to nourishment from the mother via the placenta. However, along with nutrients, any toxins in the mother's system may be delivered to the fetus. These toxins may cause damage to the developing fetal organs. A baby also may become dependent on substances used by the mother.
WHAT CAUSES SUBSTANCE ABUSE DURING PREGNANCY?
Women using illicit substances do not intend to become pregnant in most cases. They may not realize they are pregnant. Others continue to use drugs while pregnant as a result of addiction or dependency or use them recreationally.
WHAT ARE THE SIGNS AND SYMPTOMS SEEN IN AN INFANT OF A SUBSTANCE-ABUSING MOTHER?
Babies born to substance-abusing mothers may have short- or long-term effects.
- Short-term withdrawal symptoms may consist only of mild fussiness.
- More severe findings may include acting irritable or jittery, feeding problems, and diarrhea. Symptoms vary depending on which substances were used.
- The diagnosis for babies with signs of withdrawal may be confirmed with drug tests of the baby's urine or stool. The mother's urine will also be tested.
More significant long-term developmental problems may be seen in babies who are born with growth failure or various organ problems.
- Infants born to mothers who drink alcohol, even in modest amounts, are at risk for fetal alcohol syndrome (FAS). This condition consists of growth problems, unusual facial features, and intellectual disability. It may not be detected at time of birth.
- Other drugs may cause birth defects involving the heart, brain, bowel, or kidneys.
- Babies who have been exposed to drugs, alcohol, or tobacco are at higher risk for SIDS (sudden infant death syndrome).
WHAT IS THE TREATMENT FOR AN INFANT OF A SUBSTANCE-ABUSING MOTHER?
The baby's treatment will depend on the drugs the mother used. Treatment may involve:
- Limiting noise and bright lights
- Maximizing "TLC" (tender loving care)
- Using medicines (for some)
In the case of babies whose mothers used narcotics, the baby is most often given small doses of a narcotic at first. The amount is slowly adjusted as the baby is weaned off of the substance over days to weeks. Sedatives are sometimes used as well.
Infants with organ damage, birth defects or developmental issues may need medical or surgical therapy and long-term therapies.
In addition, these infants are more likely to grow up in homes that do not promote healthy emotional and mental growth.
Bencke M, Smith VC, Committee on Substance Abuse, Committee on Fetus and Newborn. American Academy of Pediatrics. Prenatal substance abuse: short- and long-term effects on the exposed fetus (technical report). Pediatrics. 2013;131(3):e1009-1024. PMID: 23439891 www.ncbi.nlm.nih.gov/pubmed/23439891.
Lawn C, Aiton N. The baby of a substance-abusing mother. In: Rennie JM, ed. Rennie and Roberton's Textbook of Neonatology. 5th ed. New York, NY: Elsevier; 2012:chap 26.
Reviewed By: Kimberly G. Lee, MD, MSc, IBCLC, Associate Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.