Frequently Asked Questions

• What would Motherisk rate as the most significant recent breakthrough in mother-child health care and research?
• What is a teratogen?
• Must a woman avoid all medication while she is pregnant?
• Do drugs ingested by the mother reach her breast milk?
• Are all medicinal drugs found in breast milk harmful to the nursing infant?
• How many women has Motherisk counselled?
• What is Fetal Alcohol Syndrome (FAS)? And how prevalent is it?
• Is there a reliable way to determine whether an infant has been exposed to cocaine before birth?
• Does "passive smoking" (secondary exposure to tobacco smoke) reach a woman's unborn child?

What would Motherisk rate as the most significant recent breakthrough in mother-child health care and research?
The most exciting news these days is what medical science has learned about the prevention of neural tube defects, such as spina bifida and anencephaly. We now have concrete evidence that these conditions can be prevented if women take enough folic acid before and while they are pregnant. Folic acid is a vitamin found in foods like dark green vegetables, liver and lentils. Please see our recommendations about Taking Folic Acid Before You Get Pregnant. It is crucial that women of childbearing age get this message.

What is a teratogen?
A teratogen is an agent that causes physical or developmental abnormalities in the fetus. In order for a drug or chemical to be considered a teratogen there must be substantive evidence that taking the drug or being exposed to the chemical causes congenital abnormalities.

Must a woman avoid all medications while she is pregnant?
Although there is good reason for therapeutic caution during pregnancy, in some instances the benefit/risk ratio favours continuation of drug therapy. Some of the best examples are the proper use of medication to treat seizure disorders and the use of antidepressants to control mood disorders common in pregnancy.

Do drugs ingested by the mother reach her breast milk?
Quite often. But that doesn't mean they will affect the baby. Motherisk is currently working to understand what controls the amounts of drugs that find their way into breast milk.

Are all medicinal drugs found in breast milk harmful to the nursing infant?
Again, more study is required. However, a Motherisk study of 838 mother-infant pairs, has produced encouraging evidence that certain antibiotics, analgesics, antihistamines, sedatives and antiepileptics have no short-term adverse effects on breastfeeding infants. The long-term effects of drugs consumed in breast milk are still not known.

How many women has Motherisk counselled?
Since its inception in 1985, the Motherisk team has counselled over 200,000 women, their families and health professionals. Motherisk currently counsels 150-200 callers daily from Ontario, other parts of Canada and the United States. The telephone information service at Motherisk operates daily from 9:00 a.m. to 5:00 p.m. Each week 10 to 20 women are scheduled for the Motherisk clinic following exposure to known or suspected teratogens, new drugs with sparse information, chronic drug therapy or drugs of abuse.

What is Fetal Alcohol Syndrome (FAS)? And how prevalent is it?
Fetal Alcohol Syndrome (FAS) is a clinical pattern of adverse effects on prenatal brain development. Full blown FAS occurs in children of mothers who drank heavily during pregnancy. "Heavy drinking" is defined as at least 4 to 6 drinks of alcohol per day. A "drink of alcohol" is generally defined as one bottle of beer, one glass of wine or a standard shot of liquor. It is estimated that up to 0.5 to 2 in 1000 babies born in North America suffer from some degree of mental retardation due to alcohol. Much larger numbers are affected to smaller degrees by Fetal Alcohol Effects (FAE). Children with FAE may exhibit difficult behavioural problems, hyperactivity and a tendency to delinquency. Motherisk offers FAS diagnosis at its clinic in Toronto.

Is there a reliable way to determine whether an infant has been exposed to cocaine before birth?
Until recently, classification of "exposed" and "non-exposed" infants was often incorrect because it was based upon unreliable blood and urine tests, or information provided by the mother. Then in 1989, Motherisk established the use of neonatal hair as a sensitive and specific marker of fetal exposure to cocaine. Studying prospectively 600 newborns in 3 nurseries in Toronto, Motherisk documented that 6.25% of babies were exposed to cocaine.

Does "passive smoking" (secondary exposure to tobacco smoke) reach a woman's unborn child?
Yes. Motherisk's neonatal hair test has been used to detect fetal exposure to maternal passive smoking. The use of this "biological marker" has helped to establish the first direct proof that environmental tobacco smoke accumulates in the unborn baby in measurable and clinically relevant concentrations.