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100  dating directory members mail contact 2016

Because there is passive diffusion across the placenta of substances smaller than 500 dalton (d), most illicit and some other substances used by a pregnant woman will directly affect the fetus (eg, methamphetamine = 149 d, buprenorphine = 467 d, tetrahydrocannabinol [THC] = 314 d).Fetal exposure to cannabis has been associated with subtle neurobehavioral disturbances (ie, exaggerated and prolonged startle reflexes and increased hand–mouth behavior), high-pitched cries, and sleep cycle disturbances with electroencephalographic changes in the newborn period.Cigarette smoking often accompanies substance use and can pose additional hazards to children (www2org/richmondcenter).Furthermore, the home environment may be unsanitary or unsafe, particularly if illegal or legal drugs, chemicals, or paraphernalia are accessible or if drugs are being cultivated or manufactured in the home.Children exposed prenatally to heavy amounts of cannabis often struggle with tasks requiring visual memory, analysis, and integration; acquire language skills slowly; show increased levels of aggression; and display poor attention span.Mothers who have heroin addiction or are receiving medication-assisted treatment with methadone may have infants who exhibit increased activity as well as poorer coordination during childhood than children of similar age without prenatal opioid exposure.Children who were exposed to crystal methamphetamine prenatally may have developmental delays in communication, personal and social skills, fine and gross motor skills, and problem-solving skills as well as aggressive or withdrawn behaviors.

The purposes of this clinical report are to review some of the short-term effects of maternal substance use during pregnancy and long-term implications of fetal exposure; describe typical medical, psychiatric, and behavioral symptoms of children and adolescents in families affected by substance use; and suggest proficiencies for pediatricians involved in the care of children and adolescents of families affected by substance use, including screening families, mandated reporting requirements, and directing families to community, regional, and state resources that can address needs and problems.Effects of fetal cocaine and opioid exposure may appear during the newborn period as any of the following symptoms of withdrawal: irritability, poor and irregular feeding patterns, frequent crying, tremulousness, increased respiratory and heart rates, hypertonia, an exaggerated startle response, vomiting, frantic sucking, and difficulty being consoled.Children with prenatal drug exposure are more likely to develop disruptive behavioral disorders such as oppositional defiant disorder; impaired intellectual and academic achievement; and cognitive problems, such as delayed language development, poor memory, and the inability to learn from mistakes.Pediatricians have an opportunity to help break multigenerational cycles of child abuse and neglect and substance use by being informed about the effects of parental substance use on children, intervening when necessary, and collaborating with the family, other health care providers, and appropriate government agencies to address the issues involved.Pediatricians are in a unique position to identify and assess a child’s risk in the context of a parent’s SUD and intervene to protect the child.

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As defined by the National Alliance for Drug Endangered Children, drug-endangered children are those who are at risk for suffering physical or emotional harm as a result of their caregiver’s substance use, possession, manufacturing, cultivation, or distribution.

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