BABIES BORN TO ADDICTED MOTHERS

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1 BABIES BORN TO ADDICTED MOTHERS PATRICA M. MESSERLE LICENSED CLINICAL PSYCHOLOGIST, M.A., ABSNP LICENSED SCHOOL PSYCHOLOGIST DIPLOMATE OF THE AMERICAN BOARD OF SCHOOL- NEUROPSYCHOLOGY 1

2 Signs and Symptoms of Drug-Addicted Babies The signs and symptoms of a drug-addicted baby can vary individually Each infant is different as is each mother The symptoms a newborn baby experiences, as well as the duration, depend upon: the amount of narcotics a mother consumed how the baby breaks down the drug the specific drug the mother was using how long during the pregnancy the mother was taking the drug whether the baby was born full term how much the baby had remaining in the bloodstream at the time of birth.

3 NEONATAL ABSTINENCE SYNDROME, NAS When a woman is pregnant, almost everything she consumes passes into the baby's bloodstream. From caffeine to nicotine, artificial stimulants can make an impact on both the appearance and behavior of a newborn baby. For a mother who uses narcotics, this impact is even stronger, and can cause a condition in an infant known as neonatal abstinence syndrome (NAS), which is the official medical term for the issues a baby experiences while coming off of the drugs that have entered their tiny systems.

4 NARCOTIC DRUGS ASSOCIATED WITH NEONATAL ABSTINENCE SYNDROME HEROIN CODEINE OXYCODONE VICODIN METHADONE BUPRENORPHINE WHAT ABOUT ALCOHOL??????? 4

5 INFANT DRUG REACTIONS NAS causes the exact same reaction in an infant as a drug-using adult if they stop taking their narcotic of choice. However, with a very young and small baby, the effects can be much more traumatic and serious. One of the first signs and symptoms of a drugaddicted baby evident at birth is a low birth weight. Although many factors can cause this, if the mother is a known drug user, narcotics are almost always taken into consideration. What are some other causes low birth weight?

6 NAS Low birth weight babies can be of special concern not just because of their size and appearance, but because of their inability to ward off infection and common germs found in every hospital. The smaller the infant, the more susceptible he or she is to falling ill, especially when the body is already fighting off the effects of drugs.

7 AT BIRTH The baby continues to be addicted to the drug If they are no longer receiving the drug symptoms of withdrawal will occur Depending on prior use of the mother, the symptoms of withdrawal can be less noticeable to severe 7

8 WHAT DOES IT LOOK LIKE? It means that every day 2-3 days, drug addicted mothers give birth to a baby and of those births four babies will suffer the withdrawal symptoms of their mother's addiction What experience have you had with addicted mothers and their babies? What have you found helpful?

9 Symptoms of Withdrawal The symptoms associated with babies who a 9

10 WITHDRAWAL Blotchy skin coloring, mottling Diarrhea Excessive crying or high -pitched crying Fever Hyperactive reflexes Increased muscle tone Irritability Poor feeding 10

11 WITHDRAWAL Poor feeding Rapid breathing Seizures Sleep problems Slow weight gain Stuffy nose, sneezing Sweating Trembling (tremors) Vomiting 11

12 Exams and Tests It is important to note that other conditions may have similar symptoms Doctor should do an in depth interview with the mother about her drug use during pregnancy Also important to note how often, the modality and the exact drugs 12

13 BABY EXAM AND TESTS Important to do a differential evaluation because different drugs can produce similar symptoms. What drugs were taken, when and how much? It is also important to ask about how the drugs were taken, by mouth, intravenously, alone or shared with others. 13

14 TREATMENT TREATMENT DEPENDS ON: The drug/s involved The infant s overall health Was the baby born premature of full term? The care team will carefully watch the baby for signs of : withdrawal, feeding problems and weight gain. If baby is dehydrated or vomiting, they may need IV fluids. 14

15 OTHER RISKS TO WATCH SMALL head circumference Sudden Infant Death, SIDS, important that mother, father, caregiver are instructed on the care of the baby: feeding, sleep conditions and positions and soothing of the baby Attachment between mother/father and baby 15

16 CARE These babies often need specialized care in hospital (higher calorie diet, smaller portions at a time) before they are allowed home and on occasions are taken from their mothers and placed in foster care or with extended family It also means that in the future, these children may have difficulty learning, social emotional problems, possible language disabilities and possible attachment challenges

