Pregnancy and addictions

On average, a quarter of women are smokers during early pregnancy and one in twenty suffers from alcoholism. This is due in part to lack of knowledge about the harmful effects of maternal addictions on the fetus, but also a lack of familiarity with options available, such as the use of replacement products.
 

SIX KEY IDEAS IN THE
“PREGNANCY AND ADDICTIONS” REPORT

 

Replacement products are an effective tool to help stop addictions

Nicotine replacements can be an effective option to help stop smoking, including after the baby is born, while the mother is nursing. Moreover, some maternity clinics measure carbon monoxide in order to determine the proper dosing for nicotine patches.
Replacement treatment can also be provided to women who are dependent on opiates during or after pregnancy.

Tip

Replacement products are an effective tool for stopping addictions. Moreover, in some cases they bring immediate improvement. The air exhaled by tobacco users, for example, becomes healthy within 24 hours of stopping!

Alcohol dependency is a taboo subject and its effects are poorly understood

Alcoholism is the primary cause of mental disability at birth. The risks tied to alcohol consumption are poorly understood. 
We know that problems become more severe when the mother consumes alcohol more frequently, in larger volumes or at an early stage of pregnancy.

Tip

A cause-and-effect relationship from alcohol has been observed, but it is still impossible to define a dose that is not hazardous to the fetus. Therefore, prudence suggests that abstinence is the best course of action during pregnancy.

Even less common addictions pose a risk

Smoking and alcoholism sometimes overshadow addictions to other substances (e.g., cannabis, anti-anxiety or psychotropic drugs) and behavioral addictions: eating disorders, physical hyperactivity, compulsive gambling, shopping addictions, etc.  In each case, the consequences for the fetus and child can be tragic: respiratory maladaptation (smoking), miscarriage (bulimia), low fetal heart rate and infant withdrawal syndrome (benzodiazepines), miscarriage or even fetal death (cocaine) and, in general, low birth weight and premature birth.
Tobacco use by the mother during pregnancy doubles the risk of ectopic pregnancy and premature birth, and triples the risk of spontaneous abortion. Over time, it increases the child’s risk of developing adult-onset cancer. Meanwhile, the mother’s use of cannabis during pregnancy can lead to learning difficulties, hyperactivity and mental disturbance in school-age children.

Tip

Dependency has a behavioral component. By reflecting on their lifestyle, mothers will be better prepared to quit.

Prevention is effective, especially as part of a multidisciplinary strategy

The issue needs to be addressed as early as possible, preferably within a multidisciplinary framework. Midwives and gynecologists are well positioned to screen for addictions at an early stage and guide the patient to an appropriate addiction specialist. In addition, some facilities, such as smoke-free maternity clinics, and certain professionals specialize in providing support for those with dependencies. Social and psychological support is often needed.

Tip

Support is more effective if it is given early on and follows a multidisciplinary approach that addresses medical, social and psychological issues.

Dependency is a widespread problem that affects numerous pregnant women

Women are increasingly affected by all types of dependency.

Tip

It’s possible to identify an addiction by posing a few simple questions: the nature of the products consumed; the quantity, circumstances and frequency of consumption; the benefits and drawbacks associated with use.

Breastfeeding and tobacco use are compatible

Contrary to received wisdom, the benefits of breastfeeding far outweigh the negative effects of substances like tobacco. A mother’s milk offers nutritional and digestive benefits and protects the baby against infection. 
It’s better for the mother to smoke immediately after breastfeeding and to wait at least two hours before nursing again, so that the level of nicotine in her milk is as low as possible. Moreover, mothers should smoke far away from their baby, inhale as little as possible, thoroughly air out the house and, of course, smoke as few cigarettes as possible.  
Nicotine replacement products are also compatible with breastfeeding. The recommended method is to chew nicotine gum just after breastfeeding, to ensure there is no nicotine in the milk the next time the mother nurses her baby.

Tip

Whatever their circumstances, mothers who wish to breastfeed their children should do so, while following a few simple rules (such as allowing as much time as possible between smoking and nursing).