Behaviors of the drug and/or alcohol exposed infants

      Infants who have been prenatally exposed to drugs and/or alcohol often have unique care needs.  This information has been developed to help you better understand the infant and how to care for these special babies. Other infants may have none or very few of these problems.  They are all different.  Each one has been exposed to drugs and/or alcohol to a different degree and at different times of development.  Exposure to drugs in utero can cause infants states to vary from highly irritable to very passive.  Most drug exposed infants are highly irritable and have difficulty sleeping and irritable infants can reach a frantic crying state very quickly. Some infants who have been prenatally exposed to drugs/alcohol will act in the following manner:

• ¨      Irritable
• ¨      Jitteriness or tremors
• ¨      Stiff muscles (hypertonia)
• ¨      Frantic sucking
• ¨      Poor feeding
• ¨      Staring or unusual eye movements
• ¨      Poor eye contact
• ¨      Diarrhea
• ¨      Fitful cry, high pitched cry
• ¨      Crying for prolonged periods of time
• ¨      Unusual drowsiness or sleepiness
• ¨      Unusually short periods of sleep

 

Stiffness and rigidity

Stiffness and rigidity are increased extensor tone and are often seen in infants prenatally exposed to drugs or alcohol.  They have increased muscle tone and will frequently roll over at a very early age.  Because of the stiffness, they do not have the ability to cuddle and will remain “stiff” when being held.  They will also tend to arch their backs.  This occurs up to 12 months of age.  Warm baths and massage can sometimes help relax the infant.  In addition, placing the infant in a cloth sling on hip will help decrease abnormal extension pattern, decrease irritability and increase tolerance of touch.

Feeding

Feeding time is important for all babies.  Infants exposed prenatally to drugs/alcohol may have some special needs in this area.  The following are some tips you may find helpful for making feedings more satisfying.

• ¨      Swaddle baby snugly during feedings.
• ¨      Be very calm and use slow, quiet care.
• ¨      It is best if they have only one caretaker to begin with.
• ¨      Talk softly to them but do not expose them to excess noise or activity.
• ¨      You may have to use a preemie nipple and enlarge hole with a sterile needle, because the baby will tire easily.  They often do not suck effectively and need time to get the hung of it.

 

Calming interventions

• ¨      Avoid quick movements in picking up infant
• ¨      Baby may require a lot of holding
• ¨      Carry or rock in vertical position
• ¨      Cuddling
• ¨      Slow rocking
• ¨      Singing, soft talking
• ¨      Swaddling with blanket
• ¨      Pacifier
• ¨      Bottle with formula warmed
• ¨      Gentle interaction (low key stimulation)
• ¨      Swing
• ¨      Music tape with lullabies and heartbeat
• ¨      Warm baths

The main secret is to handle baby slowly, frequently, calmly and with warmth, and gentleness to avoid reaching a frantic state of being upset and crying.

 

Tremors and trembling

Tremors of the hands, arms, legs, chin, and tongue are commonly observed in infants exposed to drugs in utero.  These are very common in newborn infants but can be seen in older children up to one year.  Tremors are seen while the infant is at rest and will be noticed more when the infant is extremely tired.  As they grow older, the tremors become less intense and tend to diminish.  Tremors will become more intense if the infant is trying to reach for objects or attempting a specific motor skill.

 

Taking care of yourself

Infants with special needs can be difficult to care for.  Remember there is only so much you can do.  You need to take care of yourself, too.  It may be necessary to “let the baby cry”.  This is sometimes appropriate when all interventions fail and you “need a time-out”.  Place the baby in a safe environment, and do something to relax.  The baby will be safe, and this time will allow you to provide better care to this challenging child.  It is very important to have alternate caregivers.  They also need to be trained on the challenges of caring for these children and calming interventions.  Remember, as the child grows and is able to handle different situations, you will be rewarded for your hard work with a baby that calms and can be comforted.