Family Matters

need information on drugs in a baby's urine

Hi,

My niece gave birth on Sunday. She is not a drug user, but many people she is associated with are. 

Today they did a urinalysis on the baby and 'drugs' showed in the urine.  they asked her if she used pot, antidepressants, pain killers, etc. 

She would not even take a tylenol while pregnant.

what could possibly be the reason for drugs to show in the baby's urine?

they did not say what kind of drugs showed up, but im guessing from the types of things they asked her about.. it would be 'downers' <-- are they still called that?

Any help would be appreciated

thanks so much

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Re: need information on drugs in a baby's urine

  • If there are drugs in the baby's urine, your neice did drugs while pregnant.

    Sorry, but that's the stone cold truth.  There's no other way for drugs to get into the baby's system.  I'm not even sure that second-hand pot smoke could be found in the baby's urine.....mom would have had to have smoked pot for it to be there.

    And in my county (and state, I believe) drugs in the baby's system at birth automatically trigger a CPS referral and likely suspension of parental rights to the infant.

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  • For a drug to show up in the baby's urine the mother would have had to ingest it. 
  • Wow.  I feel like that Weekend Update skit from SNL: "Really?!? REALLY!?!..." Indifferent

  • this is what i was afraid of.

    she SWEARS tho that she didnt.  I guess what else is she gonna say.

     

  • okay, before i put my foot in my mouth i wanted to reveiw a few articles...

    everything i read referenced secondhand smoke can be related to SIDS.  It doesnt say anything about the mother not ingesting the drugs and it still showing up in the baby's system.  However, if i do understand science, i can see if she was exposed daily, for extended times every day, then maybe it could happen.  but there are a lot of other things in this crazy world that could happen too.  i mean if the cig smoke could end up in the baby's system then i suppose the mary jane could too.  but anything else, is too far fetched.  she had to have done the drugs herself.  there are programs she can get in touch with to help her with the addiction, because not only will she be fighting it, the baby will be fighting the addiction as well.  i understand it is like having a colic baby.  they are in my prayers.

  • image september05:

    she SWEARS tho that she didnt.  I guess what else is she gonna say.

     

    And all of the girls on Maury swear that they've only had sex with one man, who of course never ends up being the babydaddy.

    Not to make you feel worse, since it's a sucky situation.  But you can't get much more hard core evidence that she was doing drugs.  She's lying.

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  • image september05:

    this is what i was afraid of.

    she SWEARS tho that she didnt.? I guess what else is she gonna say.

    ?

    Typically people who hang out with people who do drugs do them as well. ?Most people who are anti-drug don't associate with people who do them.

    Your neice is lying. ?Sorry.?

  • I hate to be snarky in an already crappy situation, but...

    ARE YOU REALLY THAT NAIVE?

    I don't care what she TOLD you... addicts are notorious (and usually GOOD) liars.  That's how they exist.  The quicker you accept the truth, the more you'll be able to do for that poor baby.

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  • How do you know a drug addict is lying?

    Their mouth is moving.

     

    Agree with pp who said anit-drug folks do not hang out with drug users.  Your niece is lying to you, especially since they did a urine test.  That means she didn't ONLY do drugs (pot, downers, etc) in 1st Tri and it's just now showing up.  She did them very recently.

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  • image Angeldcf:

    How do you know a drug addict is lying?

    Their mouth is moving.

     

    Agree with pp who said anit-drug folks do not hang out with drug users.  Your niece is lying to you, especially since they did a urine test.  That means she didn't ONLY do drugs (pot, downers, etc) in 1st Tri and it's just now showing up.  She did them very recently.

    Maybe I'm crazy... but if I'm someone who vows to not even take tylenol when I'm pregnant, I'm sure as heck not going to be hanging around a bunch of people who are using drugs while I'm pregnant.  I was about to say that I can't think of anything dumber than that... but actually using the drugs while you're pregnant would satisfy as dumber.

    I don't want to sound mean here... but your niece is not the victim.  Your niece's baby is.  It's time for the family to stop listening to somebody who used drugs while pregnant with no second thought to what the baby is going to suffer through, and it's time to start thinking about how to help the baby.

    Fyi, your niece will probably lose her child to foster care until she can be drug free, etc...  Feeling sorry for her and playing into her victim mode will not help the situation.  She knew what she was doing was wrong, she did it anyways...

  • image arlhello:
    image Angeldcf:

    How do you know a drug addict is lying?

    Their mouth is moving.

