Tips for Healthy Parenting When You Are Currently Using Substances or Trying to Stop Using Substances
We know you are here because you want to do everything you can to help your baby thrive and grow up to be healthy and happy. You are the most important person in the whole world for your child, and one of the most important things that you can do is keep yourself healthy. Here we describe some ways that you can best take care of yourself and your baby. This section is written for people who plan to raise their baby, but anyone is welcome to read it.
Supporting your Baby's
Health and Development
Regular Pediatric Care
The American Academy of Pediatrics recommends regular visits to the pediatrician for your baby. The first visit is usually within just a day or two after discharge from the hospital. Because the first visit is so soon after birth, it’s helpful to find a pediatrician while you are still pregnant. You can ask family, friends, neighbors, and your prenatal care provider for recommendations. Many pediatricians can meet with a new parent prior to giving birth. This can be a good way to see if the pediatrician is a good fit for you and your family. You can call the office and ask to schedule an appointment as a parent who is ‘thinking of joining the practice.’
In the first months of life, visits to the pediatrician are pretty frequent and may be even more frequent if there are concerns about weight gain or other issues. During these visits, your baby’s pediatrician will check on their physical development, mental development, and social-emotional development.
These visits also will include various vaccinations, so your child is protected against common childhood diseases. Pediatric vaccines are safe and effective and do not cause developmental delays or other conditions like autism. If you have concerns about vaccines, you can talk to your pediatrician about your questions.
Lastly, your baby’s pediatrician may ask you about whether you are experiencing sadness or depression, in a safe living situation or being harmed in your relationship. These questions are not meant to be intrusive, but rather to keep your baby healthy in your care.
Information About Well-Child Visits
Early Intervention
Most states provide in-home developmental services called Early Intervention free of charge (though each state may have a different name for their programs). Early Intervention can include things to help your child with
- language development (like communicating with you and saying their first words)
- physical development (like crawling and walking)
- cognitive development (like playing with toys, problem solving, and mental health)
You can ask to be referred to Early Intervention by hospital staff when you deliver your baby, or by your baby’s pediatrician. In many states, you can even fill out a form online yourself to get services started. In many states, babies who were exposed to substances before they are born automatically qualify for free Early Intervention services, whether or not they have any developmental differences. It can be nice to connect with these services even if your child is not experiencing delays because services can give your child a jump start.
Intervention support specialists may coach you on how to support your child’s emotional, physical, cognitive, and speech development. They may even provide emotional support to you in your role as a parent. You may also feel reassured that there are professionals helping your baby reach their full potential and checking on their development at regular intervals. Sometimes they can provide physical resources like toys and books you can use to support your child. Even infants can benefit from reading together and playing with high contrast toys to help their visual development.
The earlier you get connected to these services, the better.
Learn More About Early Intervention
Bonding With Your Baby
One of the most important things for your baby’s development is their relationship with you. Developing a strong, healthy relationship with you is so important. It can support your baby’s long-term mental health, friendships, academic achievement, and confidence.
When your baby is first born, skin-to-skin contact can help you and your baby connect. The feeling of warmth and closeness that your baby experiences helps them keep their body at the right temperature, eat better, cry less, and be more attached to you. Babywearing, which means using a baby carrier to hold your baby, is another way to bond with your baby. It helps the baby feel close to you and develops consistent rhythms connecting you and them. Some babies are less fussy when worn by their parents. Babywearing can also help you feel calmer and more connected to your baby.
Many people who have used substances report that they had difficult experiences with their parents growing up. Whether or not this is the case for you, it can be helpful to reflect about your own experiences in close relationships and how you were parented. This can help you figure out the kind of parent you want to be for your children. While some people had difficult relationships with parents, others had strong relationships that have changed over time. Other people have reliable relationships that represent a continued source of support.
Your relationships can help you to decide what your priorities are in parenting. Maybe you want your baby to feel safe, secure, and comforted by you when they are scared or upset. Maybe you want your baby to develop freedom and confidence to be independent as they grow up. Maybe you want both. Whatever your hopes and dreams are for your baby, they are more likely to be reached when you’ve taken the time to reflect on what is easy and what is difficult for you in other relationships. This can be hard work, but it gives you the chance to be the parent for your child that you want to be.
You may want to reflect on this on your own. You may also want support from a therapist or parent counselor who can learn about your story as a parent, help you consider your own thoughts and feelings as a parent, and help you think about your child’s emotional needs. Some addiction treatment centers offer parent counseling, and many child guidance clinics also have programs for parents. Home visiting programs can also be very helpful for supporting your developing relationship with your child.
Safety at Home
When parenting a new baby, you are the person who your baby relies on to keep them safe. Below we will describe some things that will help your baby stay safe and healthy. Your baby’s pediatrician will also talk to you about general ways to help keep your baby safe and can serve as a source of information and advice.
