Children's Needs â Parenting Capacity - Digital Education Resource ...
Children's Needs â Parenting Capacity - Digital Education Resource ... Children's Needs â Parenting Capacity - Digital Education Resource ...
104 Children’s Needs – Parenting Capacitycare staff will result in judgemental attitudes, the involvement of children’s socialcare services and the possible loss of the baby once it is born (Dore and Dore 1995;Burns 1996; Powell and Hart 2001). A review of the literature on child neglectfound that substance misuse may also result in neglect during pregnancy (Daniel etal. 2009).Finally, while there is general agreement that alcohol and drug use can increasethe risk of impairment to the unborn child’s healthy development, it is also probablethat most mothers who use alcohol or drugs will give birth to healthy, normalchildren who suffer from no long-term effects (Powell and Hart 2001).DrugsFor pregnant drug users in general, irrespective of the substance used, especiallywhere poor social conditions prevail, there is an increased risk of low birth weight,premature delivery, perinatal mortality and cot death (Standing Conference onDrug Misuse 1997). A meta-analysis, which included only studies which controlledfor maternal smoking although not for other lifestyle factors, found cocaine useduring pregnancy caused low birth weight. The effect was greater with heavier use(Hulse et al. 1997).Cocaine also increases the risk of a premature birth or miscarriage because itsuse can restrict the blood flow to the placenta and foetus. Babies may also be bornwith neonatal abstinence syndrome, although those born to mothers receivingmethadone under medical supervision tend to have fewer complications than babiesborn to heroin addicts or methadone users who are not receiving medical care andadequate nutrition (McNamara et al. 1995). Good ante-natal care can help thenewborn baby regain their weight deficiency and increase the likelihood that theywill achieve their milestones.Tetrahydrocannabinol (THC), the chemical in marijuana that produces a ‘high’,can easily cross the placental barrier, and when this happens it reduces the amountof oxygen present within the foetal blood. Research suggests this probably does notincrease risk of miscarriages and stillbirths, nor is there adequate evidence to suggestit causes low birth weight (McNamara et al. 1995). The effects on the unborn childof newer drugs such as Ecstasy are not well researched.In 2009 the overall prevalence of HIV among injecting drug users in England, Walesand Northern Ireland was 1.5%; twice the rate found in 2000 (Health ProtectionAgency 2010). The transmission of HIV infection across the placenta to the unbornchild is a serious complication of intravenous drug use. When the expectant motherdoes not receive drug therapy, research suggests 22% of babies are HIV positive(Ene et al. 2007). However, in developed countries where the administration ofdrugs such as zidovudine is provided, the transmission of infection can be largelyprevented (Gottlieb 2002). Clinical guidelines on the management of drug misuse
Child development and parents’ responses – children under 5 years 105and dependence is that specialist advice should be sought on breastfeeding when themother is HIV positive (Department of Health and the devolved administrations2007).Almost half of injecting drug users are infected with hepatitis C (Health ProtectionAgency 2010). Vertical transmission rates of the virus from mother to infant havebeen reported to be about 4%. However, multiple virus infection can dramaticallyincrease the risk of vertical transmission (Roberts and Latifa 2002; McMenaminet al. 2008).AlcoholExcessive drinking during pregnancy is associated with an increased rate ofmiscarriage and can cause Foetal Alcohol Syndrome, now often referred to as FoetalAlcohol Spectrum Disorder. Foetal Alcohol Spectrum Disorder describes a patternof physical, behavioural, and intellectual characteristics children may display whenprenatally exposed to alcohol. The foetus is most vulnerable to damage during thefirst three months. There are three categories of symptoms:growth deficiently for height and weightdistinct pattern of facial features and physical characteristicscentral nervous system dysfunction.Alcohol-related changes in brain structure can be identified by modern imagingtechniques (Royal College of Obstetricians and Gynaecologists 2006).Research into Foetal Alcohol Spectrum Disorder is difficult because much of thedata rely upon women being able to remember how much they had to drink monthsor even years previously and even before they became pregnant. Some women mayunderestimate their drinking because of the stigma attached to drinking whilepregnant (Alvik et al. 2006).The impact on the unborn child is related to the amount and pattern of alcoholconsumed by the mother. For example, research carried out in the United Kingdomfound women who were light drinkers (defined as 1 to 2 drinks per week) duringpregnancy did not have a higher risk of producing children (aged up to 5 years) withcognitive or behavioural problems compared to abstinent mothers (Kelly et al. 2010).There is growing evidence to suggest that moderate, regular alcohol consumptionmay be less harmful than binge drinking (Plant 1997). A small South African studyon the drinking habits of women who had a diagnosed Foetal Alcohol SpectrumDisorder child also suggests that heavy-drinking episodes may be a better predictorof Foetal Alcohol Spectrum Disorder than average weekly consumption (Khaole etal. 2004). However, research on the impact of binge drinking on the unborn babyis inconclusive in relation to the risk of miscarriage, stillbirth, intrauterine restricted
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104 Children’s <strong>Needs</strong> – <strong>Parenting</strong> <strong>Capacity</strong>care staff will result in judgemental attitudes, the involvement of children’s socialcare services and the possible loss of the baby once it is born (Dore and Dore 1995;Burns 1996; Powell and Hart 2001). A review of the literature on child neglectfound that substance misuse may also result in neglect during pregnancy (Daniel etal. 2009).Finally, while there is general agreement that alcohol and drug use can increasethe risk of impairment to the unborn child’s healthy development, it is also probablethat most mothers who use alcohol or drugs will give birth to healthy, normalchildren who suffer from no long-term effects (Powell and Hart 2001).DrugsFor pregnant drug users in general, irrespective of the substance used, especiallywhere poor social conditions prevail, there is an increased risk of low birth weight,premature delivery, perinatal mortality and cot death (Standing Conference onDrug Misuse 1997). A meta-analysis, which included only studies which controlledfor maternal smoking although not for other lifestyle factors, found cocaine useduring pregnancy caused low birth weight. The effect was greater with heavier use(Hulse et al. 1997).Cocaine also increases the risk of a premature birth or miscarriage because itsuse can restrict the blood flow to the placenta and foetus. Babies may also be bornwith neonatal abstinence syndrome, although those born to mothers receivingmethadone under medical supervision tend to have fewer complications than babiesborn to heroin addicts or methadone users who are not receiving medical care andadequate nutrition (McNamara et al. 1995). Good ante-natal care can help thenewborn baby regain their weight deficiency and increase the likelihood that theywill achieve their milestones.Tetrahydrocannabinol (THC), the chemical in marijuana that produces a ‘high’,can easily cross the placental barrier, and when this happens it reduces the amountof oxygen present within the foetal blood. Research suggests this probably does notincrease risk of miscarriages and stillbirths, nor is there adequate evidence to suggestit causes low birth weight (McNamara et al. 1995). The effects on the unborn childof newer drugs such as Ecstasy are not well researched.In 2009 the overall prevalence of HIV among injecting drug users in England, Walesand Northern Ireland was 1.5%; twice the rate found in 2000 (Health ProtectionAgency 2010). The transmission of HIV infection across the placenta to the unbornchild is a serious complication of intravenous drug use. When the expectant motherdoes not receive drug therapy, research suggests 22% of babies are HIV positive(Ene et al. 2007). However, in developed countries where the administration ofdrugs such as zidovudine is provided, the transmission of infection can be largelyprevented (Gottlieb 2002). Clinical guidelines on the management of drug misuse
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