Children whose parents or caregivers misuse alcohol or use, produce or distribute drugs face an increased risk of medical and behavioural problems, a new study has found.
According to a new clinical report by experts at Beth Israel Medical Centre (BIDMC) and Boston Children's Hospital, pediatricians are in a unique position to assess risk and intervene to protect children.
"Alcohol misuse and substance use are exceedingly common in this country, and parents' or caregivers' substance use may affect their ability to consistently prioritise their children's basic physical and emotional needs and provide a safe, nurturing environment," said Vincent C Smith, from BIDMC.
"Because these children are at risk of suffering physical or emotional harm, pediatricians need to know how to assess a child's risk and to support the family to get the help they need," said Smith, who is also an assistant professor at Harvard Medical School (HMS).
Whether from the toxic effects of exposure to these substances or from the neglect of their basic needs by parents or caretakers struggling with substance use disorders, children in these households commonly experience developmental and educational delays and, later, are at higher risk for mental health and behavioural problems.
They also are more likely than their peers to have substance use disorders themselves later in life.
Researchers reviewed the clinical signs of foetal exposure to alcohol, cannabis, stimulants and opioids.
Pediatricians must be increasingly on the lookout for signs of neonatal abstinence syndrome (NAS), the irritability, muscle stiffness, diarrhoea - even seizures - that can result from prenatal opioid exposure.
Citing studies that say children whose parents use drugs and misuse alcohol are three times more likely to be physically, sexually or emotionally abused and four times more likely to be neglected than their peers, the researchers urge all pediatricians to include questions about caregivers' substance use as part of the routine family assessment.
"Because pediatricians are the health care providers most likely to encounter families with young children who may be affected by substance use, they have the opportunity to help break multigenerational cycles of abuse," researchers said.
The research appears in the journal Pediatrics.