     

    Agree with pp who said anit-drug folks do not hang out with drug users.  Your niece is lying to you, especially since they did a urine test.  That means she didn't ONLY do drugs (pot, downers, etc) in 1st Tri and it's just now showing up.  She did them very recently.

    Maybe I'm crazy... but if I'm someone who vows to not even take tylenol when I'm pregnant, I'm sure as heck not going to be hanging around a bunch of people who are using drugs while I'm pregnant.  I was about to say that I can't think of anything dumber than that... but actually using the drugs while you're pregnant would satisfy as dumber.

    I don't want to sound mean here... but your niece is not the victim.  Your niece's baby is.  It's time for the family to stop listening to somebody who used drugs while pregnant with no second thought to what the baby is going to suffer through, and it's time to start thinking about how to help the baby.

    Fyi, your niece will probably lose her child to foster care until she can be drug free, etc...  Feeling sorry for her and playing into her victim mode will not help the situation.  She knew what she was doing was wrong, she did it anyways...

     

    Sorry, one last thing... where is the dad?

  • I did a lot of drugs in high school and my early college years.   I didn't have one friend that did not do drugs during this time.  We may not have done the same types of drugs all the time, but if one of us was high we all were.

    Now that I don't do drugs anymore I don't have any friends who do drugs.  (Unless they hide it REALLY well).  In fact if I was to find out that one of my friends were doing drugs I probably wouldn't be friends with them much longer.  I know what drugs do to a person, and what it makes you do to the people around you.

  • If she was given analgesia in labor, this would be present in the baby's urine.

    Antidepressants are sometimes used in pregnancy.

     

    People who choose to associate with drug users, use drugs themselves. Why else would they associate with them? because drug addicts are charming, positive and fun people?

  • I'm assuming that when they say there were drugs in the baby's urine, they don't mean Tylenol or a prescription antidepressant the mother was taking under a doctor's supervision or any analgesia she was given in the hospital -- they mean stuff that absolutely shouldn't be there.

    I'm sorry that this has happened, but your niece is lying about her drug usage, and her child is now going to pay the price.

    I agree 100% that non-users don't hang out with users.  I don't do drugs and never have, and I wouldn't hang out with people who did.

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  • Why did they test the baby's urine?  Is that routine?

    How is the baby's health? Is he/she doing okay?

    My darling daughter just turned 4 years old.
  • In the counties I've worked in, they usually test the baby's stool when it is born if there is reason to suspect that mom had used.  Unfortunately, the "reason to suspect" can vary from not getting prenatal care, to not having insurance, to being poor, or actually appearing to be under the influence.  Women who give birth in county hospital tend to be tested more often than women who deliver in a private hospital.

    I'd guess that if they tested the urine a while after birth that either the baby was showing signs of withdrawl or that they heard or saw something that led them to believe your niece was using.

    And, the other ladies are right.  I used to work in child welfare and mothers would swear up and down that they were clean- even when their drug tests came back positive.  There is no possible way for the baby to test positive (and yes, the hospital staff will know which drugs show up on the tox screen because they were given in the hospital and which were not-the tox screen lists the types and amount of drugs present) and the mother not to have used.

    Is your neice still in the hospital?  If so, there should be a social worker in the hospital that can help her/your family through this process.  

  • I am feeling really sorry for this baby and your family for having to deal with the truth now.

    I hate to ask this, but what prompted the urine test?  I don't think that is routine, because I don't remember them relaying the results to me when I gave birth.  However, I jsut gave birth so I could be forgetting this?

  • Drug testing is not routine, it's only done if there's reason to suspect drug use.

    Like a pp stated - if they tested the baby, they had a reason to suspect drug use.  And their suspicion was proved correct.

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  • As a recent mother, a mother period, and as a person, this sickens me.  I feel terrible for that poor baby.  Your neice is obviously a user- ditto everything everyone said about drug users being GOOD at hiding it.  My brother has apparently done just about every drug out there- we didn't know a thing about.  He got a little weird, but we never even suspected cocaine.  You know what I am saying?  But for a pregnant woman to do drugs, that's incredibly incredibly horrid.  Again, as a PP said, these drugs were done recently.  She probably would not take tylenol because it would affected her real drugs.  :-(  I would get in touch with someone about adopting that baby, if I were you.  This is an incedibly sad situation and you have an obligation to help that child, if you can at all.  Good Good luck to you and I am praying for that baby.
  • image -auntie-:

    If she was given analgesia in labor, this would be present in the baby's urine.

