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How to treat babies who suffer from addiction

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Jade Brookbank / Getty Images

The question of how best to help babies who have been exposed to drugs in the womb - including prescription pain medications, antidepressants and illicit drugs like methamphetamine and cocaine - can be an emotionally charged issue. Bringing science to bear on the issue, the American Academy of Pediatrics has just updated its guidelines on treating these infants.

The number of babies experiencing drug-related symptoms after birth has risen by 45% since 1995, according to data compiled by the Agency for Healthcare Research and Quality. The rise may be attributed in part to increased maternal drug misuse and addiction, as well as to greater legitimate use of medication to treat pain and depression. Further, more careful surveillance for symptoms associated with maternal drug use have turned up more affected babies.

About 1% of pregnant women report recreational use of opioid painkillers like Oxycontin, according to the National Household Survey on Drug Use and Health, a number that has stayed constant since 2003. The new treatment guidelines, appearing on Monday in the journal Pediatrics, recommend that pregnant women addicted to prescription pain relievers or heroin should be maintained on either methadone or buprenorphine (Suboxone, Subutex). These recommendations are in line with prior consensus documents from the National Institutes on Health and World Health Organization.
MORE: The 'Oxycontin Baby' Scare
The authors state that the alternative to maintenance - active or passive detoxification - is "associated with increased risk of fetal distress and fetal loss." However, 55% to 94% of babies prenatally exposed to opioids (that includes the maintenance drugs methadone and buprenorphine) will experience at least some withdrawal symptoms after birth. For mild withdrawal, the authors recommend simply providing a calm, nurturing environment to maximize infant sleep. In severe cases, the guidelines recommend that doctors provide tapered doses of methadone or morphine to the infant to minimize distress.

Breastfeeding may also help these babies: mothers maintained on methadone or buprenorphine will pass on small doses of the drug to their child, which can help reduce withdrawal. The child can be weaned from the drug entirely as he or she is weaned from the breast, or as the mother lowers her dose. The guidelines suggest encouraging breastfeeding unless there are other reasons to avoid it.

Although there is not much research on the question, the studies that do exist do not link the severity of withdrawal symptoms in these infants with later developmental problems.

The new guidelines also address the use of antidepressants in pregnancy, which can cause problems for some infants, especially when they are taken in the third trimester. This class of drugs, which includes Prozac, Zoloft and Paxil - the selective serotonin reuptake inhibitors - increases levels of the neurotransmitter serotonin in the brain.

The authors report that some exposed infants experience frequent crying, irritability, sleep disturbances and seizures, but the problem usually resolves itself within two weeks. The authors also note that the evidence does not suggest long-term harm from maternal use of antidepressants during pregnancy. They write:

Several recent reviews have not identified adverse neurodevelopmental outcomes among infants born to women treated with SSRI's during pregnancy. SSRI treatment should be continued at the lowest effective dose because withdrawal of medication may have harmful effects on the mother infant [bond].

The problems experienced by babies exposed to antidepressants in utero may not be caused by drug withdrawal at all, since the babies' symptoms are more consistent with exposure to too much serotonin, not too little, as would be expected if withdrawal from antidepressants were the culprit.
MORE: Why Comparing Painkillers to Crack Doesn't Help Exposed Infants
As for cocaine and other stimulants like methamphetamine, the authors report that exposure to such drugs does not produce a "clearly defined" withdrawal syndrome in babies. (In some studies, observers failed to detect specific problems in babies, unless they were specifically told the babies had been exposed to cocaine.) While some studies have found subtle differences in behavior in cocaine-exposed children, these are comparable in scale to those seen in babies born to women who smoked cigarettes while pregnant.

The new guidelines note that state laws vary on whether mothers or babies can be tested for drugs without consent. Although physicians are advised to "avoid discriminatory practices," the new recommendations fail to address how drug-testing mothers to determine whether a baby is experiencing withdrawal may lead to unintended negative consequences for both parties.

In some states, infants can be taken from their mothers after a positive drug test, even in the absence of evidence of child abuse. This, despite data showing that mother-infant bonding has a far greater effect on child outcomes than drug exposure. Overwhelmingly, the women who are tested for drug use involuntarily and who lose custody due to the results are poor or minorities.

