Prenatal drug exposure and maternal and infant feeding behaviour

• Published in: Archives of disease in childhood. Fetal and neonatal edition 2003-09, Vol.88 (5), p.F391-F399
• Main Authors: LaGasse, L L, Messinger, D, Lester, B M, Seifer, R, Tronick, E Z, Bauer, C R, Shankaran, S, Bada, H S, Wright, L L, Smeriglio, V L, Finnegan, L P, Maza, P L, Liu, J
• Format: Article
• Language: English
• Subjects: Addictive behaviors; Adult; Age; Alcohol; Arousal - drug effects; Babies; Behavior; Biological and medical sciences; Birth weight; Bottle Feeding - psychology; Care and treatment; Chi-Square Distribution; Childrens health; Chromatography; Cocaine; Cocaine abuse; Cocaine-Related Disorders - psychology; Colleges & universities; Confidentiality; Consent; Diseases; Drug abuse; Drug addictions; Drug use; drugs; Enzymes; feeding; Feeding and Eating Disorders - psychology; Feeding behavior; Feeding Behavior - drug effects; Female; Fetus; Follow-Up Studies; Gestational Age; Health aspects; Humans; Hypotheses; Immunoassay; Infant; Infant Behavior - drug effects; Infants; Infants (Newborn); Infants (Premature); Longitudinal Studies; Male; Maternal Behavior; maternal-infant interaction; Medical sciences; Metabolites; Mother-Child Relations; Mothers; Narcotics; opiate; Opioid-Related Disorders - psychology; Original; Pregnancy; Pregnancy Complications - psychology; Prenatal Exposure Delayed Effects; Prevention; Probiotics; Risk factors; Sucking Behavior - drug effects; Toxicology; Videotape Recording
• ISSN: 1359-2998; 1468-2052
• DOI: 10.1136/fn.88.5.F391

Objective: To evaluate feeding difficulties and maternal behaviour during a feeding session with 1 month old infants prenatally exposed to cocaine and/or opiates. Methods: The study is part of the maternal lifestyle study, which recruited 11 811 subjects at four urban hospitals, then followed 1388 from 1 to 36 months of age. Exposure to cocaine and opiates was determined by maternal interview and meconium assay. At the 1 month clinic visit, biological mothers were videotaped while bottle feeding their infants. This sample included 364 exposed to cocaine, 45 exposed to opiates, 31 exposed to both drugs, and 588 matched comparison infants. Mothers were mostly black, high school educated, and on public assistance. Videotapes were coded without knowledge of exposure status for frequency, duration and quality of infant sucking, arousal, feeding problems, and maternal feeding activity and interaction. Results: No cocaine effects were found on infant feeding measures, but cocaine-using mothers were less flexible (6.29 v 6.50), less engaged (5.77 v 6.22), and had shorter feeding sessions (638 v 683 seconds). Opiate exposed infants showed prolonged sucking bursts (29 v 20 seconds), fewer pauses (1.6 v 2.2 per minute), more feeding problems (0.55 v 0.38), and increased arousal (2.59 v 2.39). Their mothers showed increased activity (30 v 22), independent of their infants’ feeding problems. Conclusions: Previous concerns about feeding behaviour in cocaine exposed infants may reflect the quality of the feeding interaction rather than infant feeding problems related to prenatal exposure. However, opiate exposed infants and their mothers both contributed to increased arousal and heightened feeding behaviour.