In utero drug exposure and maternal-infant interaction: The complexities of the dyad and their environment

Abstract

This article, which examines mother‐infant interaction, addresses the complexities that affect this dyad when there is exposure to drugs. Maternal characteristics are affected by high‐stress environments and life events. Also, withdrawal or abstinence symptoms in the infant, and/or poor state regulation, further complicate the interaction. A large number of risk factors are frequently encountered with this dyad and their impact is not fully understood. Studies with other groups at high risk reveal that factors associated with biological risk affect the social and intellectual development of the infant. Among the existing areas of specific investigation, one finds maternal dual diagnosis, psychosocial problems, poor nutrition, and the physical and social environment of the dyad. Methodological and conceptual problems for research and intervention in this domain are discussed. Cet article, qui examine l'interaction mère‐nourrisson, soulève des problèmes sur la complexité accrue de cette dyade lorsqu'il y a une exposition aux stupéfiants. Les caractéristiques maternelles sont affectées par des milieux extrěmements stressants et des vies jusque‐là difficiles. De plus, les symptǒmes de manque et d'abstinence chez le nourrisson, et/ou la médiocre régulation de l'état compliquent encore plus toute interaction. Un grand nombre de facteurs de risque sont fréquemment rencontrés chez cette dyade et leur impact n'est pas totalement compris. Les recherches avec d'autres groupes à haut risque révèlent que les facteurs de risques ajoutés aux facteurs de risque biologique affectent le développement social et intellectuel de l'enfant. Parmi les domaines exigeants des investigations spécifiques, l'on trouve le double diagnostic maternel, les problemes psychosociaux, la mauvaise nutrition, et les milieux physiques et sociaux de ces dyades. Nous discutons les problèmes methodologiques et conceptuels pour la recherche et l'intervention dans ce domaine.

The early relationship of drug abusing mothers and their infants: An assessment at eight to twelve months of age

“…Many studies have been reported which identify causal factors (i.e., dual diagnoses, social isolation, violence, inattention, low education) in dyadic dysfunction with drug abusing mothers (Freier, 1994). Yet, studies have investigated the specific social skills that are lacking in the early maternal-infant relationships (Bauman & Dougherty, 1983;Bernstein, Jeremy, Hans, & Marcus, 1984;.…”

Longitudinal Effects of Prenatal Cocaine Use on Mother-Child Interactions at Ages 3 and 5 Years

“…PCE has been associated with poorer state regulation and arousal modulation in infancy, 20 and with greater attention, 21 language, 22 and in some studies, behavioral problems during childhood, 23 which have the potential to influence mother-child interaction. 2,6 Substance-using mothers who have comorbid psychopathology, high levels of stress, and ineffective parenting skills may have greater difficulties understanding and responding appropriately to infant cues, particularly in infants who may be poorly regulated. 2,24 …”

“…2,6 Substance-using mothers who have comorbid psychopathology, high levels of stress, and ineffective parenting skills may have greater difficulties understanding and responding appropriately to infant cues, particularly in infants who may be poorly regulated. 2,24 …”

“…These mothers typically reside in high-risk environments characterized by low-income communities, inadequate nutrition, ongoing familial substance use, homelessness and minimal social support. 2,3 Maternal drug abuse combined with contextual risk factors may exacerbate maternal stress which can compromise the quality of parenting and mother-child interactions.…”

Use of the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: Revised Edition (DC:0–3R) with Canadian Infants and Young Children Prenatally Exposed to Substances

“…The contextual approach of the DC:0–3R system is particularly relevant for infants with substance exposure and their families. Such infants often present with a range of difficulties that make them more challenging to care for (discussed earlier), and mothers with substance‐use problems often face a variety of stressors (e.g., poverty, unstable housing, abusive relationships, involvement in drug‐dealing activities) that may impair their ability to parent effectively (Freier, ; Mayes & Truman, ). The literature has suggested that substance‐exposed dyads are at risk for problematic interactions (Blackwell, Kirkhart, Schmitt, & Kaiser, ; Burns, Chethik, Burns, & Clark, ; Hans, Bernstein, & Henson, ; Johnson et al, ; Mayes et al, ; Minnes, Singer, Arendt, & Satayathum, ; Pajulo et al, ; Schuler, Nair, & Black, ) and at greater risk than are nonexposed dyads for insecure and disorganized attachment patterns (Swanson, Beckwith, & Howard, ).…”