The effects of substance use during pregnancy on behavioral and emotional development
Information • Guidance • Support • Stories
Children with prenatal substance exposure often experience big emotions. Their nervous systems work overtime, which can make everyday challenges feel overwhelming.
Behaviors you might notice:
These behaviors aren’t misbehavior or a “bad” temperament. They reflect a nervous system that needs extra support to feel safe. Children are signaling that they need reassurance, structure, and emotional safety. Behaviors could include:
Strong reactions to frustration or transitions
Anxiety, clinginess, or difficulty calming down
Sensitivity to change or overstimulation
Trouble forming trust at first, especially after early instability
“Slow-to-warm” behavior or hesitancy with new people
What helps:
Strong, predictable relationships are the foundation: when caregivers respond with calm, consistent support, children learn that the world is safe and people can be trusted. Over time, they develop stronger coping skills, better self-regulation, and healthier connections with others.
Predictable daily routines
Calm, patient responses to big feelings
Simple choices to build confidence
Sensory breaks and quiet spaces
Playful connection and nurturing physical touch (as accepted by the child)
For foster and adoptive families, bonding may take time. A child who has experienced multiple caregivers may struggle to trust at first. Gentle consistency, clear boundaries, and co-regulation (helping them calm with your presence) support attachment and emotional healing.