    Antidepressants are sometimes used in pregnancy.

    She's right.  But I wanted to add a couple more possibilities:

    1) Urine drug tests aren't always accurate.  If they also did a blood test using a technique called Mass Spec, those results would be very accurate.  Sometimes a postive urine test will lead them to do the Mass Spec.

    2) Some prescription and OTC drugs (and even some foods) can cause false positives.

    But she's probably doing drugs.

  • My sister's SIL was using pot when pregnant, I dont know all the facts, I dont even know the girl. But my sister told me there was this big thing in the hospital, they did test the baby and....the parents fought and ended up taking the girl home (these people are serious..for lack of a better word, white trash.) Thank god my sisters DH is nothing like his brother..but still why could they take there baby home then?...The girl is almost 2 now and fine, although small for her age...I hope she can rise above it all...
  • I'm sorry to inform you but if the baby had drugs in the urine, the mother was a drug user.  Plus, people who hang out with drug addicts 99% of the time does use drugs. 
  • How old was the baby at the time of the drug test?  Was it at birth of after?

    Wouldn't drugs pass through the baby if the mother breastfeeds?  Not that it's any better than doing it during pregnancy, but perhaps she was using after she gave birth. 

    ETA: Nevermind, I just re-read that the baby is only 4 days old.  Sorry :-(  Looks like the mom is a pretty good liar. 

    Twin boys due 7/25/12
  • If the hospital said there were "drugs" in the baby's system, then they almost cetainly did a standard toxicology screen, which tests for things like pot, cocaine, benzos like valium, opiates......

    A standard tox screen doesn't test for things like antidepressants and no doctor would randomly order that kind of screen.

  • Chiming in late here .

    If the baby has drugs in its system, then the mother did drugs. Sorry, your niece is lying.

    I hope the baby is unharmed.

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  •  Introduction
    imageTop
    imageAbstract
    imageIntroduction
    imageguidelines for medically...
    imagelaboratory testing of newborns...
    imagenewborn urine testing
    imagethresholds for urine initial...
    imagemeconium testing
    imagehair testing
    imagetesting of other fluids
    imagelaboratory report
    imageguidelines for chain-of-custody...
    imageSummary
    imageReferences
     
    Intrauterine drug exposure (IUDE) remains a major health concern (1)(2).1 Prenatal cocaine use has been associated with placental abruption and premature labor (3)(4)(5)(6)(7)(8)(9). Intrauterine cocaine exposure has also been associated with an increased risk of prematurity, small for gestational age status, microcephaly, congenital anomalies including cardiac and genitourinary abnormalities, necrotizing enterocolitis, and central nervous system stroke or hemorrhage (3)(4)(5)(6)(7)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Infants born to mothers using amphetamines have many of the same problems as cocaine-exposed infants, including increased rates of maternal abruption, prematurity, and decreased growth parameters such as low birth weight (2). In addition to an increased risk of prematurity and being small for gestational age, striking withdrawal symptoms often requiring treatment are frequently observed in infants after in utero opioid exposure. Symptoms include irritability, hypertonia, wakefulness, jitteriness, diarrhea, increased hiccups, yawning and sneezing, and excessive sucking and seizures, with onset of withdrawal earlier in heroin-exposed babies compared with methadone-exposed infants (23)(24). Some intrauterine cocaine-exposed infants may manifest symptoms of withdrawal including hypertonicity, jitteriness, and seizures (7)(9)(15)(25)(26). Intrauterine amphetamine-exposed infants may also have similar postnatal symptoms including hypertonia, tremors, poor feeding, and abnormal sleep patterns (27). Long-term follow-up of IUDE infants suggests that in addition to the potential for difficult social situations, such as increased risk for child abuse and neglect (28)(29), abnormal neurocognitive and behavioral development may occur (18)(30)(31)(32)(33)(34), as well as an increased risk of sudden infant death syndrome (35)(36)(37)(38).


       guidelines for medically indicated newborn drug testing
    imageTop
    imageAbstract
    imageIntroduction
    imageguidelines for medically...
    imagelaboratory testing of newborns...
    imagenewborn urine testing
    imagethresholds for urine initial...
    imagemeconium testing
    imagehair testing
    imagetesting of other fluids
    imagelaboratory report
    imageguidelines for chain-of-custody...
    imageSummary
    imageReferences
     
