Infants of Substance Abusing Mothers

Substance abuse by pregnant women may involve drug, chemical, alcohol, or smoking use. Drug abuse includes both street drugs and prescription medications.

The developing fetus develops from the nourishment that comes from the mother through the placenta. Along with nutrients, toxins in the mother's system may be delivered to the fetus. These toxins often cause damage to the fetal organs.

Many kinds of substances can do damage to the unborn child including:

  • Alcohol.

  • Tobacco.

  • Many prescription drugs.

  • Illegal street drugs.

Substances can be introduced into the body in different ways. They can be:

  • Smoked.

  • Inhaled.

  • Attached as a skin patch.

  • Swallowed.

  • Injected.

All can be toxic to the unborn child.


Many women use drugs and alcohol for recreation before they know they are pregnant. Others continue to abuse drugs while pregnant. In many cases drug abuse leads to the poor health and nutrition of the mother. Poor nutrition in the mother means poor nutrition for the baby. Often, the negative effects of drugs also make for a poor maternal life-style leading to little or no prenatal care, untreated infections in the uterus, and sexually transmitted diseases such as HIV/AIDS.


Problems can develop for the mother and baby even before birth. Substance-using mothers have a much higher chance of miscarriage, death of the baby before birth, preterm labor/premature birth, and infection.

Babies born to substance abusing mothers may suffer from short-term or long-term problems. Short-term symptoms after birth include:

  • Mild fussiness.

  • Irritability.

  • Poor feeding.

  • Jitteriness.

  • Restlessness.

  • Poor sleep.

  • Trembling (even when kept warm).

  • Diarrhea.

  • Poor response to sound and light stimuli.

  • Poor interaction with the mother.

Long-term problems may be seen in babies who are born with growth retardation (seen with cocaine abuse) or problems with internal organs. Infants born to mothers who drink alcohol, even in modest amounts, may be born with the fetal alcohol syndrome. Traits of this syndrome include: growth retardation, unusual facial features, and mental retardation. Other drugs may cause problems with the heart, brain, intestines, or kidneys. The effect on the brain can lead to learning disabilities, retardation, or seizures.


If caregivers are able to get a good history from the mother about the substance abuse, they will be able to anticipate what to do for the new born. New borns can be given drug tests which may sample blood, urine, stool and hair samples to find out if they have drugs in their system.


Depending on the drugs used by the mother, treating babies withdrawal symptoms varies. Treatment can include limiting stimulation to using sedatives that can then be carefully removed from the new born's system over days or weeks to lessen the impact of withdrawal. Infants with birth defects or long-term issues affecting different organs may require medical or surgical treatment and long-term assistance.


Follow normal newborn care for bathing, feeding, dressing, immunizations, and follow-up care. Your caregiver will provide instructions (if any) regarding specific home care associated with drugs used during pregnancy.


  • Feeding is poor, and the baby appears to be not taking or not holding down formula or breast milk.

  • A diaper remains completely dry for most of the day.

  • The baby seems to be wetting and/or soiling an excessive number of diapers.


  • There are seizures or the baby seems to shake in an uncontrollable fashion.

  • There appears to be problems with breathing.

  • The baby cannot be awakened.

  • The lips and/or skin appear blue despite the baby being kept warm.


  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.