17 WHAT DOES THE BABY EXPERIENCE Drug-addicted babies can also be extremely irritable and fussy. They may frustrate easily, have a short temperament or be startled at the simplest sound. They often struggle with an irregular sleep pattern, and can be very hyperactive despite the lack of rest they manage to get. Due to these extreme personality traits in such a young baby, medical staffers and caretakers must have endless patience with these infants as the drug works its way out of the baby's system

18 If mother is addicted to depressants (alcohol, sedatives, hypnotics or heroin and uses before delivery, baby may need resuscitation and in other drug use, may need withdrawal medication. Very traumatic experience for the baby

19 OTHER WITHDRAWAL PROBLEMS WITHDRAWAL FROM HEROIN IS USUALLY WITHIN FORTY-EIGHT HOURS OF BIRTH, BUT CAN BE DELAYED WITH LONGER ACTING METHADONE ALCOHOL WITHDRAWAL IS A SIMILAR PROCESS, BUT MAY CAUSE FREQUENT OCCURENCES OF SEIZURE ACTIVITY COCAINE, A STIMULANT CONSTRICTS THE BLOOD VESSELS, THEREBY DECREASING THE OXYGEN DELIVERY TO THE INFANT, WITH POSSIBLE NEONATAL STROKES AND COCAINE INTOXICATION, MORE RELATED TO USE OF COCAINE CLOSE TO BIRTH

20 LONG TERM SYMPTOMS Later in life. A drug-addicted baby may also experience repercussions These include motor skill delays The inability to interact and socialize with peers properly. Many babies born addicted to drugs go on to struggle with behavior issues once they are schoolaged. Babies born to alcohol addicted mothers have the most lifelong problems, FAS

21 Consequences of Being Born Addicted The ability to sit still, focus and maintain personal boundaries are sometimes great feats for these individuals These problems are often resolved only with therapy, a modified educational plan and/or prescription medication Anecdotally, it is suspected that babies that have been born addicted are at a greater chance for using drugs as they become adolescents. Cannot prove it at this time because the number of babies born to addicted mothers has never been at this level before.

22 WHAT CAN BE DONE If you are a foster parent or relative of a drug-addicted baby, there are things you can do to try to comfort the infant as they come off of their narcotics addiction. Swaddling a baby tightly in a blanket can bring comfort and security to a little one. Reduce noise and light. This also helps prevent overstimulation, which can further aggravate the infant. Some caretakers also find it helpful to learn infant massage or practice a lot of rocking and soothing sounds with these babies. Also provide consistency and predictability for the child. If the baby remains in mother s care, make sure there is closer supervision and a non-substance user in the home to attach and comfort the baby.

23 OTHER SUPPORTS Overall, the best way to comfort and assist a drugaddicted baby is to get to know the signs and symptoms unique to that particular infant. From darting eyes to sudden limb movement, when you learn the signs your baby is about to go over the edge, you can begin to respond quickly and appropriately. Seek support from pediatrician, social services, family, childcare providers for both mother, father, siblings and baby.

24 BABIES BORN TO ADDICTED MOTHERS, BUT DO NOT SHOW NEGATIVE SIGNS THESE BABIES ALSO NEED HELP BECAUSE THE MOTHER/OR FATHER MAY NOT BE AVAILABLE TO CARE FOR THEM AND THE ATTACHMENT IS NOT SECURE SOME BABIES BORN TO MOTHER S ADDICTED TO COCAINE DO NOT SHOW SYMPTOMS RELATED TO THE DRUG, BUT ARE SEVERELY AFFECTED BY THE MOTHER S LACK OF NUTRITION AND FOOD INTAKE DURING THE PREGNANCY DUE TO LACK OF APPETITE FROM COCAINE USE.

25 RESOURCES NATIONAL INSTITUTE ON DRUG ABUSE, NIDA RECOVERY FIRST.ORG MENTAL HEALTH ADDICTION AND RECOVERY.ORG BENCKE M, SMITH VC, COMMITTE ON SUBSTANCE ABUSE, COMMITTEE ON FETUS AND NEWBORN, AMERICAN ACADEMY OF PEDIATRICS, PRENATAL SUBSTANCE ABUSE, SHORT AND LONG-TERM EFFECTS ON EXPOSED FETUS, MARCH 3013