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Amphetamine use during pregnancy and breastfeeding

If you are pregnant, planning to be pregnant or breastfeeding, we strongly recommend that you quit all recreational drug use.

The use of, and lifestyle surrounding, amphetamine drug use can adversely affect your health and pregnancy and the health of your unborn baby. Injecting drugs increases the risk of you contracting a bacterial infection which could cause you to have a serious heart or lung problem or contracting a viral infection which could be passed on to your baby or overdosing.

After your baby’s birth, using these drugs can make parenting difficult for you and unsafe for your baby as you may be unable to respond well to your baby’s needs.

Amphetamine type stimulant drugs include amphetamines, methamphetamines and MDMA (ecstasy) and have street names of speed, ice, crystal meth, go-ee or uppers. These drugs are illegal; often crudely manufactured and the types and amounts of their ingredients are unknown.

There are many forms of these drugs which can be taken into the body in different ways, so the effects are wide and varied. Generally, the drugs are known to cause sleeplessness, high blood pressure, tremors, restlessness, anorexia and sweating. While they may give the user a sense of confidence and energy, high doses can cause dizziness, headaches, irregular heartbeat, confusion, paranoia, mood disorder and aggression. Serious physical and mental conditions may result from heavy use or overdose of these drugs. 1

Amphetamines are considered unsafe to use in pregnancy and while there is limited medical evidence of the consequences of using amphetamine type stimulant drugs during pregnancy, the following effects have been described:

  • Reduced blood flow caused by narrowing of the blood vessels 2, limiting oxygen and nutrient supply to your unborn baby and resulting in reduced growth and head circumference
  • Antepartum bleeding conditions.
  • Behaviour and learning difficulties in children who were exposed in utero.
  • Other medical evidence suggests the drugs may cause pregnancy complications including miscarriage and early labour; an increased risk of fetal abnormalities (i.e. heart abnormalities); altered fetal nervous system as the drug acts as a stressor to baby and alteration of (baby) brain structure and development. 2,3,4,5,6

There are a few reports of neonatal withdrawal associated with maternal amphetamine type stimulant drug use. Some exposed babies may have sleep disturbances and feeding problems. In addition, babies may be born drug affected (i.e. over-active and agitated).

Antenatal care:

  • When you are booking-in to have your baby at Mater Mothers’ Hospital, you will be asked about current and recent prescribed, non-prescribed and recreational drug use. It is important to tell your midwife about any drug use that may impact on your pregnancy.
  • Regular antenatal care is important to ensure you are healthy, and that your unborn baby is developing and growing well. If you are concerned about poor appetite or diet, ask to be referred to a dietitian. You can also ask for help if you have anxiety or a mood disorder, and the hospital social worker can provide practical assistance for social matters.
  • If you are having trouble quitting or are at risk of relapsing, we recommend you attend the Mater Mothers’ Hospital CHAMP Clinic which is a midwife led clinic where you can have your antenatal appointments and at the same time receive help to quit your drug use. CHAMP Clinic staff work with women to change their drug use behaviours and help them prepare for the birth of their baby.

After the birth of your baby

Your baby may need to stay in hospital longer than usual to ensure they are settled, feeding well and gaining weight. Some babies exposed to maternal use of these drugs throughout pregnancy may experience problems after birth and require supportive care and treatment.

If your doctor or midwife has concerns regarding your baby’s health, they will refer your baby to a paediatrician (baby’s doctor). Community Child Health is an accessible and free health service for you and baby. We would encourage you to attend your local clinic.

Breastfeeding

Amphetamine type stimulant drugs are thought to concentrate in breast milk and may cause irritability and disturbed sleep in babies. The long-term effects of this exposure are unknown. It is advisable not to breastfeed for 24 to 48 hours after the use of amphetamines. It is important to express and discard breast milk after using these drugs (not to simply stop breastfeeding). 8

Child safety

It is unwise to be intoxicated while caring for, or handling your baby. Concerns for your baby’s safety are raised when this occurs, as your baby could be accidentally injured by the intoxicated person. It is also unsafe to sleep your baby with you in bed at any time, especially if you have been using alcohol or drugs. Always follow the safe sleeping guidelines.

Stopping amphetamine use

While pregnancy is a good motivator to change your drug use behaviour, you may find it hard to stop using amphetamines. If you are experiencing difficulties, speak with your midwife or doctor who can refer you to a specialist service. You may also find the following suggestions helpful. Set a goal to quit. Keep a diary of your use and how much you spend on your use. Avoid situations that make you uncomfortable (that is, Hunger, Anger, Loneliness, and Tiredness (HALT) to prevent relapsing back into drug use). Avoid places or “friends” who use drugs and use other (positive) ways to cope with everyday stress such as relaxation techniques and distracting yourself with other, pleasurable activities. Counselling may help you to explore personal issues and make positive changes, learn new ways to manage stress and develop strategies to stop using drugs.

Further support and information

Information about the effects of using substances while you are pregnant is available from staff at Mater Mothers’ Hospital CHAMP Clinic, on telephone 07 3163 2417 or via email champ@mater.org.au. Alternatively, please contact Alcohol and Drug Information Service on free call 1800 177 833.

References

  1. Amphetamines Brochure. Queensland Health. Alcohol Tobacco and Other Drug Services, November 1995.
  2. Women’s Alcohol and Drug Service 2005. Cited on 11/03/2010 at: www.thewomens.org.au/Amphetamines.
  3. Salisbury AL, Ponder KL, Padbury JF, Lester BM. Fetal effects of psychoactive drugs. Clin Perinatal. 2009;36(3):595-619.
  4. Chang L, cloak C, Jiang CS, Farnham S, Tokeshi B, Buchthal S, Hedemark B, Smith LM, Ernst T. Altered neurometabolites and motor integration in children exposed to methamphetamine in utero. Neuroimage. 2009;48(2):391-7.
  5. Lu LH, Johnson A, O’Hare ED, Bookheimer SY, Smith LM, O’Connor and MJ, Sowell ER. Effects of prenatal methamphetamine exposure on verbal memory revealed with functional magnetic resonance imaging. J Dev Behav Pediatr. 2009;30(3):185-92.
  6. Cloak CC, Ernst T, Fujii L, Hedemark B and Chang L. Lower diffusion in white matter of children with prenatal methamphetamine exposure. Neurology. 2009;72(24):2068-75. Epub 2009 Apr 15.
  7. National clinical guidelines for the management of drug use during pregnancy, birth and the early developmental years of the newborn, 2006, Commonwealth of Australia, 3.9.1, 3.9.2 (pp42); ,2.5.7 pp21.
Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: PI-CLN-430030
Last modified 09/8/2017.
Consumers were consulted in the development of this patient information.
Last consumer engagement date: 18/1/2014
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