Moreover, there's no evidence that putting these children in foster care improves outcomes. Indeed, studies of children in "borderline" cases, in which investigators were unsure whether or not to remove them, find that those who end up staying with their parents have far better long-term outcomes than those who are removed.

This month, 50 medical and public policy organizations and child welfare experts filed an Amicus Curiae brief in the state of New Jersey, siding with a mother who was accused of child abuse solely on the grounds of a positive cocaine test when she gave birth. They note that such testing policies typically backfire because they deter drug-using women from seeking prenatal care, which is the most effective way of reducing drug-related harm to their infants

As the American College of Obstetrics and Gynecology (a party to the Amicus brief) put it in a policy statement on its website: "Seeking obstetric-gynecologic care should not expose a woman to criminal or civil penalties, such as incarceration, involuntary commitment, loss of custody of her children, or loss of housing."
MORE: The Perils of 'Metabolic Chauvinism'
Indeed, research on children exposed to crack during pregnancy has found that the kids who do best later in life are not those whose mothers took the least cocaine during pregnancy. Instead, it is those whose mothers refrain from drug use during their babies' early childhood. Both mothers and children do better when they receive supportive, nonjudgmental access to addiction treatment and other health care - not when they are unduly stigmatized because of drug use.

Indeed, the stigma associated with labeling infants as "drug addicted" (a term that is inaccurate, since babies are not capable of continuing to use drugs despite negative consequences - a condition that is required to meet the medical definition of addiction) can often produce greater harm than the drugs themselves. Giving a child the label "crack baby," for example, has been shown to lead even trained adults to view that child's normal behavior as pathological.

Moreover, the drug that consistently causes the most permanent and irreversible damage in utero is alcohol - and yet no one takes babies away from their parents for a positive breathalyzer test at birth. Nonetheless, fetal alcohol spectrum disorder remains the leading known preventable cause of intellectual disability, affecting 1% of all babies, about one-third of them severely.

Maia Szalavitz is a health writer for TIME.com. Find her on Twitter at . You can also continue the discussion on TIME Healthland 's Facebook page and on Twitter at @TIMEHealthland.

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Updated Guidelines for Treating Babies Exposed to Drugs in the Womb

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The question of how best to help babies who have been exposed to drugs in the womb - including prescription pain medications, antidepressants and illicit drugs like methamphetamine and cocaine - can be an emotionally charged issue. Bringing science to bear on the issue, the American Academy of Pediatrics has just updated its guidelines on treating these infants.

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Using street drugs can cause problems for you before and during pregnancy, including:

Not being able to get pregnant. This is called infertility.

Problems with the placenta. The placenta grows in your uterus and supplies your baby with food and oxygen through the umbilical cord.

Preterm labor. This is labor that happens before 37 weeks of pregnancy.

Miscarriage. This is when a baby dies in the womb before 20 weeks of pregnancy.

Stillbirth. This is when a baby dies in the womb after 20 weeks of pregnancy.

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Babies born to moms who use drugs often have problems later in life, including:

Learning and behavior problems

Slower-than-normal growth

Sudden infant death syndrome (also called SIDS). This is the unexplained death of a child while sleeping.

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Babies suffer from mothers being addicted 

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Babies suffer from mothers being addicted 

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Addicted At Birth: The Babies Hooked On Heroin | Special Report | Sky News

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The number of babies born addicted to drugs in the United States has quadrupled in the last decade, new figures reveal. Every half an hour a baby is born craving the drug its mother was addicted to, according to a report published in the New England Journal of Medicine.

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When you are pregnant, it is important that you watch what you put into your body. Consumption of illegal drugs is not safe for the unborn baby or for the mother.

Studies have shown that consumption of illegal drugs during pregnancy can result in miscarriage, low birth weight, premature labor, placental abruption, fetal death, and even maternal death.
The following information can help you understand these drugs and their effects:
Marijuana

Common slang names: pot, weed, grass and reefer

What happens when a pregnant woman smokes marijuana? Marijuana crosses the placenta to your baby. Marijuana, like cigarette smoke, contains toxins that keep your baby from getting the proper supply of oxygen that he or she needs to grow.

