If a baby is exposed to drugs from her mother while in utero, does that count as an ACE? 
If a newborn is taken from her mother within days after birth, does that count as an ACE?
In other words, are ACEs incurred in the womb or newborn immediately after birth?
Looking for research and information on this topic.
Thanks!
Original Post

I would say yes.                                                                                                                                          Much of the effects on a babies developments will have been impacted because off drugs, this will be an ACE.. The effects of no early bonding and attachment whilst developing in the womb or newborn will be an ACE. (even though early intervention may reverse some of the effects of ACE) some children never get over being abandoned or removed by social care (UK)... these effects are ACE.                                                                                                                    Because of Drugs taken by a mother a child may never know its parentage, this has a profound on children that lasts well into adulthood, these too will be an ACE.  there is much research to support this argument.. 

 

 

I wouldn't consider drug use by a pregnant mom an ACE, at least while the fetus is still in the womb, though the drugs themselves could affect fetal development. I'm pretty sure it was Van Der Kolk, in "The Body Keeps the Score", that discussed the long term effects seen in children of women who were pregnant and at the World Trade Center in New York City, on 9/11, supporting the idea that trauma and increased stress hormones in a pregnant woman can affect fetal brain development, presumably just as ACEs do.

I'd say that a newborn taken away from its mother, in and of itself, isn't an ACE, but if whomever assumed care of the baby was not providing nurturing, then this neglect would be an ACE. I'm an adult medicine primary care doc, and have seen two cases of young adults who were born in Eastern European countries, put in foster care soon after they were born, adopted by seemingly nurturing, supportive American parents, but who both developed very disruptive behavioral issues starting in early in childhood. While these are far from evidence based, case controlled studies that prove a connection, it's hard for me not to presume that these kids were neglected during their time in the orphanages, leading to the ACEs-induced neurohormonal changes that we now understand causes long term health issues. I would think this neglect would also disrupt normal attachment, which could later be considered a maladaptive coping mechanism, presuming it affected the person's ability to connect with other people (though we're getting out of my field of expertise on the attachment issue).

Great topic! Thank you for bringing this up.

I wrote an article on a related subject last year for JOPPPAH, which is the APPPAH journal (Birth Psychology). I give the ACE questionnaires to pregnant moms. We need to keep in mind that the parents take the ACE not the babies. However, most likely the adult, who once was a womb-baby, may or may not be aware if her/his parents used drugs/alcohol during that perod of time. If the person remembers I would record it.

I think that it is important to distinguish between ACEs and factors that impact child neuropsychobiological development.  

There are many who consider "ACEs" to be the 10 factors from the original Adverse Childhood Experiences Study of Felitti and Anda published in the 1990's.   

There are others who have added to these 10 factors what they consider to be important for an urban setting and changed 1 of the original adversities from "Has a parent or close caregiver gone to Prison" to "Has a parent or close caregiver gone to Jail." 

However --- There is nothing special about these 10 factors as they relate to child development and subsequent neuropsychobiological pathology and stress reactivity.  They don't tell us anything about prenatal or perinatal stress on the developing infant and child.  The American Academy of Pediatrics original concept was "The First 1000 days" referring to the time period from Conception to Two years of age.   And the developmental factor was termed "Toxic Stress."  

Is parental drug use a toxic stressor to the development of the fetus?  More than likely for most YES because most of these mothers have their own childhood trauma histories (Both the original 10 ACEs and a history of Relational Trauma from their own Attachment Relationship Plus lots of other Epigenetic Factors that are going to affect the fetus.  In fact, these toxic stressors work through epigenetics.  See the work of Steven Soumi as one example).

If you want to get a lot more information about this.... I would look at the work of Allan Schore.  He has a new book called "The Development of the Unconscious Mind."   He also has an amazing book called "Affect Regulation and the Development of Self."

You could probably look him up at UCLA and send him or his secretory an email and get a ton of articles that would give you the information you are looking for.  

I'll put some more things together when I get a chance --- But almost all of the origins of Violence, Empathy/or its lack,  a compassionate society, personality disorders and all the most serious of human psychopathology finds origins in the prenatal period and in infancy.      How a society treats its infants and mothers determines to a great extent how that society functions.  

( And to everyone out there - probably at least 1/3 of the folks on ACEsConnection who are finding that it is really hard to heal your ACEs ---- You might want to read some of Allen Schore's Books and look into structural dissociation, anything you can find about the Development of Self, Dissociation - Which is much more complicated than what your Average MD is taught about; look into Right Brain Development and Emotional Regulation and find out all you can about attachment and Implicit, Non-Cognitive Procedural Memory).   

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Sandra EmmanouilidesTina CainKaren Clemmer (ACEs Connection Staff)
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