Background Maternal substance misuse has potential serious harmful effects on mother and infant. Association of maternal substance misuse and perinatal complications is well recognized but there is growing concern about long term neurodevelopment outcome.

Aim To review our developmental follow-up care provided to babies born to substance misusing mother's (SMM) admitted to the neonatal unit.

Methods A retrospective audit of follow-up care provided to babies born to SMM admitted to our neonatal unit during a 5 year period (1 May 2004–30 April 2009).

Results During this 5 year period there were 100 babies born to SMM admitted to our neonatal unit. Median gestation was 38 weeks and 4 days. Median head circumference was 33 cm and birth weight was 2800 g. Median Apgar score at 1 and 5 min were 9 and 9 respectively. 30/100 babies needed treatment with morphine. Median length of stay for all babies was 16 days.81/100 babies passed hearing test before discharge. 51 /100 babies were discharged to foster care.87/100 babies had follow-up arranged at discharge.75/100 babies had appropriate developmental follow-up up to 18 months age and only 3 babies did not attend appointments. Except two babies all had normal developmental assessment. Two babies had mild isolated speech and language delay.

Conclusion Babies born to SMM are at risk of developmental problems but our results have shown that there is no direct association with an adverse neurodevelopment outcome for these babies.