View Full Version : crackhead babies

04-01-2008, 02:12 PM

1) So you have a male and female who are crackhead/drug users. They have a baby and as soon as it is born, it is a crack addict. Yes - no?

2) Also what is the correct procedure to get the baby off heroin or whatever?
Is it to slowly reduce the heroin? Give the kid a bit of heroin each day until it is free?

3) Would "cold turkey" kill the baby?

4) Would the baby need a blood transfusion?

My story is about two drug users who have a baby and i need to know how the hospital would deal with this, especially if they have no or little insurance.

Thanks in advance.


Calla Lily
04-01-2008, 03:37 PM
Kev, I can only answer #1: Yes, it'll be born addicted.

(I know this because when my next door neighbors were trying to adopt their 2nd, one of the pregnant moms was addicted, and a doctor friend of theirs advised them not to adopt the baby, because their first adoptive baby had developmental problems.)

04-01-2008, 05:52 PM
I don't think the fact that they have insurance or not is any kind of problem in this situation. As far as I know the baby would be removed immediately from the parents and eventually placed in child care - addicting a child to crack is a definite example of child abuse and endangerment, and the parents would have a major problem.

I'm not 100% positive on this, but I don't believe they continue to give the infant the drug - but if you can't get satisfactory answers, PM me - I have two friends that have adopted crack babies, and they would more than likely answer any questions you may have.

Tish Davidson
04-01-2008, 07:10 PM
From Substance Abuse: Cocaine
(Article is rather technical if you don't speak medicine)

Cocaine use has well-known negative effects on pregnancy, including an increased risk of preterm labor, abruptio placentae, spontaneous abortions, and intrauterine growth retardation.6 (http://www.emedicine.com/ped/TOPIC2666.HTM#ref6), 7 (http://www.emedicine.com/ped/TOPIC2666.HTM#ref7) Newborns can be born addicted to cocaine and go through withdrawal within 48 hours of birth. The following effects may also occur:

Increased spotting or vaginal bleeding
Precipitous labor
Placental insufficiency
Premature rupture of membranes
Intrauterine fetal demise
Breech presentation
Low birth weight

Also take a look at Neonatal Abstinence Syndrome

It is an entire article about newborn withdrawal from drugs. Also somewhat technical, but less so than the first article.

Here are the basic symptoms
Infants exposed to cocaine may exhibit signs and symptoms of withdrawal of lower intensity and shorter duration than seen in infants with opiate dependency. Newborn behavior often prompts the examiner to suspect in utero drug exposure. The newborn examination may reveal low birth weight for gestational age, drug-related or alcohol-related birth defects, and characteristic facial abnormalities.

* Central nervous system dysfunction

o High-pitched cry

o Restlessness, with sleep duration less than 1-3 hours after feeding

o Hyperactive reflexes

o Tremors

o Increased muscle tone

o Myoclonic jerks

o Generalized convulsions

* Metabolic, vasomotor, and respiratory disturbances

o Sweating

o Fever

o Mottling

o Frequent yawning

o Sneezing, more than 3 times per interval

o Nasal flaring

o Respiratory rate greater than 60/min without retractions

o Apnea

* Gastrointestinal dysfunction

o Excessive (frantic) sucking or rooting

o Poor feeding

o Regurgitation or projectile vomiting

o Loose or watery stools

04-02-2008, 03:41 AM
Heroin and crack, way way different. Yes, people use both, but be sure what you meant, both or one.

Heroin babies are born not breathing, we give them Narcan, while assisting respirations and they turn around. They just went cold turkey. Assuming the kid is born under the influence (and he doesn't have to be---mom might not have been under the influence when she delivered) it's very very likely the baby will not breathe when born, but it's very fiaxble. The mess is compounded by the fact that there are two patients, because if the mom is depressed by the opiate during delivery, delivery is going to be additionally stressful for all.

Crack babies are just miserable, but at least they breathe.

Neither necessarily need blood, much less a transfusion.

04-02-2008, 03:51 AM
Here (http://aappolicy.aappublications.org/cgi/content/full/pediatrics;101/6/1079) is an authoritative discussion from the American Academy of Pediatrics about how to treat withdrawal of addicted infants. There are various options. For severe symptoms, I've used mostly methadone, clonidine, or phenobarbital.

04-02-2008, 09:13 PM
Thanks guy this is great info.

Just one more Q.
Is there ANY way that the couple would keep the baby or is it goodbye? What it the parents and the kid all come off the drugs and stay free?


04-02-2008, 09:24 PM
It depends on where they are and what the circumstances are.

I had a client who was able to successfully fight for custody while she was on crack. She kept promising she was done with it and we kept believing her. And then one day she just walked away from them all. Custody reverted to Dad, who's arguably the worse parent, crack or no.

Almost anything is believable, IMO.

04-02-2008, 09:50 PM

The doctor caring for the newborn may file a report of suspected child abuse or neglect, based either on the results of drug screening of the baby's urine or stool, or on observations of worrisome parental behavior in the hospital. A positive drug screen automatically merits a report.

Child Protective Services would then get involved. An investigative worker from CPS would do an assessment on the parents and the home. Depending on the results of that assessment, the child might be discharged to foster care. If the child goes home with the birth family (the "crackheads" in your OP) CPS would develop a safety plan which would include things like rehab, parenting classes, required random drug screens. If the parents can't comply, CPS may well remove the child.

04-03-2008, 08:06 AM
Thanks Terza

This really helps my story.


Jenan Mac
04-03-2008, 08:21 PM
Hey, KC.

When I worked L&D and newborn nursery we did routine tox screens on all newborns of clinic patients, all no-prenatal-care patients, and anyone else the docs ordered them for. If the baby turns up positive, it's pretty obvious Mom was using. At that point hospital social services would be involved, and CPS usually took the babies, though not always.
The average crack baby was jittery as all hell, cried constantly, tended to arch away instead of snuggling down in your arms when they were held by staff. Care was basically palliative, and in no way shape or form included giving illegal drugs to babies.

The other thing that might be helpful (or not) is that there's a sort of street folklore that "crack brings the baby". Pregnant girls would get within a few weeks of their due date, get bored with being pregnant ("TOBP" on the triage forms), and smoke, hoping to go into labor. Often if they did it would be fast, furious, and occasionally a complete train wreck.

The only difference having insurance (and therefore a private OB instead of the clinic) might make is that the mom might not have an automatic tox screen ordered-- but if the L&D nurses suspect it's needed, they'll talk the nursery staff (either the resident or ARNP) into ordering one.