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Prenatal Substance Exposure

Advise on short term and long term exposure to heroin

My husband and I are highly considering adopting a baby who is due in two weeks that has been exposed to heroin all through the pregnancy. The bmother has had zero prenatal care up until a couple weeks ago. We do know the baby is at a healthy weight for its gestational age.

I’ve read a lot about how the home environment and structure can play a huge part in overcoming prenatal drug exposure, but I’ve also read that a lot of issues that don’t surface until they are school age.

I would welcome any feedback, positive or negative on your experience with a child exposed to prenatal heroin.

Thank you!


I am not sure about heroin. I am I know alcohol can do irreparable damage and some addicts drink as well as do drugs.

Posted by Regina on Apr 03, 2018 at 8:03pm

I used to work at a childrens hospital and would often take care of the babies who were born addicted to opiates like heroin. some of the babies were inconsolable while they went through withdrawals, they just cried and cried and cried. but just as many were very sleepy, they just slept all the time and you had to wake them to feed and change diapers. for the crying babies you will want to learn how to do a tight swaddle, get a good swing or vibrating chair, and ask the nurses for some sucrose and a small syringe to take home. the sucrose is just a sugar water solution, a very small amount (just 1ml) will often calm a fussy baby for hours. the brand our hospital used was called toot-sweet, but there are other brands. some babies are able to go home from the hospital after just a couple days of observation while others will need to stay in for a few weeks and be weaned off the heroin. heroin does not cause birth defects.  I haven’t had the experience with these children in the long term, but the research shows they do very well. generally no behavior issues related to the heroin, sometimes some minor learning difficulties. long term heroin is nowhere near as bad as alcohol exposure.

Posted by rn4kidz on Apr 03, 2018 at 9:08pm

Hi, Regina -

This is anecdotal evidence, of course, but just over 9 mos. ago our beautiful, amazing, developmentally right-on-target and brilliant daughter was born to a birthmom who not only did heroin for 8 of the 9 months of gestation, but she also did crack, marijuana, benzos, and near constant cigarettes.  She had (except for the one month she was in a rehab) NO prenatal care and really sketchy nurtrition. She did not, however, drink alcohol. This was what was key for us, in combination with a feeling in our gut (we were scared, don’t get me wrong!!!) that this was the right thing to do.

We were matched (chosen by) with our daughter’s birthmom on a Friday, met her for lunch four days Monday, and were in the emergency room with her that following Friday (yes, a week later).  Again, I’ll be frank: we were really scared. Particularly the fact that our daughter had virtually no prenatal care, not even a sonogram - that really scared us.  But (we’re both professors and did a lot of research, including in medical journals) we also felt very certain the - as of the research that is available today - alcohol is the scary one.

Opiate exposure’s effects long term is still not avialable in the way that the result for alcohol long term is (for children, teens, adults), but the research that is out there suggests that the longterm effects aren’t significant.  There ARE vulnerabilities you have to be aware of, look for (e.g., we know our child, around the age of 3 or so, might start to show signs of needing occupational therapy; also, hearing - depending on how much heroin and for how long during that time in gestation - might be affected. Our daughter is also more “vulnerable” (that’s the preferred language from doctors) to ADD and other impulse control issues. But as I mentioned, my partner and I are professors and we see kids with learning disabilities, ADD, and even kids on the autism spectrum (the latter is not an issue with opiate exposure, by the way, any more than a non-opiate exposed baby) in our classrooms with regularity. Seriously, in every class of 25-30 undergraduates, there are always at least 2-4 students who come in with special accomodations. You can’t predict ADD or any other issues with a biological child, just as you can’t with an adopted child.

So we went for it and, well, there aren’t words to express how we feel. It was completely the right thing to do, we’ve never been happier, our lives have changed forever, it was meant to be, these don’t even start to cover it. It’s such a deeply personal decision.  And no two babies/children are the same.  But you are dealing with more information (and less exposure) than we were, and our story has a very happy ending. I say this with complete awareness that there may be challenges for us in the future - that’s possible. But I still write, with complete truthfulness, that when our birthmom chose us it was the rightest right thing that ever happened to us.

One caveat: the nurses in the NICU (as one’s baby completes the withdrawal process, getting through what is called Neonatal Abstinence Disorder - just a phrase describing the withdrawal process - which doesn’t last forever), anyway, the nurses in the NICU can make your life much less scary or (as what happened with us) a living hell. Have this on your radar: we love, feel gratitude for, and respect our birthmom.  We see her as a woman who gave us her daughter, the greatest gift anyone can give or receive, and we see her as a really, really sick human being who is basically the “walking wounded” in terms of her disease (heroine addiction). What she has already lived through (as an addict) and what she continues to experience (loss, shame, hopelessness) is heartbreaking. This is our daughter’s first mother and we love her and honor her, even if we hate the choices she made and we hate her disease.  This attitude did NOT rub the nurses the right way. That, and worse, they felt like and treated us like we weren’t the “real parents.” Faced with the fear and pain of watching our daughter suffer, this experience (from the nurses, not the doctors) of being treater like interlopers and traitors (the nurses HATE the bio moms of opiate-addicted newborns) made our daughter’s birth and 2 weeks (yes, only 2 weeks!) in the NICU one of the most traumatic events in our life. (In Detroit, stay away from St. John’s on Moross). So bear that in mind.

