Let’s get serious for a minute
Let’s talk about a serious but not uncommon health issue affecting many pregnant mothers: substance abuse.
First, remember that you are not alone. Substance abuse can be the abuse or misuse of legal and illegal substances, but many of these substances can cause health concerns for mom and baby because they pass easily through the placenta.
The most common substances we see are alcohol, tobacco, stimulants (cocaine and prescription ADHD medications), marijuana and opioids (prescription pain medications, heroin, Methadone/ buprenorphine). We are also seeing an increase in the use of over-the-counter dietary and herbal supplements like Tianaa and Za Za that can cause severe symptoms in baby after delivery.
Regular use of any of these substances can cause concerns in the growing fetus such as delayed brain and body growth, premature birth and birth defects, as well as motor and cognitive deficits. Use of any of these substances can also significantly increase the risk of stillbirth. Following delivery, infants exposed to these substances in the womb can display signs of withdrawal that prolongs their hospital stay. These symptoms may include:
- Diarrhea, vomiting and increased weight loss
- Abnormal sucking and poor feeding
- Hyperactive reflexes and increased muscle tone
- Rapid breathing
- Stuffy nose and sneezing
- Sleep problems
These symptoms tend to be most severe and pronounced in infants born to mothers who use opioids during pregnancy. At Madison Hospital and Huntsville Hospital for Women & Children, infants exposed to opioids are required to stay in the hospital for five days following delivery to ensure their symptoms are manageable – and to help mom learn comforting techniques to help care for her newborn. The infant will room-in with the mother for up to five days. Meanwhile, our staff provides education on what we are looking for and also how to help console the baby.
The staff is primarily looking to see if the baby can eat, sleep and be consoled. If so, baby will stay with mom and continue monitoring and educating. If the baby cannot eat, sleep or be consoled, the staff, along with the parents will evaluate what other measures can be taken to help the baby. If all techniques are exhausted and baby is still struggling, the physician will be consulted to determine if medication treatment is needed for baby. Throughout this process, the care team and family will be in constant communication.
Breastfeeding may be possible depending on the substance used. The lactation team, along with the other members of the hospital care team, can help determine if breastfeeding is a safe option for you. The team will weigh the risk and benefit and help you make an informed decision.
If you use any of the substances mentioned in this blog and are pregnant or planning to become pregnant, the most important thing you can do is talk to your health care provider. Many of these substances can be controlled to lower the risk to mom and baby, but an abrupt discontinuation of some drugs can be harmful. Your provider can assist you in a treatment plan that is right for you.
Many treatment plans include medication modification as well as behavior management. There are several great resources in our community for any mother struggling with addiction or substance abuse.
Renee Colquitt, CRNP, NNP-BC
Director of Perinatal Services at Madison Hospital