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  • Shaken Baby Syndrome

    Tuesday, 21 July 2015 16:28
  • Amniotic fluid problems

    Thursday, 14 May 2015 12:54
  • Choosing a pre-school

    Friday, 10 April 2015 17:50
  • Newborn reflexes

    Tuesday, 03 March 2015 15:49
  • Mastitis

    Tuesday, 03 March 2015 15:41
  • Pelvic floor exercises

    Wednesday, 11 February 2015 17:20
  • Colic

    Wednesday, 11 February 2015 17:11
  • Antenatal Classes

    Monday, 03 June 2013 09:34
  • Strap-in-the-Future

    Thursday, 30 June 2011 13:52

Smoking and the effects thereof

There are several dangerous chemicals present in tobacco, including ammonia, cyanide and phenol. Some of these chemicals, such as carbon monoxide and tar, have been proven to cause cancer. Nicotine is the addictive ingredient in cigarettes.

Both alcohol and tobacco use during pregnancy have been associated with a number of adverse effects on the growth, cognitive development, and behaviour of the exposed child. Despite greater awareness of the adverse health effects of smoking during pregnancy, many pregnant women and girls continue to smoke (estimates range from 12-22%).

Essentially pregnancy is about creating new life and our unborn children are completely dependent on us to make decisions regarding their well being. Ultimately it is a mother’s decision whether or not to continue smoking during pregnancy. For many women, pregnancy serves as a motivation to give up smoking, not only for their own health but for the health of their unborn child.

Smoking and fertility

Irrespective of which partner smokes, smoking lowers fertility levels in both male and female smokers, therefore making it more difficult to conceive. Smoking also reduces the chances of IVF being successful.

In women:

  • Nicotine is thought to affect the production of hormones that are necessary for pregnancy.
  • Smoking also impedes the transportation of the egg through the Fallopian tubes to the womb.

In men, smoking can:

  • Reduce the amount of semen- smokers tend to have a sperm count that is 15% lower than non-smokers.
  • Harm the mobility of sperm.
  • Affect their shape.
  • Affect the blood vessels that supply the penis, causing erection problems.
  • Men should therefore give up smoking at least 3 months before trying for a baby, in order to increase their chances of successful conception. Furthermore, men who continue to smoke while their partner is pregnant, risk damaging the health of their unborn baby via passive smoking.

Pregnancy care

As soon as you know you are pregnant, you should seek assistance from your health care provider, to reduce or preferably quit smoking. Encourage your partner to consider quitting too. Counselling can assist you in coping with withdrawal symptoms. NB: Nicotine replacement therapy such as patches or gum should NOT be used during pregnancy.

Smoking and your baby

Not only is smoking harmful to you, but it is harmful to your unborn child. When you smoke during pregnancy, your baby is also exposed to the dangerous chemicals found in cigarettes. These chemicals decrease the amount of oxygen (foetal hypoxia) and blood flow supply available to your baby. Sufficient oxygen is essential for healthy foetal development. When you smoke during pregnancy, nicotine not only increases your heart rate, but your baby's heart rate too. It causes your blood vessels to narrow and as a result, the flow of blood through the umbilical cord is reduced. Furthermore, carbon monoxide replaces oxygen in your blood, reducing the amount of oxygen made available to your baby through the umbilical cord and placenta. The toxins found in tobacco, affect the blood's ability work in a normal, healthy manner. This can damage placental function.

Smoking can also damage your baby's lungs. In preparing to breathe on his/her own after birth, your unborn child will be practicing by exercising some of his/her chest muscles. Nicotine causes a reduction in these breathing movements. Newborns are also nose-dependent breathers and they have narrow nasal passages. Exposure to smoking is a common nasal irritant to tiny babies and contributes to the sniffles. For this reason, try keep their environment free of all possible nasal irritants, including smoke from pipes, cigars and cigarettes. Cigarette smoke is one of the most common inhalant allergens found in the home that may adversely affect your baby's health.

Smoking along with prenatal viral infections, in utero radiation and exposure to other agents, such as drugs and dietary substances during embryonic development, may cause damage to foetal tissue, organs, or systems that are developing at that particular time. These insults, whether toxic, metabolic, vascular or environmental are known as teratogens. In order to prevent possible teratogenic effects on the foetus and non-genetic congenital abnormalities, all women who are at risk of conceiving should avoid all drugs, including tobacco, and should have a healthy balanced diet at the time of conception and throughout pregnancy.