One last thing to bear in mind, should you go for it (and there are books and podcasts that talk about this better than I am here): it’s extremely important to have on your radar the potential for one’s son/daughter to grow up (wrongly) having bad/shameful feelings about her/himself because “they came from a heroine addict” etc.  Not only is it crucial that you keep the information about birthmom private (it’s the child’s story to tell and her/his decision who to tell), but to find a way to teach one’s child that s/he comes from a brave, sick person who is not “bad” but merely sick; this person chose to keep (not abort) her baby so that s/he could have a better life (one she couldn’t provide).  All of the potential psychological speed bumps that are present in the trauma of adoption (trauma for the child, I mean, the loss that they’ll have to figure out how to deal with) are multiplied with the birthmom has a past (conceived by sexual assault, opiate addiction during pregnancy, etc.). It’s so important to be on the ball in terms of how to best support your child with her/his self-image, how to deal with the loss and anger and shame s/he might feel about their genetic roots, etc.

Again, it’s a hugely personal decision. But for us, it was the best (THE BEST THE BEST THE BEST!!!!!) thing we were ever lucky enough to do.  I wish you and your family much luck and good wishes. You’ll figure out what is right for you.

Posted by WhiteLakeMom on Apr 04, 2018 at 9:34am

We have done quite a bit of research on heroin exposure as it is so prevalent these days. We had a potential match with a birth mom who had been on heroin with sporadic methadone but we ended up getting picked by a different birthmother in the process. (Now, the birthmother that picked us was on Norco and oxycontin for the last 2 months of her pregnancy and we had the potential for neonatal abstinence syndrome from those medications but our son had almost zero issues after being born and is doing great with all his milestones - he is 15 months now)

The really hard thing with the research that’s available is that it’s really hard to sift out environmental factors and the exposure to the drug itself. Heroin and opiates are really difficult to withdraw from for these poor little ones but long-term effects are really minimal compared to other prenatal exposures. It will be difficult for you and your husband to watch your little one struggle with the withdrawals, it will be likely a 2-3 week hospitalization after birth. As we start the process on baby number 2, my husband and I decided that a few weeks of difficulty may be worth it compared to years of difficulties with other exposures, but it is course of a very difficult decision.

Best of luck to you and your husband and your growing family smile

Posted by lizh512 on Apr 04, 2018 at 1:25pm

As Regina says, prenatal alcohol exposure is a huge problem, and children born with FAS have life-long issues.  Addiction is a difficult disease, and most addicts do not stick to just one drug.  Many years ago there were articles about prenatal exposure to cocaine, but much of that has been shown to be untrue.  Prenatal exposure to narcotics can cause neonatal abstinence syndrome, meaning the babies are born addicted, and have withdrawal symptoms, which can require prolonged stay in NICU, but don’t appear to be associated with long-term problems for the child.

Whether or not you proceed with this match is a very personal decision, one only you and your husband can make, but there is a lot of science to suggest that opioid exposure does not cause long-term problems for babies.

Posted by jszmom on Apr 04, 2018 at 7:48pm

I would proceed with caution.

Dispite what you may read about there being few long term effects of prenatal heroin or oxicodone thats not what I’ve seen with the exposed children I’ve known over the course of my life.

My first experience with a child born addicted to heroin was nearly 20 yrs ago as the nanny for a family who adopted their daughter at birth.
D. was by 6 diagnosed with ADHD, ODD, dyslexia, cognitive delays, irritable bowel syndrome, and the inability to feel hunger or fullness (i forget the actual term for the last one) from the accounts of her adoptive parents she was one of the sleepy easier babies during withdrawals, but they still had to deal with uncontrollable tremors and sudden rigidity. I’m not sure what treatments where offered by the medical community, but from the sounds of it they were pretty much left to deal with her withdrawals on their own. Her true issues only became apparent later. When I met D. at 6 she was still not fully potty trained due to the I.B.S, would fly into uncontrollable rages throughout the day, at times would refuse to eat for days but if given unlimited access to food she wanted she would eat untill she would throw up. They stocked the house with only foods she really liked, but the cupboards and refidgerator had to be locked at all times otherwise she would gorge herself at night. The list of her behaviors goes on and on, but ultimately she became a danger to herself and others in the household. Her parents were not prepared for the challenges and the adoption ultimately disrupted.

my second experience was 15yrs ago with a mother who suffered cronic pain. I drove her to doctors appointments and would sometimes sit in with her. when she became pregnant with her son I was literally in the room when the doctor told her oxicodone was 100% safe to take during pregnancy and that he would up her dose since it would be best if she had as little stress as possible while pregnant. After several weeks of what i now belive to be undiagnosed withdrawals her son G. developed into a very easy baby, but was diagnosed with autism at 4 and ADHD and ODD at 5. He ended up with a family member who was better able to get him the services and therapies he needed.

