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Prenatal drug exposure and maternal and infant feeding behaviour
  1. L L LaGasse1,
  2. D Messinger2,
  3. B M Lester1,
  4. R Seifer3,
  5. E Z Tronick4,
  6. C R Bauer5,
  7. S Shankaran6,
  8. H S Bada7,
  9. L L Wright8,
  10. V L Smeriglio9,
  11. L P Finnegan10,
  12. P L Maza11,
  13. J Liu1
  1. 1Brown Medical School, Women & Infant’s Hospital and Bradley Hospital, Providence, RI, USA
  2. 2University of Miami, Miami, FL, USA
  3. 3Brown Medical School and Bradley Hospital, Providence
  4. 4Harvard University Medical School and Children’s Hospital, Boston, MA, USA
  5. 5University of Miami School of Medicine, Miami
  6. 6Wayne State University School of Medicine, Detroit, MI, USA
  7. 7University of Kentucky College of Medicine, Lexington, KY, USA
  8. 8National Institute of Child Health and Human Development (NICHD), Bethesda, MD, USA
  9. 9National Institute on Drug Abuse (NIDA), Bethesda
  10. 10Office of Research on Women’s Health, National Institutes of Health, Bethesda
  11. 11Administration on Children, Youth and Families (ACYF), Washington, DC, USA
  1. Correspondence to:
    Dr LaGasse, Infant Development Center, 79 Plain St, Providence, RI 02903, USA;


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.

  • drugs
  • cocaine
  • opiate
  • maternal-infant interaction
  • feeding

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