How can marijuana affect the baby? Studies of marijuana in pregnancy are inconclusive, because many women who smoke marijuana also use tobacco and alcohol. Smoking marijuana increases the levels of carbon monoxide and carbon dioxide in the blood, which reduces the oxygen supply to the baby. Smoking marijuana during pregnancy can increase the chance of miscarriage, low birth weight, premature births, developmental delays, and behavioral and learning problems.

What if I smoked marijuana before I knew I was pregnant? According to Dr. Richard S. Abram, author of Will it Hurt the Baby, "occasional use of marijuana during the first trimester is unlikely to cause birth defects." Once you are aware you are pregnant, you should stop smoking. Doing this will decrease the chance of harming your baby.

Cocaine

Common slang names: bump, toot, C, coke, crack, flake, snow, and candy

What happens when a pregnant woman consumes cocaine? Cocaine crosses the placenta and enters your baby's circulation. The elimination of cocaine is slower in a fetus than in an adult. This means that cocaine remains in the baby's body much longer than it does in your body.

How can cocaine affect my baby? According to the Organization of Teratology Information Services (OTIS), during the early months of pregnancy cocaine exposure may increase the risk of miscarriage. Later in pregnancy, cocaine use can cause placental abruption, which can lead to severe bleeding, preterm birth, and fetal death. OTIS also states that the risk of birth defects appears to be greater when the mother has used cocaine frequently during pregnancy. According to the American Congress of Obstetricians and Gynecology (ACOG), women who use cocaine during their pregnancy have a 25 % increased chance of premature labor. Babies born to mothers who use cocaine throughout their pregnancy may also have a smaller head and be growth restricted. Babies who are exposed to cocaine later in pregnancy may be born dependent and suffer from withdrawal symptoms such as tremors, sleeplessness, muscle spasms, and feeding difficulties. Some experts believe that learning difficulties may result as the child gets older. Defects of the genitals, kidneys, and brain are also possible.

What if I consumed cocaine before I knew I was pregnant? There have not been any conclusive studies done on single doses of cocaine during pregnancy. Birth defects and other side effects are usually a result of prolonged use, but because studies are inconclusive, it is best to avoid cocaine altogether. Cocaine is a very addictive drug and experimentation often leads to abuse of the drug.

Heroin

Common slang names: horse, smack, junk, and H-stuff

What happens when a pregnant woman uses heroin? Heroin is a very addictive drug that crosses the placenta to the baby. Because this drug is so addictive, the unborn baby can become dependent on the drug.

How can heroin affect my baby? Using heroin during pregnancy increases the chance of premature birth, low birth weight, breathing difficulties, low blood sugar (hypoglycemia), bleeding within the brain (intracranial hemorrhage), and infant death. Babies can also be born addicted to heroin and can suffer from withdrawal symptoms. Withdrawal symptoms include irritability, convulsions, diarrhea, fever, sleep abnormalities, and joint stiffness. Mothers who inject narcotics are more susceptible to HIV, which can be passed to their unborn children.

What if I am addicted to heroin and I am pregnant? Treating an addiction to heroin can be complicated, especially when you are pregnant. Your healthcare provider may prescribe methadone as a form of treatment. It is best that you communicate with your healthcare provider so he or she can provide the best treatment for you and your baby.

PCP & LSD

What happens when a pregnant woman takes PCP and LSD? PCP and LSD are hallucinogens. Both PCP and LSD users can behave violently, which may harm the baby if the mother hurts herself.

How can PCP and LSD affect my baby? PCP use during pregnancy can lead to low birth weight, poor muscle control, brain damage, and withdrawal syndrome if used frequently. Withdrawal symptoms include lethargy, alternating with tremors. LSD can lead to birth defects if used frequently.

What if I experimented with LSD or PCP before I knew I was pregnant? No conclusive studies have been done on one-time use effects of these drugs on the fetus. It is best not to experiment if you are trying to get pregnant or think you might be pregnant.

Methamphetamine

Common slang names: meth, speed, crystal, glass, and crank

What happens when a pregnant woman takes methamphetamine? Methamphetamine is chemically related to amphetamine, which causes the heart rate of the mother and baby to increase.

