Methamphetamine Exposure in Infants

From Pediatrics in Review:

   Methamphetamines
Despite concerns about infants exposed to this drug as rates of usage in the United States increase, there is a general dearth of reports involving in utero exposure. Isolated cases of cardiac defects, cleft lip, and biliary atresia have been reported. Use during pregnancy also has been associated with increased rates of fetal distress and growth restriction, resulting in small-for-gestational age size at birth. Methamphetamine exposure has been associated with preterm birth, but this linkage has been disputed more recently. Neurobehavioral patterns of decreased arousal, increased stress, and poor quality of movement  have been described, as has a withdrawal syndrome in a few infants (4%).

Diarrhea that won't go away

Ulcerative Colitis and Crohn Disease

What is that?

Well simply put it is diarrhea and abdominal pain that lasts a long time.  This is thought to be a result of your immune system overreacting in your digestive system.

How do you tell the difference between the two?

Ulcerative Colitis - like it sounds involves the colon.  It is often associated with rectal bleeding. 

Crohn's Disease.  Children usually present with chronic tummy pain, diarrhea, and weight loss.  Ulcers can present from the mouth to the bottom. 

These two diseases can also present with skin or joint problems.

How do you diagnose it?

A Gastroenterologist will use a scope to take pictures of your insides and also do a biopsy.

How do you treat it?

Medicines that calm down the immune system are used like steroids.  For severe Ulcerative Colitis a chance to cut is a chance to cure.  Removal of the large intestine is often curative in UC.

Take Home Points

Most diarrhea is self limited and will resolve after about 2 weeks.  If your diarrhea lasts longer you should see a specialist.

What Can Prenatal Drugs Do To My Baby?

Prescription and non-Prescription drugs can influence how your baby thinks, behaves, and looks.  The following are just a few examples.

Nicotene
Prenatally nicotine-exposed infants are at increased risk for preterm birth and sudden infant death syndrome  as well as fetal growth restriction.  There is a higher incidences of orofacial clefts, neural tube defects, and cryptorchidism.

Alcohol

can produce preterm birth, Low Birth Weight, and fetal alcohol spectrum disorder which affects brain and facial features.

A smooth philtrum — The divot between the nose and upper lip flattens
Thin vermilion — The upper lip thins
Small palpebral fissures —  Eye width decreases

Opioids

The most notable opioid effects may include tonal problems, tachypnea, feeding and sleeping problems, fever, and seizures.

Benzodiazepines
"Withdrawal phenomena have been reported in exposed infants. Signs include hypoventilation, irritability, hypertonicity, and "floppy infant syndrome," particularly after use in late gestation. These symptoms can appear within a few days to 3 weeks after birth and can last for several months."

Lauren M. Jansson and Martha L. Velez
Infants of Drug-dependent Mothers
Pediatr. Rev. 2011 32: 5-13. 

Doctor Means Teacher

The word "doctor" means "teacher," in Latin.   The best primary care physicians will be master teachers and students. 

From Pediatrics in Review Jan 2011:
"When performing health maintenance or managing chronic illness, teaching becomes a major component of care. Patients, parents, and caregivers are the students (although the complete physician will be learning constantly from those folks as well)."

Look for a physician that helps you learn and also is willing to listen to you.