Substance exposure can easily overwhelm hopeful adoptive parents and I get it. I remember when I was pregnant and being worried about eating lunch meat. LUNCH MEAT. There are also women who struggle with infertility and have spent years avoiding anything that might jeopardize a pregnancy. So it's common for there to be a lot of questions when hopeful adoptive parents are thinking about saying they'd consider an infant who was exposed to substances because it is a complete mindset shift.
Upon doing my own research, I found that substance exposure comes laced with big medical words and a bunch of mumble jumble that the typical person (i.e. ME) just gets lost in. In hopes to help others who find themselves confused by all of the terminology, here is your quick reference. Please be aware, if it's not clear already, that I am not an expert or a researcher or a medical professional. But let's get to it...
According to a national survey done in the United States in 2012, 5.9% of pregnant women use illicit drugs, 8.5% drink alcohol and 15.9% smoke cigarettes, resulting in over 380,000 babies exposed to illicit substances, over 550,000 exposed to alcohol and over one million exposed to tobacco in utero.
NICOTINE
At birth, exposed infants tend to be smaller in body weight, height, and head circumference, effects attributable to third and possibly second trimester exposure. Newborns exposed in utero to nicotine are more irritable and have poorer attention than unexposed infants, increased tremors and startle responses, and deficient speech processing as well. Within the first month of life, exposed infants show signs of poorer self-regulation and require more handling by caregivers. Newborns also demonstrate decreased response to auditory stimuli, an effect that can contribute to language and learning impairments later in life.
ALCOHOL
Alcohol consumption during pregnancy can result in a long-recognized fetal alcohol syndrome (FAS), which can distort limb and facial development, reduced birth weight, and cognitive delays. However, even moderate exposure can impact brain development and these effects persist at least into young adulthood. While FAS represents the most severe manifestation of heavy maternal alcohol consumption during pregnancy, the term ‘fetal alcohol spectrum disorders’ (FASDs) has been applied to characterize a broad range of deficits present in individuals with or without facial distortions. Thus, moderate alcohol exposure during fetal development produces significant neuro-behavioral consequences, and FASDs currently represent the leading cause of intellectual disabilities in North America, ahead of Down syndrome and cerebral palsy.
OPIATES
Opiates include, but are not limited to, heroin, fentanyl, and pain relievers available legally by prescription, such as oxycodone, hydrocodone (Vicodin), codeine, and morphine. Illicit opiate use has been steadily increasing in the past decade and a large part of this increase is in the 18–25 age bracket, which includes women of reproductive age. The probability of preeclampsia, premature labor and rupture of membranes, placental insufficiency, intrauterine growth reduction, and intrauterine death increases greatly with illicit opiate use during pregnancy. Even with a successful labor and delivery, newborns often have low birthweight and smaller head circumference as well as experience symptoms of opiate withdrawal. Some clinical studies have also suggested an increased prevalence of heart defects, emotional dysregulation, and different vision conditions in children exposed prenatally to opiates. At the pre- and elementary-school ages, these children show motor and cognitive impairments, inattention, hyperactivity, and an increase in ADHD when exposed prenatally to heroin.
MARIJUANA
Prenatal cannabis use has been linked with adverse effects for the growth of fetal and adolescent brains, reduced attention and executive functioning skills, poorer academic achievement and behavioral problems. However, the adverse effects of marijuana are frequently observed when other substances are being used and are greatest in heavy users.
METH
Meth has been linked to reduced fine motor performance at 1 year, with the poorest performance observed in the most heavily exposed children. However, by 3 years of age, no differences in fine motor performance were observed. These findings suggest meth exposure has modest motor effects in the first year of life, but that this may be mostly resolved by 3 years of age. There was also a study that found that prenatal meth exposure was associated with behavioral problems at 5 years and psychological symptoms experienced by primary caregivers indicating these effected children may have more difficulties with the academic and social demands of school-age children.
COCAINE
Clinical reports of the impact of prenatal cocaine have been varied; some suggest severe physical malformations, others document specific deficits in physical, cognitive, and emotional development, and yet other studies indicate no effects. It is important to note that the magnitude of these effects depend upon the dosage, gestational timing, duration of exposure, and/or postnatal care. Nevertheless, well-controlled studies have demonstrated that prenatal cocaine exposure does in fact affect fetal physical growth and results in an increase of premature birth—including decreased birth weight, shorter body length, and smaller head circumference.
Long-term studies have reported that prenatal cocaine is associated with impaired language development through early adolescence. However, some studies suggest a general improvement in receptive language starting in adolescence through age 17. Overall, fetal cocaine exposure can affect fetal and long-term growth patterns, as well as cause language deficits, behavior defects, and executive functioning abnormalities.
To summarize, here's a table that makes it so simple:
With all of this said, lets be sure that we account for God in the midst of substance exposure. Although it can illicit fear when we read through what could happen to a newborn who has been exposed to substances, we must remember God's sovereignty over all of it. He is the ultimate healer, protector, and peace giver. I have personally seen God's protection and felt His peace while caring for babies who has been exposed and I can confidently say that He is faithful despite the effects my precious children have endured.
+ If you are interested in learning more about adoption and the services we provide at Christian Adoption Consultants, I would love to chat! Feel free to email me at meg@christianadoptionconsultant.com. +
Resources:
www.ncbi.nlm.nih.gov/pmc/articles/PMC4870985/
www.ncbi.nlm.nih.gov/pmc/articles/PMC4262892/
www.marchofdimes.org/materials/NAS-Issue-Brief-February-2015.pdf
ncsacw.samhsa.gov/resources/substance-exposed-infants.aspx
pediatrics.aappublications.org/content/pediatrics/131/3/e1009.full.pdf
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