    Identification of drug-using mothers before or early in pregnancy would be ideal, potentially avoiding intrauterine exposure. However, the physician with primary responsibility for the infant is not in a position to test mothers, but, rather, can only consider ordering a newborn drug test after IUDE may have occurred. Possible benefits of identifying IUDE infants could include programs for improvement of parenting skills, maternal drug treatment, home assistance, focused medical observation during the newborn period, restriction of breast-feeding, and close pediatric follow-up emphasizing developmental and social issues. In addition, currently unidentified problems caused by IUDE may be discovered in the future; beyond the immediate newborn period the opportunity to identify IUDE infants by urine testing is lost. With adequate testing and successful maternal treatment, there is also the potential for decreased postnatal infant exposure, which can have deleterious effects (39)(40)(41) and decreased risk of IUDE in future pregnancies.

    Drug testing is one of the only methods of identification of IUDE. Maternal history of drug use is often unreliable. If identification of IUDE infants is worthwhile, it is inadequate to rely on maternal self-reporting; for example, 24?63% of mothers with positive cocaine tests deny cocaine use (4)(21)(42)(43)(44). Even if the mother does admit to substance abuse, the accuracy of the recall about frequency of use, purity, and range of drugs used is often poor. Clinical diagnosis is complicated by the fact that some drug-exposed infants do not have immediate or specifically recognizable symptoms in the newborn period. A combination of maternal history, newborn clinical symptoms, and laboratory toxicological testing of the mother and newborn serve best to avoid significant underestimation of the incidence of in utero exposure determined by any one of these approaches independently. In addition, in many jurisdictions, a physician caring for a newborn suspected of IUDE is required to investigate and report the findings to the appropriate authorities. A positive maternal history of drug use or the demonstration of drug in maternal urine may not constitute sufficient evidence to indicate a report to child protective services. Definitive documentation of the presence of drug in the baby may be required.

    Possible maternal and infant risk factors can be culled from the current literature and then can be developed into specific guidelines to identify those infants for drug testing; this is more cost-effective than universal screening, which is currently not recommended (45). Also, a set of formal guidelines based on maternal history and newborn clinical findings removes the bias in physician-ordered drug tests, and fewer IUDE infants are missed. Guidelines protect the physician who orders the drug screening. When the ordering physician informs the mother that a drug test has been ordered for her baby, he or she can inform parents that all infants who meet these guidelines are screened as a matter of routine, and that they are not being "singled out" for other reasons. Physicians should document in the chart the indication for the infant drug test and that the mother has been informed that an infant sample has been sent to the laboratory for drug testing. The following guidelines were developed on the basis of previous studies in the literature:

    1) Infants whose mothers have any of the following: (a) History of drug abuse in present or previous pregnancies; (b) limited prenatal care (<5 prenatal visits); (c) history of hepatitis B, AIDS, syphilis, gonorrhea, prostitution; (d) unexplained placental abruption; (e) unexplained premature labor.

    2) Infants who have any of the following: (a) Unexplained neurologic complications (e.g., intracranial hemorrhage or infarction, seizures); (b) evidence of possible drug withdrawal (e.g., hypertonia, irritability, seizures, tremulousness, muscle rigidity, decreased or increased stooling); (c) unexplained intrauterine growth retardation.

    These guidelines were tested prospectively to be 89% sensitive in a population with mixed socioeconomic status (46) and confirmed the association of specific maternal characteristics with maternal cocaine use (6)(7)(42)(43)(47)(48)(49)(50)(51)(52). Note that adolescent pregnancy and a maternal history of genital herpes or Chlamydia infection are not included as risk factors because they have not been associated with increased maternal drug use either in our population or in most prior published reports. We include a full copy of our protocol as an aid to those faced with developing guidelines at their own institutions (see Appendix).


       laboratory testing of newborns for drugs of abuse
    imageTop
    imageAbstract
    imageIntroduction
    imageguidelines for medically...
    imagelaboratory testing of newborns...
    imagenewborn urine testing
    imagethresholds for urine initial...
    imagemeconium testing
    imagehair testing
    imagetesting of other fluids
    imagelaboratory report
    imageguidelines for chain-of-custody...
    imageSummary
    imageReferences
     
    Testing should aim at accurate and early identification of drug-exposed newborns. Drug or drug metabolite concentrations in newborn specimens can be below the detection limits of many of the clinical laboratory analytical techniques. Thin-layer chromatography and HPLC methods can detect the relatively high drug concentrations found in suspected drug overdose patients, but lack the sensitivity needed for newborn testing. Most testing protocols rely on nonisotopic immunoassays for the initial testing phase, rather than the more difficult and costly gas chromatography?mass spectrometry (GC-MS) procedures. The immunospecificity of immunoassays are generally directed toward a group of structurally closely related drugs or metabolites and not a specific drug. Therefore, a positive immunoassay result must be considered as presumptive for a group of drug compounds and should be subjected to confirmation testing for definitive identification.