Exposure to Toxins
Toxins include things like chemicals from smoke and lead, a metal that can be found in water. Even after the baby is born, second and thirdhand smoke can be a health risk to your baby. Thirdhand smoke is smoke that is on your clothes, your couch, or your floor. If you live with people who smoke, it is best to make sure they smoke outside, away from the doors and windows.
Lead exposure can also be damaging to a child’s brain and nervous system and can lead to developmental delays. Your child can be exposed to lead through lead-based paint, some older and imported toys, and some pipes. Small practices can really change the risks to your infant, even from birth. For example, if your baby is receiving formula and you live in an older house, it is important to only get cold water from the tap and then heat the water on stove or in the microwave. Hot water is more likely to carry lead from pipes. The CDC has more information about lead exposure here. Talk to your child’s pediatrician if you think your child’s home or other care environments, such as daycare, may have risks for lead.Taking Care of Yourself
Focusing on your own recovery, physical health, and emotional health is often the most important thing that you can do. It’s important that your child grows up with the healthiest you possible. Bringing home a baby is often a wonderful experience, however, babies do bring a new level of stress into the home. It will be important to continue your relationships that support your health and wellness during this time. This could include therapists or other supports in your recovery journey, such as peer support. If you have been able to make positive recovery changes during pregnancy, it will be important to continue those. You can also make transition plans to continue accessing supports if you were accessing pregnancy specific services.
Parenting a fussy baby is very challenging. It is normal to feel big emotions when parenting a new baby. If you ever notice yourself feeling frustrated with your infant or feeling overwhelmed, the best thing that you can do is put your baby on its back in its crib (or another safe place) and take a few minutes for yourself to calm down. A crib is a nice safe space, and your baby will be fine while you take a few minutes away, even if they are crying.
Lactation and Nursing
There are many benefits to providing your milk to your baby. Your child will benefit by having a lower risk of some common infections (like ear infections) and later health benefits as well (like lower risk for asthma). You will benefit by having a lower risk of certain cancers and lower risk for type 2 diabetes. You can provide milk through nursing or pumping. Even if you are separated from your child, it is often possible for you to still pump and provide breastmilk. If you are using substances, you should be open with your doctor in order to discuss the benefits and risks. Taking medication for opioid use disorder and providing milk is safe for your baby and can reduce the impact of withdrawal for your baby. Make sure to talk to your doctor if you have HIV or Hepatitis C. It is not safe to provide your milk to your baby if you have HIV. You can usually safely give your milk to your baby if you have Hepatitis C, as long as your nipples are not cracked.
Find Out More Lactation, Substance Use, HIV, and Hep C.
Childcare
When deciding who will watch your baby, it is important to choose people that you trust will keep your baby safe. Safe people to watch your baby are
- People who you know will not be under the influence of drugs the whole time they are with your child.
- People who you haven’t seen be violent towards you or anyone else.
- People who know about baby safety. For example, using car seats and putting baby to sleep on its back.
As you know, babies often cry a lot, and it can be very frustrating to watch a baby who is fussy. You need to be sure that you trust that they will safely and calmly care for your baby.
Return to Use and Recurrence
It’s hard to stop using substances. If you are reading this, you are already working hard to be the best parent you can be. While many people identify that their goal after substance use disorder treatment is to never use drugs or alcohol again, return to use is common. The stress of being a new parent or having your child removed from your care can increase your chances of returning to using substances. This is why it is so very important to keep meeting with people who support you in your recovery.
If you think you will use drugs or alcohol again, or if you do return to use, the most important thing that you can do for your child is to make sure that they are safe. This means to make sure that if you are not sober, your baby is being taken care of by someone that you trust to keep them safe while you are under the influence of drugs and alcohol. Even if you are sure that you will not have a recurrence of use, it is a good idea to have a plan in place for who can help with your kids if you end up using drugs or alcohol.
If you do have a return of use, you may feel like you have failed or feel like you are not a good parent. These are common feelings but struggling to not use does not make you a failure or a bad person. Recurrence is often a part of recovery. Return to use often occurs as a part of the recovery process where someone stays sober, returns to use, and then gets sober again.
However, when you are parenting a child who depends on you, one worry about returning to use is that your child will not be safe, or child welfare will remove your child from your care. This is why it is so important to have plans in place in case you do relapse so that your child will stay safe, and so that you can work with child welfare to demonstrate that your child was never in harm’s way.
Your Baby's Sleep
One very important way that you keep your baby safe is by providing your baby with a safe place to sleep. It is important every time and every place that they sleep.
The safest place for your baby to sleep is on their back on a firm, protected surface. In some homes, that surface is a crib, for others, it is a bassinet or pack-and-play. This space should not be a place for storage for other stuff like blankets, clothes, stuffies/stuffed animals, or diapers. These things could fall onto baby’s face and block their breathing. If you do not have a crib, child welfare offices can help you get a safe place for your baby to sleep. Sometimes community organizations can help or offer alternatives, such as “baby boxes” that are fit with a mattress. It is not safe for babies to sleep in car seats or swings because the baby’s head is slightly upright which may interfere with the baby’s breathing. Babies who sleep in a crib (or other safe sleep space) on their backs are less likely to have sudden infant death syndrome, where babies stop breathing while sleeping.
