INFANT OF DRUGS DEPENDENT MOTHERS

• An infant of a substance-abusing mother (ISAM) is one whose mother has taken drugs that may potentially cause neonatal withdrawal symptoms.
• infant of a substance-abusing mother (ISAM) is also known as intrauterine drug exposure and maternal drug abuse.
• CAUSES OF SUBSTANCE ABUSE:

  • Addiction

  • Recreation

  • Psychiatric problem
• ILLICIT DRUGS:

  Cocaine

  Opioids

  Amphetamines

  Marijuana
• Cocaine constricts blood vessels, reducing blood flow (and the oxygen supply) to the fetus, particularly of the bones and the intestine
• Examples of Opioids include heroin, methadone, and morphine
• Consequently, the fetus may become addicted to them and may have withdrawal symptoms 6 hours to 8 days after birth.
• Babies of heroin users are more likely to be small.
• Use of amphetamines during pregnancy may result in birth defects, especially of the heart.
• the main ingredient of marijuana is tetrahydrocannabinol
• fetal alcohol syndrome (FAS) - This condition consists of growth problems, unusual facial features, and intellectual disability. It may not be detected at the time of birth.
• Babies who have been exposed to drugs, alcohol, or tobacco are at higher risk for sudden infant death syndrome
• TREATMENT

  Limiting noise and bright lights

  Maximizing TLC (tender loving care)

  Using medications (for some)
• Nursing Diagnosis:

  • Ineffective breathing pattern related to pulmonary and neuromuscular immaturity.

  • Ineffective thermoregulation
• Nursing Interventions

  • Respiratory Support
  • Thermoregulation
  • Protection from Infection
  • Hydration
  • Nutrition
• The primary objective in the care of high-risk iinfantsfant is to establish and maintain adequate respiration.
• After or concurrent with the establishment of respiration, the most crucial need of high risk infants is application of external warmth.
• A neutral thermal environment is one that permits the infant to maintain a normal core temperature with minimum oxygen consumption and calorie expenditure
• Parenteral fluids may be given to the high-risk neonate via several routes depending on the nature of the illness, the duration and type of fluid therapy, and unit preference
• infants who are critically ill often obtain the majority of their nutrients by the Parenteral route because of their inability to digest and absorb enteral nutrition.
• The incidence of respiratory distress syndrome (RDS) is decreased after maternal use of heroin and possibly also cocaine, likely due to fetal stress rather than a direct maturational effect.
• SIGNS AND SYMPTOMS

  • Mild fussiness.
  • Irritable or jittery
  • Feeding problems
  • diarrhea
• Caffeine also may decrease blood flow across the placenta and decreases the absorption of iron (possibly increasing the risk of anemia).
• Aspartame, an artificial sweetener, appears to be safe during pregnancy when it is consumed in small amounts, such as in amounts used in artific
• Cigarettes during pregnancy has a consistent effect on the fetus leading to a reduction in birth weight and birth defects of heart, brain, and face.
• Caffeine may stimulate the fetus, increasing the heart and breathing rates.
• Caffeine may decrease blood flow across the placenta and decreases the absorption of iron (possibly increasing the risk of anemia).
• Aspartame, an artificial sweetener, appears to be safe during pregnancy when it is consumed in small amounts, such as in amounts used in artificial sweeteners