Substance abuse is bad enough for a ‘normal’ individual, much more a pregnant woman. After all, it can increase her risk of developing infections, liver problems, and sexually transmitted diseases.

Since the alcohol or drugs in the mother’s bloodstream can reach the baby through the placenta, the infant may be born with withdrawal symptoms.
How Substance Abuse Affects the Baby
Unfortunately, about 5% of pregnant women use one or more addictive substances. That being said, the effects on the baby greatly vary according to the substance used.
1. Alcohol
There is no safe amount of alcohol that can be taken during pregnancy. Despite this warning, some women opt to continue drinking whilst they are pregnant. Sadly, this often results in stillbirth or miscarriages.

In worse cases, this could lead to the baby developing a wide range of disabilities known as Fetal Alcohol Spectrum Disorders (FASD). Symptoms include:
- A smooth ridge between the upper lip and nose (philtrum)
- Small head size
- Shorter height
- Low body weight
- Incoordination
- Sleep and sucking problems
- Heart, bone, or kidney problems
As the baby grows up, he/she may develop any of the following:
- Incoordination
- Attention deficits
- Poor memory
- Low IQ
- Learning difficulties, especially in math
- Poor judgment and reasoning skills
- Language and speech delays
- Vision and/or hearing problems
2. Cocaine
It is said that about 750,000 pregnancies are influenced by cocaine use/abuse. As for the mother, this could lead to migraines and seizures. Since many heart and circulatory changes that occur during pregnancy, she can also develop high blood pressure, miscarriage, rupture of membranes, and preterm labor. Topping these off is a high possibility of a complicated delivery.

These ‘crack babies’ are often premature, with smaller heads and low birth weights. They often develop behavior problems, apart from difficulties sustaining attention and processing information. They can also suffer from language and memory problems as they grow old.
3. Meth
Methamphetamine and dextromethamphetamine can lead to premature deliveries. It can also lead to placental abruption, where the placenta prematurely separates from the womb.

Babies born to meth mothers are often small and lethargic. Add to that, they may suffer from brain and heart problems as well. When meth babies grow old, they may develop attention deficit, cognitive issues, behavioral problems, and motor development problems.
4. Opiates
According to the Centers for Disease Control, opiates are used by about 7% of pregnant women. Unfortunately, 1 in every 5 women admits to misusing opioids. Sadly, this pattern has been linked to a higher risk of maternal death.

As for babies, opiates and similar drugs such as heroin and methadone can lead to poor growth in the womb. It could also cause preterm birth, stillbirth, and a variety of birth defects.
These drugs can lead to babies being born in a state of withdrawal. They’re not addicted to drugs per se. However, they experience similar discomforts to that of an adult withdrawing from addiction – that of Neonatal Abstinence Syndrome.
What is Neonatal Abstinence Syndrome?
Neonatal abstinence syndrome (NAS) is a condition affecting babies of alcohol or drug-addicted mothers. According to the National Institute on Drug Abuse, it affects 1 in 1,000 babies.
Since the substance passes from the mother to the baby, the infant is born with drugs in his/her system. The delivery cuts off the source, so the newborn develops withdrawal symptoms.

Apart from NAS, an opioid-specific condition may occur in babies born to addicted mothers. This is neonatal opioid withdrawal syndrome, which takes place within the first 28 days of the infant’s life.
Causes
NAS often follows maternal use of opioids. These include include morphine, oxycodone, codeine, buprenorphine, methadone, even heroin.
It can also occur in babies of mothers who abuse cocaine, meth, marijuana, alcohol, nicotine, benzodiazepines, barbiturates, and some anti-depressants (SSRIs).
Symptoms
NAS symptoms can take place within 24 hours to a week after birth. They can last anywhere from 1 week to 6 months:
- Seizures
- Fever
- Increased sweating
- Irritability (High-pitched and excessive crying)
- Yawning or sneezing
- Vomiting
- Breathing problems
- Poor feeding
- Diarrhea
- Tremors
- Pronounced reflexes
The severity depends on the abused substance and the last time of use. Other confounding factors include the baby’s age of gestation (preterm or full-term) and his/her exposure to other substances. These may include tobacco, alcohol, or other medications.
Apart from withdrawal symptoms, babies with NAS may grow up with speech/language impairments and developmental delays.
Treatment
As NAS babies are very irritable, swaddling or snuggling can help soothe the baby. It also helps to reduce stimuli, such as that of lights or noise.
Vomiting and diarrhea can lead to dehydration. As such, the baby will be given IV fluids to replenish the lost fluids and electrolytes.
When seizures occur, drugs are used to treat the withdrawal symptoms. According to a study, roughly 50% to 70% of NAS babies require such medications. The prescribed drugs include Methadone for babies of heroin/opiate-addicted mothers. Benzodiazepine, on the other hand, is for infants of alcoholic mothers.
Prevention
Preventing NAS is possible. It’s all about avoiding alcohol, opiates, and other illegal drugs. However, this is easier said than done.
Although this is the case, pregnant women can be weaned from their addictions safely. Although there are no FDA-approved medications for this population, there are treatment systems in place.
Buprenorphine or methadone are given to heroin-addicted mothers for maintenance. They also undergo a comprehensive drug treatment program and good prenatal care.
As for alcoholic mothers, medication-assisted treatment and good prenatal care are key. Apart from these, they also undergo individual counseling and group therapy.
Conclusion
Babies born to addicted mothers can be born with neonatal abstinence syndrome. This includes withdrawal symptoms such as tremors, irritability, vomiting, and diarrhea, to name a few. These can be managed with IV fluids, medications, and a ‘soothing’ approach to caring.
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