ORIGINAL ARTICLE

Prenatal drug exposure and maternal and infant feeding behaviour

L L LaGasse¹, D Messinger², B M Lester¹, R Seifer³, E Z Tronick⁴, C R Bauer⁵, S Shankaran⁶, H S Bada⁷, L L Wright⁸, V L Smeriglio⁹, L P Finnegan¹⁰, P L Maza¹¹ and J Liu¹

¹ Brown Medical School, Women & Infant’s Hospital and Bradley Hospital, Providence, RI, USA
² University of Miami, Miami, FL, USA
³ Brown Medical School and Bradley Hospital, Providence
⁴ Harvard University Medical School and Children’s Hospital, Boston, MA, USA
⁵ University of Miami School of Medicine, Miami
⁶ Wayne State University School of Medicine, Detroit, MI, USA
⁷ University of Kentucky College of Medicine, Lexington, KY, USA
⁸ National Institute of Child Health and Human Development (NICHD), Bethesda, MD, USA
⁹ National Institute on Drug Abuse (NIDA), Bethesda
¹⁰ Office of Research on Women’s Health, National Institutes of Health, Bethesda
¹¹ Administration on Children, Youth and Families (ACYF), Washington, DC, USA

Correspondence to:
Correspondence to:
Dr LaGasse, Infant Development Center, 79 Plain St, Providence, RI 02903, USA;
linda_lagasse{at}brown.edu

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.

Keywords: drugs; cocaine; opiate; maternal-infant interaction; feeding

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