Did you know that 10-11% of babies born in the US have been exposed to alcohol, drugs, or both before birth? The percentage is even higher for kids who are being raised by their grandparents or other relatives. And remember that drug exposure can include both legal and illegal drugs. Prenatal exposure can make caring for these little ones harder at first.
Common Symptoms of Prenatal Exposure in Babies
Both alcohol and drug exposure during pregnancy can cause problems for babies at birth and later in life. Babies exposed to drugs prenatally may show withdrawal symptoms within the first few days of life. Among these are trouble sleeping, high-pitched crying, tremors and twitching, stiff muscles, diarrhea, and vomiting. If these are intense, the baby might require medication given in the hospital. Usually these symptoms pass by the time the baby is about 6 months old or even sooner.
Alcohol causes more long term harm than all other drugs. A baby exposed to alcohol before birth can have brain damage that lasts throughout their life but depending on the amount of alcohol the mom drank, these impacts may not be apparent at birth. As the child ages you may notice some physical signs, including a small head, small eyes, a thin upper lip, a short upturned nose, and smooth skin between the nose and upper lip. These facial features are not common and only happen if the mother drank heavily during the few weeks when the baby’s face was developing in the first trimester of the pregnancy.
Babies exposed to both alcohol and drugs have symptoms you can see in a baby’s behavior, including sleep issues, difficulty soothing and eating difficulties. Other symptoms of prenatal alcohol exposure can develop as the child ages. You will likely need some extra ideas in your parenting toolbox when caring for these little ones.
Soothing and Sleeping
How much sleep is enough? Newborn babies should get about 14-17 hours of sleep over 24 hours. By six months, this decreases to about 12-16 hours per day. This includes both daytime naps and nighttime sleeping. Here are some tips to help.
1. Create a calm environment.
Make the space where the baby is sleeping feel calm and soothing. Use low lighting, soft white noise such as a fan, or quiet calming music. You can find background noise or soothing tunes on YouTube. Here is one example: Native American Flutes and Nature Sounds – for Sleep or Relaxation
2. Massage the baby.
A gentle massage of the baby’s back, arms, legs, and even their forehead and cheeks can calm them. It might also help you stay calm and help them bond with you.
3. Try a calming scent.
You can use made-for-babies scented soap, bath wash, or lotion. Or use a diffuser such as this one: Koala Bear Diffuser. As long as your pediatrician gives you the “okay,” you could try a drop or two of an essential oil such as lavender or vanilla in the diffuser. It will also create soft white noise and add moisture to the baby’s room.
4. Use diaper wipes that are warm and not cold.
Here’s a warmer for diaper wipes that also has a night light for those midnight diaper changes. Wipes Warmer
5. Make a warm bath before bedtime part of the baby’s nightly routine.
The activity will tire them and the warm water and your touch will calm them. It will make them extra snugly!
6. Put the baby down to sleep consistently.
Baby should go down to naps or bed at the same time, in the same place, and with the same caregiver. Frequent changes in caregivers can cause more stress to prenatally exposed babies.
7. Encourage regular feeds during the day.
If the baby is fussy and not hungry, use other calming methods to ready them for feeding time..
8. Cuddle, rock, or swaddle the baby.
Nothing beats being held by grandma in her rocking chair! And for those days you don’t have time to sit down, there are lots of great carriers, such as this one. It feels good to have baby near you, and is another great bonding tool.
9. Encourage self-soothing behaviors.
This could be sucking on their fist, a pacifier, or cuddling with a soft toy or blanket (after infancy). Some babies with prenatal exposure need to be taught to self-soothe, so be patient with this process.
10. Give comfort when the baby needs it.
A baby who has been prenatally exposed has likely had damage to its central nervous system. They may not be able to calm themselves and will need your help every time, at least for a while.
Good sleep is important for your baby. It strengthens their immune system and helps their brain and body grow. It will make them, and you, feel better each day!
*An Important note about SIDS: To prevent Sudden Infant Death Syndrome, always put the baby to sleep on their backs for the first year.
Conquering Eating Difficulties
In addition to sleep challenges, it is common for babies who have been prenatally exposed to have eating issues. They may struggle with the “suck-swallow-breathe” rhythm. This can keep them from getting enough to eat.
1. Feed baby at the first signs of hunger.
Waiting too long can lead to a frustrated baby who then sucks frantically without getting much. Signs of hunger are crying or sucking on their fingers.
2. Feed slowly and burp often.
Giving smaller feedings more often and keeping the baby elevated for 30 minutes after feeding will also help keep the formula down.
3. Try different shaped or size bottle nipples.
You can also change the size of the hole in the nipple. This can speed up or slow down the flow of the formula. Once you find the right combination, use the same one every time.
4. Try changing the texture of the bottle nipple.
You can do this yourself by using an emery board to roughen plastic nipples.
5. Stroke the baby’s lips and gums gently before giving a bottle.
This can wake up the baby’s sucking reflex. If the baby struggles with the “suck-swallow-breathe” reflex, be patient while teaching them to respond.
6. Massage the baby’s cheeks before feeding.
It can encourage them to close their lips and not dribble.
7. Keep the baby’s chin tucked.
Be certain that their chin is neither too far down nor too far back. Tucking their chin to feed makes sucking and swallowing easier. An angled bottle may also help.
8. Limit distractions and stimulation.
Feed the baby in a quiet dark room away from distractions. You might even need to avoid eye contact with the baby while feeding.
Take Care of Yourself
Caring for a little one who has been prenatally exposed can be especially hard. Make sure you are eating healthy and getting enough sleep, which probably means you need to ask for help during the night—at least a couple of nights a week at the beginning. Allow yourself a break when you are feeling overwhelmed. It’s okay to ask for help! Don’t hesitate to talk with your child’s doctor, daycare provider, birth family, or others. They may be able to share the child’s history with you and strategies they have found successful.
There are many resources where you can find more information. Here are a few to get you started:
- Caring for Babies with Prenatal Substance Exposure is a download you can read for more information and tips.
- FASD United is the “National Voice on Fetal Alcohol Spectrum Disorder.”
- The Grandfamilies Kinship Support Network offers specific support for tribal kinship families.
There are also support groups that can connect you with other caregivers going through the same things that you are, such as Creating a Family’s online support community. You can find these on Facebook and other websites. It’s important to remember that you are not alone. And what you are doing matters!
Spending time in your nurturing, loving, and safe home helps protect the baby from further impacts of prenatal exposure. Parenting is hard, but there are resources to help you and your little one in your journey.