Substance Abuse and Pregnancy

As an expectant mother, you want your baby to be as healthy as possible. Remember that most of what you consume is passed along to your growing baby. While some things are good for your baby, others can be harmful. Alcohol and illegal drugs are known to be particularly dangerous for a developing baby. Any amount of these substances is considered unsafe during pregnancy. You should avoid them altogether while you’re pregnant. Quitting before you get pregnant is ideal, but stopping drug or alcohol use at any point during pregnancy will benefit your baby.

How Does Drug Use During Pregnancy Affect the Baby?

You and your baby are connected by the placenta and umbilical cord. Nearly everything that enters your body will be shared with your baby. This means that any drug you use will also affect your baby. A fetus is very sensitive to drugs and can’t eliminate drugs as effectively as you can. Consequently, the chemicals can build up to extremely high levels in the baby’s system and cause permanent damage.

The risks associated with drug use during pregnancy depend on various factors, including:

  • the type of drug used
  • the point at which the drug was used
  • the number of times the drug was used

In general, however, using drugs during pregnancy can result in the following:

  • miscarriage
  • stillbirth
  • small size
  • low birth weight
  • premature birth
  • birth defects
  • sudden infant death syndrome
  • drug dependency in the baby

Here are some of the specific consequences of drug use during pregnancy:

  • Low birth weight places an infant at a higher risk for illness, intellectual disability, and even death.
  • Premature birth increases the risk of lung, eye, and learning problems in the infant.
  • Birth defects that often occur due to drug use include seizure, stroke, and intellectual and learning disabilities.
  • Fetuses can become dependent on the drug(s) the mother is using and may experience withdrawal symptoms after delivery.

Drug use during early pregnancy can affect the developing organs and limbs of the fetus. Even one episode of drug use during this period can affect the development of your child. In most cases, it results in a birth defect or miscarriage. Drug use later in pregnancy can affect the development of your baby’s central nervous system. After pregnancy, many drugs can pass through breast milk and harm the baby.

Using any type of illegal drug during pregnancy can have a detrimental effect on your child. Here is some information on the most commonly used drugs and how they can affect a developing baby.


To get the full effect of marijuana, smokers need to inhale deeply and hold the smoke in their lungs for as long as possible. There are many harmful gases in marijuana smoke that can be passed along to your baby, increasing the risk for complications. Smoking marijuana during pregnancy may increase the chances that your baby will have a bowel movement while inside the womb, which can cause early onset of labor and fetal distress. Marijuana use can also result in poor growth, behavioral problems, and breathing problems.

Marijuana use should also be avoided while breast-feeding, as the drug can easily be transmitted to the baby through breast milk.


Cocaine use during pregnancy increases the risk of miscarriage and stillbirth. It can also cause premature rupture of membranes (water breaks early), early separation of the placenta, and preterm labor. A baby exposed to cocaine is at a higher risk for:

  • stroke
  • poor growth
  • feeding problems
  • deformed limbs
  • brain damage
  • reproductive or urinary system abnormalities
  • sudden infant death syndrome
  • long-term behavioral problems

After pregnancy, cocaine can be transmitted to the baby through breast milk, so it shouldn’t be used while breast-feeding.

Opiates (Narcotics)

Opiates, also known as narcotics, include heroin and methadone. Women who use narcotics during pregnancy are at increased risk for preterm labor and delivery. They are also more likely to deliver a stillborn baby or a baby with growth problems. Babies exposed to narcotics in utero are at increased risk for neonatal death.


If you use heroin during pregnancy, your baby may be born addicted to the drug. They may experience a severe, life-threatening withdrawal syndrome after delivery. This condition is characterized by the following symptoms:

  • high-pitched crying
  • poor feeding
  • tremors
  • irritability
  • sneezing
  • sweating
  • vomiting
  • diarrhea
  • seizures

Your baby will need special care and medication to treat their withdrawals.

If you share needles, you should be tested for HIV and hepatitis. These infections can also cause complications in your baby.

