Crack cocaine impairs brain development of a fetus resulting in reduced cognitive performance in the areas of language and speech development, behaviour, somatic and intellectual growth. High levels and prolonged exposure increase risk and may be fatal. Crack cocaine increased chance of pre-term births and cause changes in brain structure, which results in attention and cognitive deficiencies. Crack babies are more excitable and have problems self-regulating. Infants may also develop symptoms similar to those of attention deficit disorder. Some crack babies become withdrawn and exhibit depressed behaviours, while others become more aggressive and exhibit disruptive behaviours (Barol, 1997). If the mother reveals crack cocaine exposure at an early stage during pregnancy, it is possible to reduce or eliminate the negative effects of exposure. However, in many cases, interventions begin at birth because many crack mothers do not seek prenatal care (Ross, Graham, Money, & Stanwood, 2014).
Pharmacologic measures for crack exposure are rare. However, when an infant exhibit symptoms of abnormal Central Nervous System (CNS) behaviour or extreme irritability, doctors often use phenobarb at a rate of 3-5 mg/kg/day. The dose is administered until abnormal CNS behaviour seizes. Phenobarb is highly addictive; therefore, the baby is weaned at a 10% rate or depending on symptomatology (Hakan, Aydin, Yilmaz, Zenciroglu & Okumus, 2014). Often, crack cocaine is used together with other drugs, such as alcohol, tobacco, and heroin. Consideration for the effects of other causes of abnormal CNS behaviour should be taken into account before the pharmacologic intervention. Other drugs a doctor may administer to sedate a crack baby include valium or throrazine. Unlike other drugs, such as heroin, cocaine addiction is more psychological than physical. At birth, crack babies’ emotions and behaviour are erratic. They can be inconsolable in one moment, and the next minute they are peacefully asleep. The best course of action for a doctor in such a case is to sedate the baby to prevent it from harming itself (Barol, 1997). Inpatient treatment may last up to a month.
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Description of the Treatment
The main problem associated with the use of crack cocaine while pregnant is not giving birth to addicted babies; it is having pre-term babies or full-term babies with physical and psychological challenges. Crack cocaine causes the constriction of blood vessels, which reduces the number of nutrients and oxygen, reaching the baby in the womb. In extreme conditions, it may result in the detachment of the placement. The lungs are usually some of the last organs to develop; therefore, pre-term babies have difficulty breathing. Phenobarbital is administered before administering curare to ensure effective mechanical ventilation. The drug is also administered to neonates showing symptoms of paroxysmal activity. Phenobarbital helps avoid intraventricular illness and treatment of bacterial meningitis in infants. The drug is administered intravenously, and the loading dose is 15-20 mg/kg. A maintenance dose of 5mg/kg/day is recommended to avoid an overdose. The drug has a half-life of 69-165 hours (Hakan, Aydin, Yilmaz, Zenciroglu & Okumus, 2014). The duration of therapy varies depending on the condition of the infant and its response to treatment. Generally, treatment lasts for one to two weeks and is followed by a period of weaning the infant from the drug.
Majority of crack babies who are reported to the child welfare system are black. Hispanics babies are few and whites even fewer. However, it is estimated that more than half of crack babies go unreported. Treating crack babies immediately after birth is only the tip of the iceberg. Other than the high likelihood of the child ending up in foster care, there are other services the child may require depending on symptoms. These include developmental intervention, health, and education services (Ross, Graham, Money, & Stanwood, 2014). With the right care and environment, crack babies are indistinguishable from non-exposed babies in their adult life. However, it cost more and takes much more effort to realize this. For example, a child with language and speech development problems coupled with emotional disturbance, may require residential treatment in a special education institution. Here, the child will require the services of a speech therapist, psychologist, and special educator.
Analysis of the Treatment
Phenobarbital acts on GABA A receptors to reduce excitatory synaptic responses and help a patient relax. The drug is commonly used to treat seizures. The drug is also used to treat crack babies because they suffer from a psychological addiction, which makes them restless and likely to harm themselves (Barol, 1997). After the initial treatment to reduce the withdrawal symptoms of crack cocaine in the baby, the next step is to ensure the baby grows in an enabling environment. Most crack mothers are unlikely to stop the use of crack after giving birth. Crack affects the maternal instincts of the mother, making her detached. Without care and attention, the child is likely to suffer abuse. Therefore, most crack babies end up in the foster care system despite studies showing that those who grow up with a supportive mother or family member have better outcomes (Kusserow, 1990). In the United States, the law allows the state to take custody of a baby even in the absence of abuse if the mother test positive to crack cocaine (Logan, 1999).
Reactions of the Treatment
The foster care system is, in most cases, the best option for crack babies whose mothers will not quit crack cocaine abuse and relatives are unwilling or unable to take responsibility for the child. In foster care homes, crack babies undergo a full assessment to determine the physical and psychological effects of prenatal crack exposure. The homes tailor individualized programs based on individual results. This gives children access to experts such as a therapist, and special educators, among others (Kusserow, 1990). Research conducted on crack babies reveals that those who do better in life are those who grow up in an enabling environment where the mother refrain from abusing drugs during early childhood and give the child maternal care and love. Crack babies do better when they receive care in a non-judgmental environment. For example, those who go to school in places where the teachers and other students are unaware of their past exposure to crack perform better and have fewer incidences of unwanted behaviour. Although prenatal exposure to crack cause a number of physical and psychological deficiencies in infants, the children tend to catch up with non-exposed children as they grow up (Singer, Farkas & Kliegman, 1992).
Conclusion
Crack cocaine continues to be a problem destroying the fabric of society. Although prenatal exposure to crack does not cause long-lasting effects, being brought up by a parent who uses crack and the associated social stigma causes lasting effects. Programs to change the perception of crack babies in society and to encourage new mothers to seek prenatal care are of the essence. New mothers should be helped with their drug-use problem to enable them to take care of their maternal responsibilities.
References
Barol, B. (1997). Cocaine Babies: Hooked at Birth. Retrieved 19 November 2019, from http://www.cog.brown.edu/courses/63/crackbabies1.html
Hakan, N., Aydin, M., Yilmaz, O., Zenciroglu, A., & Okumus, N. (2014). Is phenobarbital a neuroprotective agent in newborn infants with perinatal asphyxia?. Pediatrics International , 56 (1), 128-128. doi: 10.1111/ped.12264
Kusserow, R. (1990). Crack Babies [Ebook]. Office of the Inspector General, Office of Evaluation and Inspections. Retrieved from https://oig.hhs.gov/oei/reports/oei-03-89-01540.pdf
Logan, E. (1999). The Wrong Race, Committing Crime, Doing Drugs, and Maladjusted for Motherhood: The Nation's Fury over "Crack Babies". Social Justice , 26 (1(75), 115-138. Retrieved from http://www.jstor.org/stable/29767115
Ross, E., Graham, D., Money, K., & Stanwood, G. (2014). Developmental Consequences of Fetal Exposure to Drugs: What We Know and What We Still Must Learn. Neuropsychopharmacology , 40 (1), 61-87. doi: 10.1038/npp.2014.147
Singer, L., Farkas, K., & Kliegman, R. (1992). Childhood Medical and Behavioral Consequences of Maternal Cocaine Use. Journal of Pediatric Psychology , 17 (4), 389-406. doi: 10.1093/jpepsy/17.4.389