Safe sleeping practices are important for all babies, but they are particularly important if you are using substances, are worried that you may return to use, or are sharing a bed with another person who is using substances. If you or someone you share a bed with is continuing to use substances while parenting, then it is especially important that your baby sleeps on their back in a crib. You will be less aware of where the baby is and may sleep deeper yourself. This makes sleeping with your baby especially unsafe.
Some strategies to help your baby sleep in their bassinet or crib include:
- Give baby a pacifier. Pacifiers can prevent SIDS.
- Keeping the room cool to avoid overheating.
- Using a snug fitting, light weight, sleeper without any loose strings.
- Using a swaddle or a sleep sack. Make sure to stop swaddling once your baby has learned how to roll over.
- Use a sound machine or sound app on your phone to replicate the noises your baby heard in the womb.
- Keep the space dark and soothing.
- Sleep with the baby’s swaddle, sleeper, or crib sheet before using it with your baby to give it your scent.
- Make sure you’re feeding your newborn baby every 2 to 3 hours, 8 to 12 times a day. They will need to eat less often as they get older.
- Create a routine that you can follow any time you are getting ready for sleep — not just for bedtime.
Bathing your Baby
There are lots of safe ways to bathe your baby. You can buy a small bathtub that is made just for a baby, or even put an insert into a sink. After your baby is born, the nurse at the hospital will often show you how to give your baby their very first bath.
One thing to keep in mind is that your baby should never be around water when you are under the influence of alcohol or any substance. This is because your baby is at risk for drowning in even a very tiny amount of water. If you do need to clean your baby and aren’t completely sober, it is best to use a washcloth or baby wipes, as that prevents your baby from being near water so there is no risk for drowning.
Navigating Relationships with Child Welfare
Navigating Relationships with Child Welfare
It is completely normal to worry about becoming involved with child welfare. This is especially true if you know other parents struggling with addiction who have had a difficult time with these systems. It can be a stressful experience, especially if you feel like you have gotten in trouble and like you need to ‘jump through hoops’ to satisfy any case plan requirements.
Although children are not always removed from their parent’s care when their parent is struggling with addiction, it can feel traumatic and extremely upsetting if your child is removed from your care and placed with a family member or foster caregiver. Being separated from your child can be extremely difficult and can lead to very strong emotions. This could potentially put you at risk for relapse as big changes and emotions make it more difficult to be abstinent. Therefore, if you find yourself in the position of being involved with child welfare, the most important thing you can do is lean on your social supports that help you when you are upset and angry and focus on maintaining your recovery. When you are interacting with people who work in the child welfare system, it can be difficult to keep your cool. It is often helpful to focus on:
- being polite
- being responsive
- coming to appointments
- returning texts and phone calls
Each of these actions can help support you in your goal to no longer be involved with the child welfare system.
Even with all of these very strong, understandable emotions, being involved with child welfare can be an opportunity to receive help and support. Whether or not your child is removed from your care, child welfare workers will often come up with a case plan that includes things for you to do. This could include:
- attending addiction treatment
- attending individual therapy
- attending parent counseling
- obtaining employment
- living somewhere safe
It is important to learn the exact steps you need to take to satisfy these requirements. You can talk about this with your case worker. It can be helpful to ask for a copy of this plan and these requirements in writing so that you can keep track of your progress. You can also ask your case worker if they have suggestions or connections to help you attain the case goals included, such as access to parent counseling.
Again, it can feel overwhelming and upsetting to be required to do things by a system that you did not want to be involved with. However, the best thing you can do is complete all of your case plan steps so that you don’t have to be involved any longer. Developing a strong relationship with your lawyer or public defender is also a good idea so that they can help advocate for you and prove you are doing what you need to do.
If your child is placed with a family member or foster caregiver:
Sometimes, it may be necessary for you and your child to be separated from one another. This can happen if
- You need to enter inpatient treatment where they do not allow children. However, there are many programs that allow infants and young children to live with their birth parents.
- The child welfare system determines that your child may be safer with another caregiver. This could be one of your relatives or family members, or this could be with a foster family.
If there is a separation, there are many ways you can ensure that your baby feels as safe and comforted as possible.
- you can give the baby a shirt that you have worn that has your smell
- you can find different ways to connect with your baby like reading to your baby over the phone
- you can also consider coordinating with your child’s caregivers if you decide you wish to pump and provide your baby with breast milk, even if you are not able to breastfeed directly.
- you can ask for frequent visitation with the baby
The goal of child welfare is often to reunite you and your baby when its safe for them to return home.