( It has now been proven that opiods during pregancy lead to an increased chance of preterm birth regardless of the type you use)

I know 5 other school age to teen children with verified prenatal opiod exposure. 2 raised by bio parents, 2 adopted via. foster care,  1 private newborn adoption.

They are as follows.

Teen boy- Oxi. /meth exposure. diagnosed ADHD, ODD, dyslexia. Parents faced many issues with the school system as he was growing up, but ultimately he ended up doing very well and is college bound in the fall.

Teen boy2- Oxi. / heroin exposure all throughout pregnancy. (no alcohol) severely disabled.

school age boy-  heroin, alcohol exposure. diagnosed ADHD,ODD, dyslexia,  possible F.A.S and or possible autism spectrum. many senosory issues.

school age girl- Oxicodone exposure throughout pregnancy. born premature. Partially def, heart defect, gut issues. On track in cognitive development.

preschool boy- Oxicodone use first 5months of pregnancy. 10 weeks premature leading to brain bleed and ROP. diagnosed autistic spectrum at 4

These are all kids I know personally, and while other factors may also have affected their development none of them have been unscathed. If you go forward please do not go in with the expectation this child will be completely nuro-typical or be free of all health issues. Although the child may be one of the lucky ones, I would definitely be very proactive in seeking services if needed. I may be wrong and in no way are an expert,
but I personally feel that the pharmaceutical companies WAY over hyped the safty of Opiods during pregnancy (and in general) and are still quick to blame any disabilities steming from prenatal use on other factors. We are now battling the fall out of gross negligence from the medical community.

As for dealing with the NICU. Yes, I agree with white lake mom that the nurses can either ease your experience or make it a living hell. My bio daughter spent 3 months in the NICU due to prematurity and I practically lived at the hospital. I learned alot while I was there about adoption issues from a pre adoptive mom in my NICU family support group Please know that even if an adoption plan is in place the doctors and nurses CANNOT treat you as the parents until the adoption is finalized and the social workers give the all clear.  In their line of work they have seen more disrupted adoption plans then we can dream. They are on the front lines and often in the room when Mom decides to parent. They cannot afford to become emotionaly involved with the potential adoptive parents and legally they are not allowed to share medical information directly without approval.  Potential adoptive parents in the hospital we stayed at were also not alowed unlimited access to NICU babies even with bio parental approval. All visits had to be overseen by social workers or nurses untill everything with the adoption had been finalized. This means that the stress on potential adoptive parents is even greater than with a typical NICU stay especially If there are issues with finalization.

I feel like I’m getting rather long winded, so I’ll end it with trust your gut as to what you think you can handle. There are alot of unknowns and the child may be amazing in the long term, but never hesitate in seeking early interventions if needed. If you wish to go forward and want tips on navigating the NICU experience dont hesitate to PM me.

Best of luck with all!!

Posted by AriaEli on Apr 05, 2018 at 8:46pm

I may be too late to the conversation since this was started more than 2 weeks ago….

My daughter was born addicted to heroin and benzodiazepines. She was 3 months premature. She was in the hospital for 3 months detoxing. There things that came up when she was a baby that we had to have checked out because I didn’t have a lot of history about her birth family…. all was fine.

She is 8 now.  She does have ADHD… suspect her birth mother probably had it to as there is a strong genetic association.  There are times things can be hard but I wouldn’t change a thing. 

I am actually the one who requested the start of this group because I couldn’t find any information 8 years ago and I felt very alone. 

There is a lot more information and support now which is great because there are so many children affected by prenatal exposure.

It is a very personal decision. Follow your heart.

Posted by JJ's Mommy on Apr 17, 2018 at 11:16pm

I just want to say thank you to all of those who responded. My husband and I are hopefully adopting a baby boy due in a few weeks whose mother is a heroin addict.
This opportunity was literally dropped in my lap last week and I’m sure you all know all of the emotions to follow. We immediately said yes. I am a believer in prayer and this baby has been prayed for extensively for the past week, not to mention the years I have prayed for him.
Your responses have eased my mind on long term effects he can have. I know we are in for a long, possible rough road ahead of us. But I also know that he is my answered prayer and everything will work out.

Posted by KimD2014 on Apr 25, 2018 at 1:40pm

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