    Confirmation testing, performed on a fresh aliquot, should be an assay that is based on an analytical principle different from that of the initial test, and one that is more specific and at least equally sensitive. Therefore, an initial result by an immunoassay should not be confirmed by another immunoassay, even if the latter has more selective immunospecificity or is a product of a different vendor. Confirmation of a positive result by an amphetamine or methamphetamine-specific immunoassay is best considered as an intermediary test that will be followed by a more definitive confirmation test. The laboratory should be familiar with the specificity of both initial and confirmation assays, and the drugs or medications that can cause significant interference, including those that are administered during the birthing process. If the initial result cannot be confirmed, a negative report must be issued. If confirmation testing is performed by a reference laboratory, it is good laboratory quality-assurance practice to save an aliquot of the specimen for retest if necessary.


       newborn urine testing
    imageTop
    imageAbstract
    imageIntroduction
    imageguidelines for medically...
    imagelaboratory testing of newborns...
    imagenewborn urine testing
    imagethresholds for urine initial...
    imagemeconium testing
    imagehair testing
    imagetesting of other fluids
    imagelaboratory report
    imageguidelines for chain-of-custody...
    imageSummary
    imageReferences
     
    Because the specimen of choice for toxicology analysis in most clinical laboratories is urine, many laboratories have applied their urine-based methodologies to testing newborns suspected of IUDE. Newborn urine is far from ideal for this purpose. The most serious drawbacks are the difficulty in urine collection and the critical timing needed for a successful collection (53). Positioning the collection bag and maintaining it in position to avoid loss through leakage can be a frustrating exercise, and may require 2?3 attempts before a suitable specimen is obtained. Very often multiple attempts still result in failure. Skin rashes as a reaction to the adhesive bag are common and further complicate the collection process. The urine collected may not be of sufficient quantity to permit both initial and confirmation testing because of collection difficulties and also as a result of the lower normal urine volume in newborns. Timing of specimen collection is critical for testing newborns. The time a urine specimen is finally collected may be outside the narrow window of detection. Many negative findings caused by delays in obtaining a specimen soon after birth can be attributed to late onset of withdrawal symptoms and belated arrival at the clinical suspicion of drug exposure as well as difficulties in urine collection (53). The various problems associated with specimen collection contribute to the underestimation of IUDE.
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  • I do volunteer work with abuse/neglected children, as well as work in an office that deals with this daily. 

    Is it likely that she did drugs and is a liar?  YES!  However, I have sent countless cases where parents have just been around people using drugs, and it's affected their unborn and already here kiddos. 

    There is a reason they say 2nd hand smoke is dangerous, and it doesn't just apply to cigs.

  • image hockeymomma:

    Is it likely that she did drugs and is a liar?  YES!  However, I have sent countless cases where parents have just been around people using drugs, and it's affected their unborn and already here kiddos. 

    A newborn is not going to have drugs in its system simply due to mom being around drug users while pregnant. 

    The parents that told you that they never used drugs were lying, just like the OP's neice is.

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  • Your niece had to be using while she was pregnant for there to be any drugs in the baby's system.  Does the baby seem to be doing okay?  I don't know what state she's in but I am a social worker in WV and if the baby tested positive there will be a CPS investigation.  IF it is a drug that she had a prescription for she will likely get to keep the baby and maybe take parenting classes or something.  If not than the baby will be taken and will either be placed in foster care or with other family members. Good luck!
  • I'm late chiming in here, but I'm a CPS social worker. If a baby has drugs in their urine, the mother did drugs. Plain and simple. I've heard every excuse in the book as to why someone tested postive or why their baby tested positive and it always comes back to THEY DID DRUGS. With the exception of pot, most drugs clear out of your system quickly, which means she did drugs close to the delivery of the baby. If she tells you she used at the begining of her pregnancy "before she knew she was pregnant (that's my personal favorite excuse)" she is lying. Good luck and let your family members know that they may need to be prepared to take custody of this child if CPS steps in and removes the baby.
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