Like cocaine and marijuana, heroin shouldn’t be used while breast-feeding.


If you can quit using opiates altogether, it will be best for you and your baby. However, switching to methadone is better than continued heroin use. Methadone is associated with better pregnancy outcomes than heroin, but babies can still experience the narcotic withdrawal syndrome. Additionally, they may still be at an increased risk for sudden infant death syndrome. For these reasons, it’s best to avoid using methadone during pregnancy. Methadone use of 20 milligrams or less per day is compatible with breast-feeding.


If you use stimulants, such as crystal methamphetamine (speed), then you are at increased risk for the following problems:

  • early placental separation
  • delivery of a baby with growth problems
  • death of the fetus in utero

Amphetamines shouldn’t be used if you’re breast-feeding.


If you need assistance or support at any time, call the Substance Abuse and Mental Health Services Administration’s National Helpline at 1-800-662-HELP or 1-800-662-AYUDA (in Spanish). There are people available to help you 24 hours a day, seven days a week.

How Does Drinking Alcohol During Pregnancy Affect the Baby?

Whatever you eat or drink is shared with your baby. Foods and liquids quickly pass from you to your child through the placenta. This is why it’s important to consume nutritious foods and juices during pregnancy. However, just as these substances reach your baby, so does alcohol. Alcohol can have detrimental effects on your developing baby. A fetus can’t process alcohol the same way an adult can. The alcohol is more concentrated in a fetus and can prevent sufficient amounts of nutrients and oxygen from reaching their vital organs.

Drinking alcohol during pregnancy can cause abnormal fetal development and fetal alcohol syndrome (FAS). FAS is a congenital condition characterized by mental and physical defects. Infants with FAS may experience withdrawal symptoms of jitteriness, irritability, and poor feeding within 12 hours after delivery. Since FAS covers a wide range of problems, there are many possible symptoms. These include:

  • a small head
  • facial abnormalities, such as a cleft palate, thin upper lip, or wide-set eyes
  • dental malformations
  • intellectual disability
  • delayed development
  • difficulties with speech, movement, and social skills
  • vision impairment
  • poor coordination
  • heart problems
  • kidney defects and abnormalities
  • deformed limbs or fingers
  • below average height and weight
  • behavioral disorders, such as attention deficit hyperactivity disorder (ADHD)

To protect your baby from alcohol-related danger, you should not drink any alcohol while you’re pregnant. Drinking during the first three months of pregnancy is especially dangerous. This is the time when important organ development occurs. For this reason, you should stop drinking alcohol if you plan on becoming pregnant in the near future. Several weeks may pass before you know you’re pregnant. You don’t want to risk drinking a toxic substance during a very important time in your baby’s development.

Can I Drink While Breast-Feeding?

Alcohol easily passes into breast milk. A baby that is repeatedly exposed to alcohol in breast milk can develop problems with mental and motor development. For this reason, there’s no level of alcohol in breast milk that’s safe for a baby to drink. If you do choose to drink while breast-feeding, make sure to avoid giving your child breast milk until the alcohol has been cleared from your body. Depending on your body weight, this usually takes two to three hours for 12 ounces of 5 percent beer, 5 ounces of 11 percent wine, and 1.5 ounces of 40 percent liquor.

Where Can I Find Help?

If you have a problem with alcohol or drug use, get help before you become pregnant. If you’re pregnant now, seek help as soon as possible. You may still be able to give birth to a happy, healthy baby.

Help is available for any drug or alcohol problem at hospitals and clinics. These facilities can give you support and provide you with the appropriate resources to help you stop using drugs or alcohol. Numerous additional resources are available. You can look online for information on support groups in your area, such as Alcoholics Anonymous, Narcotics Anonymous, and Cocaine Anonymous. There are also drug treatment centers, social and family service agencies, and alcoholism and drug abuse counselors.

If you’re breast-feeding, talk to your doctor or healthcare provider before you take anything. Alcohol, illegal drugs, and certain medications can be transferred to your baby through your breast milk and cause complications.