Ask Dr. Mommy Archive — March 2008

A Pediatrician's Q&A About Angels Foster Babies

Click here to submit a question to Dr. Mommy

This is the first in a series of monthly columns. Each month, Dr. Mommy will answer your questions about the health and wellness of our children. In this first issue she will explore questions and concerns surrounding drug exposed infants and toddlers.

Dr. Mommy is better known as Rachel Zahn, MD, a pediatrician and local mom of three kids, ages 20, 18, and 14. All three were born during her medical training, earning her the title. Rachel is also one of our newest Angels Board members. She attended our annual luncheon last year and says “I was so impressed with the organization, and so moved by the kids and their stories that I had to offer to help. The more I learn about Angels, the more passionate I become about our goals.”

Dear Dr. Mommy,
Two days ago our family welcomed an adorable 3 week old little boy who, we understand, tested positive for illegal drugs at birth. We aren’t sure which drugs are involved, or in what amounts. He is the cutest little guy, and seems normal, but we’re worried. What should we expect?

Dear Worried:
First, let me encourage you to worry a bit less. The myths and stories surrounding drug-exposed newborns are far scarier than the reality. With a little extra information and care it’s more than likely that your family can provide all that this little guy needs, and more.

You say that you aren’t sure which drugs the baby was exposed to. The two most common categories are stimulants, which include methamphetamine, cocaine, and crack, and narcotics such as heroin and methadone. A third major category of exposure is alcohol, which we will put aside for the moment because its effects (possible fetal alcohol syndrome) are more complicated.

Infants who are born to moms using major narcotics may be at risk of withdrawal symptoms. If so, these will begin within 3 days after delivery and are often managed in the hospital. Since your little guy is 3 weeks old, chances are that either there was no significant narcotic exposure or any symptoms have largely resolved. In either case, the prognosis is good. Though there are never guarantees, any remaining effects should be mild and manageable with the techniques I will describe. Exposure to stimulant drugs can result in symptoms that are typically less severe, though similar, and may last weeks or months. Research has NOT shown long-term damage as exposed babies grow into childhood.

Some short-term symptoms you may see include:

Irritability: a lower tolerance to noise, light, and even touch. The baby may become fretful when he is in the midst of lots of people, loud music, bright lights or colors. He may be more sensitive than other babies, and need a quieter environment.

Changes in muscle tone: more tense or more lax. You may sense that the baby is more jittery or on edge, or a bit more floppy. He may take longer to calm when upset.

Difficulties with feeding and/or sleeping: He may need to eat more often and require a quiet environment while feeding. If he is sensitive to noise and sensation, he may need to be held snugly so that he can calm down and suck effectively. He may wake more frequently during the night, though you can expect any newborn to need you about every three hours for a feeding and cuddling. A dark, quiet room will help.

There are a few basic strategies you can use to help your baby through these.

1. Control your baby’s environment: While you are getting to know your little guy, keep things on the quiet side. Introduce him to friends and relatives one at a time, instead of in large groups. Swaddling (that burrito-wrap blanket style) will help him feel secure. When you change and dress him, speak or sing quietly to him. Feed him in a quiet place away from the household hustle and bustle.
   
   
2. Learn your baby’s cues: As time goes on, pay attention to how he responds to you. Does he enjoy play-time, or does it tend to make him fretful? Does he calm when bounced in your arms, or tense up? Some jittery newborns will be calmed when held in a snug C position in the crook of your arm. Experiment with soothing methods to find what works and what doesn’t. Soon you’ll find you can tell his hungry cries from his stressed cries easily.
   
   
3. Help your baby calm down before he becomes frantic: This one is immensely helpful. When you start to sense that your little guy has had enough play or people time, and is beginning to fret, start to use your soothing techniques before he’s crying uncontrollably. Take him to a quiet place, coo gently, swaddle him … whatever works. As you practice this, he’ll tolerate longer and longer periods of play and stimulation without getting overwhelmed.

With these few, simple techniques your family should enjoy a smoother getting-to-know-you period. Of course, if you see problems that seem more severe, or your little guy seems ill, call your pediatrician immediately. If something concerns you, it’s always worth checking out.

Congratulations! You are making a tremendous difference.

See the Video
Please watch our Earning Your Wings video to learn more about the crisis in foster care and how you can help. (9 min 30 sec)

Call Now to Change a Child's Life
Call 619-283-8100 or contact us on-line to learn how you can make a donation or become a foster parent.

Please note that Angels places babies only in San Diego County of California.We regret that many of the interested applicants who contact us live outside of this area, but we cannot accept any applications from outside of San Diego County.

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