How can methamphetamine affect my baby: Taking methamphetamine during pregnancy can result in problems similar to those seen with the use of cocaine in pregnancy. The use of speed can cause the baby to get less oxygen, which can lead to low birth weight. Methamphetamine can also increase the likelihood of premature labor, miscarriage, and placental abruption. Babies can be born addicted to methamphetamine and suffer withdrawal symptoms that include tremors, sleeplessness, muscle spasms, and feeding difficulties. Some experts believe that learning difficulties may result as the child gets older.

What if I experimented with methamphetamine before I knew I was pregnant? There have not been any significant studies done on the effect of one-time use of methamphetamine during pregnancy. It is best not to experiment if you are trying to get pregnant or think you might be pregnant.

What does the law say?

Currently, Tennessee is the only state that holds prenatal substance abuse as a criminal act of child abuse and neglect. That does not always stop prosecutors from trying to charge mothers with endangerment or neglect. Women are typically offered a choice between serving time in jail or joining a rehab program.

Many states have expanded their civil child-welfare requirements to include substance abuse during pregnancy as grounds for terminating parental rights in relation to child abuse and neglect.
The laws that address prenatal substance abuse are as follows:

Iowa, Kentucky, Louisiana, Minnesota, North Dakota, and Rhode Island's healthcare providers are required to test for and report prenatal drug exposure. Indiana health care providers are only required to test.

Alaska, Arizona, Arkansas, California, District of Columbia, Illinois, Maine, Maryland, Massachusetts, Michigan, Montana, Nevada, Ohio, Oklahoma, Pennsylvania, Utah, Virginia, and Wisconsin's health care providers are required to report prenatal drug exposure. Reporting and testing can be evidence used in child welfare proceedings.

Some states consider prenatal substance abuse as part of their child welfare laws. Therefore, prenatal drug exposure can provide grounds for terminating parental rights because of child abuse or neglect. These states include Alabama, Arizona, Arkansas, Colorado, District of Columbia, Florida, Illinois, Indiana, Iowa, Louisiana, Maryland, Minnesota, Missouri, Nevada, North Dakota, Ohio, Oklahoma, Rhode Island, South Carolina, South Dakota, Texas, Utah, Virginia, Washington, and Wisconsin.

Indiana's laws only allow a healthcare provider to release drug use information with the woman's consent.

Missouri's laws state that testing positive for drugs within 8 hours post delivery AND she has either a previous child abuse/neglect conviction or if she did not complete a recommended substance abuse treatment program, constitutes unfitness as a parent.

Some states have policies that enforce admission to an inpatient treatment program for pregnant women who use drugs. These states include Minnesota, South Dakota, and Wisconsin.

In 2014, Tennessee made drug use during pregnancy a criminal offense.

How can I get help?

You can get help from counseling, support groups, and treatment programs. Popular groups include the 12 step program.
Numbers that can help you locate a treatment center include:

National Drug Help Hotline 1-800-662-4357

National Alcohol and Drug Dependence Hopeline 1-800-622-2255

Last updated: February 1, 2018 at 17:56 pm
Compiled using information from the following sources:
Organization of Teratology Information Services, http://otispregnancy.org/ Motherisk.org, http://www.motherisk.org/ American Council for Drug's Education, http://www.acde.org/ March of Dimes, http://www.marchofdimes.com/ The Alan Guttmacher Institute, http://www.guttmacher.org/

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When you are pregnant, it is important that you watch what you put into your body. Consumption of illegal drugs is not safe for the unborn baby or for the mother. Studies have shown that consumption of illegal drugs during pregnancy can result in miscarriage, low birth weight, premature labor, placental abruption, fetal death, and even maternal death.

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In January 2013, a little girl named Isabella Hope was born in Pensacola, Florida. Hope was born six weeks premature and delivered by caesarean section. She spent 23 days in the Neonatal Intensive Care Unit at a hospital in Florida, and her survival was nothing short of a miracle.

Hope's birth mother was only eight weeks pregnant when she suffered a severe poly-substance drug overdose that nearly killed her. The doctors who treated her said that her body was deprived of oxygen for approximately four hours. The overdose combined with the lack of oxygen left Hope's mother brain damaged and she was put on life support at a local hospital.

