Does the prenatal exposure of infants to substance use constitute neglect or abuse?

No, the prenatal exposure of newborns to their mothers' substance use does not automatically constitute abuse or neglect, nor does it require prosecution for any illegal action. However, it does give the system for child protection a strong indication that a family and child may need intervention in the form of services and supports.

The Child Abuse Prevention and Treatment Act, as reauthorized in the Keeping Children and Families Safe Act of 2003, includes new requirements for responding to the identification of infants known to have prenatal exposure to drugs. States must now develop policies and procedures or have in effect a state law that:

• Requires health care workers to notify child protective services about infants born and identified as being affected by illegal substance use or having withdrawl symptoms resulting from prenatal drug exposure
• Ensures the development of a safe plan of care for those identified infants

As amended, the law requires notification of child protective services, but does not mandate an abuse or neglect report. It appears that the intention of the change is to make sure that these infants and their families receive the types of services and supports that they to need in order to ensure the safety and well-being of the identified infant. The implementation of this amendment will require a collaborative effort across multiple systems including hospitals and other medical providers, substance abuse treatment providers, maternal and child health agencies, as well as child protective services.