This sheet is about exposure to cocaine in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider.
What is cocaine?
Cocaine is a powerful stimulant of the central nervous system (brain and spinal cord). Cocaine has been used medically as a local anesthetic (for pain). Cocaine has also been used without a prescription (misused) to get a “high” feeling. Cocaine can be inhaled through the nose, rubbed onto the gums, injected, or smoked. Some nicknames for cocaine are blow, coke, flake, and snow. Crack is powdered cocaine that has been mixed and cooked with baking soda. It is broken into chunks (rocks) and most often smoked.
If you have been using any form of cocaine, talk with your healthcare providers right away. It is important to stop using cocaine. This must be done under the supervision of a healthcare provider. Stopping suddenly (also called “cold turkey”) could cause you to go into withdrawal. It is not known if or how withdrawal might affect a pregnancy.
I use cocaine. Can it make it harder for me to get pregnant?
It is not known if using cocaine can make it harder to get pregnant.
Does using cocaine increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. Using cocaine can increase the chance of miscarriage, especially when tobacco is also used.
Does using cocaine increase the chance of birth defects?
Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like cocaine, might increase the chance of birth defects in a pregnancy.
It is not known if cocaine can increase the chance of birth defects. Birth defects that have been reported with cocaine use in pregnancy include abnormalities of the brain, skull, face, eyes, heart, limbs, intestines, genitals, and urinary tract. However, most babies exposed to cocaine during pregnancy do not have a birth defect.
Does using cocaine in pregnancy increase the chance of other pregnancy-related problems?
Babies exposed to cocaine during pregnancy tend to weigh less, are born shorter in length, and have smaller heads than babies who were not exposed to cocaine during pregnancy. Cocaine can also increase the chance for preterm delivery (birth before week 37).
Cocaine use can cause the placenta to pull away from the wall of the uterus before labor starts (placental abruption). This can lead to heavy bleeding and can be fatal for the person who is pregnant and/or for the pregnancy.
If I use cocaine throughout my entire pregnancy, will it cause symptoms in my baby after birth?
The use of cocaine during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Symptoms reported in newborns with exposure to cocaine late in pregnancy include irritability, tremors, muscle stiffness, poor feeding, trouble with sleeping, and hyperactivity at birth. Less commonly, vomiting, diarrhea, and seizures have also been reported. Symptoms usually start 1 to 2 days after birth. Some of these problems might last for weeks after birth, and sometimes longer. Not all babies exposed to cocaine will have symptoms. It is important that your healthcare providers know you are taking cocaine so that if symptoms occur your baby can get the care that is best for them.
Does using cocaine in pregnancy affect future behavior or learning for the child?
Cocaine exposure in pregnancy can cause significant central nervous system problems that might not be seen until the child is older. This can include problems with attention and self-control, delays in learning, trouble processing emotions, language difficulties, and increased need for special education in school.
What screenings or tests are available to see if my pregnancy has birth defects or other issues?
Prenatal ultrasounds can be used to screen for some birth defects. Ultrasound can also be used to watch the growth of the pregnancy. Talk with your healthcare provider about any prenatal screenings or testing that are available to you. There are no tests available during pregnancy that can tell how much effect there could be on future behavior or learning.
Breastfeeding while using cocaine:
Breastfeeding while using cocaine is not recommended. Cocaine in any form can pass into breast milk. Exposure to cocaine is serious and can cause toxicity in the nursing child. Symptoms can include irritability, choking, high blood pressure, vomiting, trouble breathing, and seizures. Never put cocaine on your nipples to treat soreness. This is extremely dangerous for the baby and is known to cause seizures. If you suspect the baby has any symptoms (irritability, choking, high blood pressure, vomiting, trouble breathing, or seizures), contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions.
If a man uses cocaine, could it affect fertility or increase the chance of birth defects?
It has been suggested to avoid cocaine and other substance use before conception. Using cocaine might affect sperm shape and movement, which could affect men’s fertility (ability to get a partner pregnant). No birth defects have been reported as a direct result of a man’s exposure to cocaine. For more general information on paternal exposures, please see the MotherToBaby paternal exposures fact sheet at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
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