But immediately after the mother's tragic incident, doctors said there was no way her baby would survive and suggested that she be taken off life support. Thankfully, the maternal grandmother was against this proposition and said that her daughter would want her child to have a chance.

After Hope was born, the mother's family needed help with caring for both Hope and her mother. This is when a woman named Angie Odom came into the picture. Angie worked as the Founder and Director of the TLC Community Center in Elizabethton, Tennessee, and knew Hope's birth mother through an abstinence only program she taught at a girl's group home. At first, the mother was very involved and even developed a friendship with Angie. The Center helped her through her first pregnancy and after her son was born, they stay involved in her life.

However, after some time passed, Hope's mother stopped coming to the program and eventually lost contact with Angie. Angie didn't hear about Hope's birth and her mother's condition until she was contacted by the birth family.

Angie told LifeNews:

"It was due to our previous contact with Hope's birth mother that her family turned to us for assistance, not only with Hope but with her birth mother as well. In February 2013, Hope's maternal grandmother came to our Center and shared with me the story of her daughter and granddaughter and our Center began helping the family in every way we could.

After Hope was born, her birth mother was transferred to a skilled nursing home facility to be cared for. While the nursing facility was in Tennessee, it was more than 3 hours away from the family. I went to the nursing facility to see this young woman I had come to know over the years and I was appalled at what I found. The conditions in which Hope's birth mothers were living in were deplorable. Something had to be done. I began contacting nursing facilities around Elizabethton trying to get her transferred closer to her family. I was turned down by nine different skilled nursing facilities. Desperate, I contacted Congressman Phil Roe who assisted us in getting her transferred to a medical rehabilitation facility for a full evaluation of her status. Our local emergency medical service- The Carter County Rescue Squad- assisted us by making the seven hour round trip transport for her evaluations.

Following several evaluations over the course of three weeks, doctors determined that she is in a persistent vegetative state. Not only was she brain damaged as a result of the overdose but also her brain stem was also severely damaged. It was also determined that she was blind. The doctors told me that developmentally an infant has more function than she does.

It was during this time that the Department of Children's Services (DCS) became involved and Hope was removed from the custody of the grandmother. They wanted to place her with other family members but no one could pass the background check. Then the grandmother asked the DCS worker if they would place Hope in our care. The grandmother couldn't care for her and asked Earl and I to raise and adopt Hope. We agreed, and our beautiful, healthy little girl has impacted so many lives with her story of survival.

Now Angie and her husband visit Hope's mother regularly and assist with her care. Hope is almost two years old and is in very good health. This is truly miraculous -not only because of her mother's overdose- but because of all the health complications she had afterward.
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Angie concluded, "Despite infections, placenta issues, distress in the womb, her mother going through drug withdrawal, and all of the medications which were being used to treat her mother, Hope continued to fight and grow in the womb."

As sad as Hope's mother's overdose was, her daughter's survival is a testament to how hope can be born out of tragedy.

At the end of September the Odom family has a book coming out called "And Then There Was Hope." To find out more information contact angiedodom@yahoo.com.

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her mother overdosed on drugs 8 weeks into the pregnancy

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Her Mother Overdosed on Drugs 8 Weeks Into the Pregnancy, But She Survived

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In January 2013, a little girl named Isabella Hope was born in Pensacola, Florida. Hope was born six weeks premature and delivered by caesarean section. She spent 23 days in the Neonatal Intensive Care Unit at a hospital in Florida, and her survival was nothing short of a miracle.

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Studies show that using drugs -- legal or illegal -- during pregnancy has a direct impact on the fetus. If you smoke, drink alcohol, or ingest caffeine, so does the fetus. If you use marijuana or crystal meth, your fetus also feels the impact of these dangerous drugs. And if you are addicted to cocaine -- also called coke, snow, or blow -- you're not only putting your own life on the line, but you are risking the health of your unborn baby.. The consequences of using cocaine include heart attacks, respiratory failure, strokes, and seizures. And these life-threatening health problems can also be passed to an unborn baby.