The drug-exposed mother and infant: a regional center experience

Drug-exposed mothers and infants continue to challenge maternal and infant health care resources. The woman who abuses drugs may have a complex social history and high resistance to change. Drug use may be intergenerational and long-standing. Although cocaine may be a drug of choice, there is often polydrug abuse, complicating the assessment of the newborn who may be suffering from an overall unstable intrauterine environment due to poor general health and lack of nutrition, inadequate prenatal care, and risk of exposure to contaminants from street drugs and of infection, including Hepatitis B and HIV. Infants must be thoroughly assessed and treated as any newborn at risk. Drug screening and child welfare issues are discussed. Hepatitis B immunization is recommended. Ongoing assessment of the infant and intervention techniques are described. Since many drug-exposed infants go home with their mothers, an integrated plan of care for mother and infant may contribute to a therapeutic relationship, facilitate maternal attachment behaviors, and motivate maternal rehabilitation. For nurses caring for these demanding families, burnout prevention and self-care strategies are discussed.