COCAINE

Identifying

The typical cocaine-exposed infant is prematurely born under 37 weeks gestation. There will be no outward signs of withdrawal symptoms. She will have good color and be soft and cuddly. The only way to verify the presence of cocaine in a baby’s system is by a toxicology screening. For the first two weeks of life, the cocaine-exposed baby will snuggle up without being fussy. She/he will not have tremors and will want to sleep most of the time.  One observable sign will be that the baby does not wake to feed and will take less than two ounces of formula every three to four hours. The main concern will be their inability to take as much formula as they should for proper nutrition/poor weight gain. Monoclonic jerks may occur, not to be confused with tremors, which, if noted, might indicate the exposure to other drugs besides cocaine.  Feeding problems will also continue. 

Support

Feeding is going to be the utmost concern with a newborn pre-nataly exposed to cocaine. The baby must be fed regularly. This means every three to four hours. During the first few days, one or two ounces per feed may be the correct amount but this must quickly increase. Within three weeks the baby needs to be taking at least three ounces every three to four hours. More frequent feedings are not advisable because they require too much of the baby’s energy and will burn precious calories.  Four ounces should be the norm shortly after that. The baby will need to be encouraged to feed. Many times he will become lethargic and will be difficult to be wakened to feed. He will have no sucking power and may even fight the bottle. The manner of feeding is important. (Please see the feeding section.) During times other than feeding times, therapeutic care techniques need to be applied. (See handling section)  These little ones will need to be closely monitored and carefully managed by their caregivers.

Risk Factors

• -Failure to thrive

• -Therapeutic needs

• -Breast feeding

• -Dehydration