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What if taking a child from the mother while she undergoes substance use treatment hurts the child more?

That’s a question you never hear anyone ask. Probably because when people find out that a mother has a drug or alcohol problem, the first thing they say is, “Get her children away from her.”

And at first, that sounds like exactly the right approach. But is it really?

All you have to do is take a look at our country’s child welfare system to figure out the answer to that question. Truth is, the system that was created to protect children from trauma, neglect and abuse often exposes them to it instead.

But even when a child doesn’t encounter any bad experiences, there’s still another issue with foster care that can hurt the child emotionally. Custody transitions. In addition to the initial trauma caused by a child’s removal from the mother, every move to a new foster home is another custody transition. And every custody transition is another chance for a child to experience emotional trauma. On average, a single child can experience as many as 9.5 custody transitions while in foster care. Even if the child is too young to remember these transitions, the trauma they cause could still Increase the risk for mental health and substance use issues later in life.

But what about pregnant women who are substance users? Surely they should be separated from the baby as soon as the baby is born.

Again, the answer is no.

Medication-Assisted Treatment, a harm-reduction practice widely supported by medical experts for use during pregnancy, helps mothers maintain sobriety and decreases withdrawal symptoms in the baby. With this treatment, the mother is not impaired and can still successfully parent.

According to Dr. Elisha Wachman, a neonatologist at Boston Medical Center and assistant professor of pediatrics at Boston University School of Medicine, who works with infants born to addicted mothers, “The first couple of weeks is when babies need their parents the most.” Says Wachman. “For us, the most critical time is the first month. What helps these babies most is more exposure to their mothers — not less…That skin to skin contact, holding, everything you do that calms the baby makes a difference.”

Of course, there is another really good reason for keeping a child and mother together during her treatment. It could actually improve the mother’s odds of overcoming her addiction.

The Center for Great Expectations provides substance use treatment and a safe environment for pregnant women and adolescents and their children up to age 5. To learn more, visit