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tools for starting important conversations - and promoting positive change
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4 Things You Can Do to Improve Your Health
and Lower Your Risks
for Complications
What You Should Know:

There are things you can do to decrease the risks associated with substance use and increase your chances of having a healthy pregnancy - and a healthy baby.


Getting good prenatal care is the single most important thing you can do to have a healthy pregnancy and a healthy baby. Prenatal care can eliminate many of the risks associated with substance use.

El-Mohandes A, Herman AA, Nabil El-Khorazaty M, Katta PS, White D, Grylack L.
Prenatal care reduces the impact of illicit drug use on perinatal outcomes. J Perinatol 2003;23:354–60.

How to Care for a Baby with Signs of Withdrawal
What You Should Know:

Substance exposure is what happens when a developing fetus is affected by medications or substances that cross the placenta or an infant ingests substances that can pass through human milk. Sometimes what passes through is only the metabolites of the substance and not the substance itself. The dose a fetus or infant might receive is always a smaller percentage of the parental dose.

Substance Use Disorder (SUD) is a mental health diagnosis. It is diagnosed when there is a pattern of symptoms that results from continuing to use a substance when it is causing problems.

A dyad is something that consists of two elements or parts. In this case, "dyad" means a parent and a baby. They aren't separate beings. The baby needs their parent and a parent needs their baby. And whatever we do that affects one of them affects the other.

Rooming-in after birth is when your baby stays in your room with you, instead of in the nursery or the NICU (Neonatal Intensive Care Unit).

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Kangaroo care - or “skin-to-skin” care - means holding your baby against your bare chest. Babies and parents need to touch. When they do, their breathing and heart rates stabilize, they become more relaxed, they sleep better, and milk production increases.

Non-pharmacological care is evidence-based interventions that don't require medication. Sometimes, babies who are showing signs of withdrawal are treated with medications (that they've become dependent on) - and then slowly weaned off of them. A different model of care that is very effective is called Eat, Sleep, Console (ESC). It focuses on the comfort and care of the infant by maximizing non-pharmacologic methods, increasing family involvement in the treatment of their infant, and only using medications "as needed" to keep the baby comfortable.

Lactation support should be provided to every parent who wants to give their baby their milk. Support can be provided by peer counselors or IBCLCs (International Board Certified Lactation Consultants). Support should be provided at the hospital and once you go home. Ask how these services are covered under insurance.

Signs and symptoms of substance exposure and physiological dependence may include gastrointestinal issues (e.g. dehydration, diarrhea, non-coordinated suck and swallow), autonomic disregulation (e.g. temperature instability, increased breathing rate), and neurological (e.g. high-pitched cry, irritability).

When we are talking about infants we see "signs" of dependence and withdrawal. A sign is an objective, observable phenomenon that can be identified by another person. Babies are not reporting "symptoms." A symptom is a subjective experience that cannot be identified by anyone else.

Inclusive terms include: breastfeeding, chestfeeding, body feeding, lactation, milk production, human milk, parental milk, pumping + feeding

When considering a urine drug test (UDT) to screen for substance use
Ask Yourself:  What does pee tell you?
The Answer:   Not a lot.
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5 Ways You Can Improve Care
During Pregnancy and Beyond
For Providers:
Language Matters
For the Press and Public:
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