Substance-Exposed Infants

pregnancy Each year, an estimated 400,000–440,000 infants (10–11% of all births) are affected by prenatal alcohol or illicit drug exposure, as described in the analysis in this section. Prenatal exposure to alcohol, tobacco, and illicit drugs has the potential to cause a wide spectrum of physical, emotional, and developmental problems for these infants. The harm caused to the child can be significant and long-lasting, especially if the exposure is not detected and the effects are not treated as soon as possible.

To fully address substance exposed infant issues, they must be handled in an intensely collaborative setting, since no single agency has the resources, the information base, or the lead role to address the full range of needs of all substance-exposed or substance-affected newborns and their families. If concern for these children is to continue past birth, the number of families who may need services increases to several million; these are the families of preschoolers who were prenatally exposed, many of whom may also be affected by continuing substance use disorders in their families. These increases in the scope and complexity of States’ interagency networking are important aspects of the context for State substance exposed infant policy and its implementation.


A Framework for Intervention for Infants with Prenatal Exposure and Their Families

A Framework for Intervention for Infants with Prenatal Exposure and Their FamiliesThe Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment and the Administration on Children, Youth and Families, Children’s Bureau, Office on Child Abuse and Neglect, in partnership with the National Center on Substance Abuse and Child Welfare present a webinar to addresses practice and policy issues for infants with prenatal exposure and their families. The webinar introduces the Five Point Framework, which identifies points of intervention for comprehensive reform to prevent prenatal exposure and respond to the needs of pregnant women, mothers, their families and infants. The five points of intervention include pre-pregnancy, prenatal, identification at birth, post-partum, and infancy and beyond.


    • Nancy K. Young, PhD

Statistics and Factsheets

Policy and Practice Resources

    • Substance-Exposed Infants:  State Responses to the Problem (PDF 1,150 KB)
      Young, N. K., Gardner, S., Otero, C., Dennis, K., Chang, R., Earle, K., & Amatetti, S
      Substance Abuse and Mental Health Services Administration, 2009
      This study assessed State policy from the broadest perspective: prevention, intervention, identification, and treatment of prenatal substance exposure, including immediate and ongoing services for the infant, the mother, and the family.
    • Substance Abuse During Pregnancy(PDF 82 KB)
      Guttmacher Institute State Policies in Brief, July 1, 2014. This brief provides a summary of state policies on substance abuse during pregnancy, including: whether substance abuse during pregnancy is considered a criminal act, child abuse or grounds for civil commitment; whether the state requires either reporting or testing when substance abuse is suspected; and whether preganant women are given priority access to substance abuse treatment programs.
    • Substance-Exposed Infants: Current Issues and Responses
      American Professional Society on the Abuse of Children Advisor 19(4), 2007
      Provides a brief review of prevalence estimates, a summary of state policies and programs to assist families of substance-exposed infants, and suggestions of needed interventions in both policy and direct practice.
    • SAMHSA Fetal Alcohol Spectrum Disorders Center for Excellence
      Website has a wealth of resources for persons interested in fetal alcohol spectrum disorders, including a FASD resource database with over 5,000 entries. Their site also has fact sheets, special reports, an events calendar, and more.
    • Baby Steps: Caring for Babies with Prenatal Substance Exposure (September 2011) (PDF 4.94 MB)
      Ministry of Children and Family Development, British Columbia
      Information in this guide focuses on the daily care of babies aged birth to 6 months of age who have been exposed to substances in the womb. This caregiver guide is intended to be a hands-on resource for parents and caregivers of babies who have been prenatally exposed to alcohol and other drugs.
    • Improving Treatment for Drug Exposed Infants (PDF 825 KB)
      Examines guidelines and standards of care in monitoring and evaluating programs that treat drug-exposed infants. Treatment Improvement Protocol (TIP) Series 5.

State and Local Examples

Additional Resources

    • National Abandoned Infants Assistance Resource Center
      The Center’s mission is to enhance the quality of social and health services delivered to children who are abandoned or at-risk of abandonment due to the presence of drugs and/or HIV in the family.
    • Caring for Babies Who Have Been Exposed to Drugs or Alcohol
      This brochure is designed for parents and caregivers of substance exposed infants. It offers caregiving tips for soothing a baby, as well as resources specific to the Sacramento, California region. If you are interested in personalizing this brochure for caregivers of substance exposed infants in your region, please email us at for more information and a customizable version of the brochure.
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