This sheet is about exposure to cocaine in pregnancy and while breastfeeding. This information 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. However, reducing / stopping cocaine use needs to be done under the care of a healthcare provider. Stopping suddenly (also called “cold turkey”) could cause you to go into withdrawal. It is not known how withdrawal might affect a pregnancy.
I use cocaine. Can it make it harder for me to get pregnant?
It is not known if 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?
Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. It is not known if cocaine can increase the chance of birth defects above the background risk. 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, be 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 withdrawal symptoms in my baby after birth?
The use of some drugs 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. Less commonly, vomiting, diarrhea, and seizures have also been reported. Symptoms usually start at 1 to 2 days after birth. Some of these problems might last for weeks after birth, and sometimes longer.
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 may 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.
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 male uses cocaine, could it affect fertility (ability to get partner pregnant) or increase the chance of birth defects?
It has been suggested to avoid cocaine and other substance use before conception. Using cocaine may affect sperm shape and movement, which could make it harder to conceive a pregnancy. No birth defects have been reported as a direct result of male exposure to cocaine. For more general information on paternal exposures, please see the MotherToBaby fact sheet at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
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OTIS/MotherToBaby encourages inclusive and person-centered language. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. Use of the term mother or maternal refers to a person who is pregnant. Use of the term father or paternal refers to a person who contributes sperm.