Smoking during pregnancy, increases the risk of:

  • An ectopic pregnancy
  • Vaginal bleeding
  • Placental abruption, whereby the placenta, partially or almost completely, pulls away from the uterine wall before delivery. This may cause the baby to be born prematurely, starve of oxygen or die in the womb (stillborn).
  • Placenta previa or a low lying placenta that covers part or all of the opening of the uterus. This condition frequently leads to delivery by Caesarean section.
  • A still birth

Babies born to mothers who smoke during pregnancy, are more likely to be born:

  • With birth defects, such as a cleft lip or palate.
  • Prematurely or at less than 36 weeks. Smokers are at a higher risk for premature rupture of membranes before labour begins. This means that pregnant women who smoke will often carry their babies for a shorter than normal gestation period. Premature babies are not equipped for life outside the womb and may develop problems involving breathing, immune system, digestion, reflexes and temperature regulation. For example, because preterm babies have small, immature digestive systems they may find it difficult to hold down food, are more likely to vomit and have difficulty in digesting essential proteins, so these need to be given in pre-digested form.
  • At low birth weight (below 2.5kg). Babies of smokers weigh on average 200g less than those born to non-smokers. The effect of smoking on birth weight increases proportionally- the more the mother smokes, the less the child weighs. Infants of smokers show growth retardation at all gestational stages. Low birth weight is the leading cause of infant death. Birth weight is less likely to be affected if you stop smoking by the fourth month of pregnancy.
  • Underweight for the number of weeks of pregnancy/ small for gestational age (SGA). These babies often do not tolerate the birthing process well and are predisposed to a number of clinical problems. These may include birth asphyxia, hypoglycaemia during the first 48 hours, due to poor glycogen reserves, and infections due to suppressed immunity.
  • With a reduced birth length, head and chest circumference.
  • Some studies have linked prenatal tobacco exposure to CNS effects, including cognitive and neurobehavioral outcomes. For example, prenatal tobacco exposure has been linked to an increase in activity, inattention and impulsivity. However, there are inconsistencies between reports and hereditary may be an important factor when interpreting these findings. Mothers and children may have a shared genetic component. Therefore, women who are more impulsive, are more likely to smoke and to produce impulsive children, than prenatal tobacco exposure causing more impulsive children to be born.

Second-hand smoke

Compared to alcohol and other drug use, tobacco use is less likely to decline during pregnancy, and women who smoke during pregnancy are likely to continue smoking after delivery. This means that children who were exposed to tobacco smoke prenatally, are at a greater risk of being exposed to continued environmental smoke (ETS) from their mothers and other household smokers.

Passive smoking is associated with an increase in Sudden Infant Death Syndrome (SIDS), more commonly known as cot death. There is a direct link between parents smoking and cot death, or the sudden and unexpected death of a baby for no obvious reason. Children of smokers are twice as likely to die from cot death, and with every 10 cigarettes a day the risk increases threefold. You should therefore not smoke inside your house if you have infants or children and avoid taking them into smoky places.

Babies of smokers tend to suffer from more frequent illness. Research shows that babies born to mothers, who smoked 15 cigarettes or more a day during pregnancy, are hospitalized twice as often in the first 8 months.

In young children the most significant effect of tobacco smoke is related to second-hand smoke or passive smoking. Children of smokers are not only more likely to develop infections and diseases such as bronchiolitis, asthma and pneumonia, but the severity of these breathing conditions tends to be more severe in children exposed to tobacco smoke. As a result, they may require more medical attention, visits to clinics, and hospitalization.

Research has shown that the children of fathers, who smoke 20 cigarettes or more a day, have a higher risk of cancer than children of non-smoking fathers.

Children of smokers are more likely to be smokers themselves in later life.


Nicotine passes rapidly into breast milk and can affect your milk supply. Exposure to nicotine in breast milk and second-hand smoke is associated with more frequent respiratory tract infections, vomiting, diarrhoea and increased irritability.

Pregnant and still smoking?

It is never too late to stop smoking. Stopping smoking at any time during pregnancy is beneficial, but quitting right from the time you plan or start your pregnancy is wisest. Most of the damage caused by smoking is reversible because our bodies are living organisms that are able to heal themselves. For example, women who stopped smoking halfway through their pregnancies gave birth to babies with the same average birth weight as those who never smoked during pregnancy.

Pregnant women may be tempted to cut down on the number of cigarettes they smoke during pregnancy. However, many smokers find that they inhale more deeply if they smoke fewer cigarettes, resulting in the inhalation of damaging substances because residues are concentrated towards the butt.

Other studies show that even moderate cigarette smoking is harmful to your unborn child. This makes quitting the most important thing you can do to improve your and your baby's health.

Staying away from tobacco during pregnancy:

Since most people become addicted to nicotine after only 100 cigarettes, it is important to get professional help in order to quit successfully and stay quit. Breaking any addiction requires sympathetic encouragement, help and support. Avoid situations where you may be exposed to the second-hand smoke of other tobacco users, if you might be pregnant. Enlist the support of your partner, family and friends, in your decision to quit. Speak to your healthcare provider about stop smoking programs in your area.

Two thirds of women who stop smoking when pregnant, resume the habit after birth. Tiredness, stress and hormonal changes, all seem to play a role in relapse. To minimize stress levels and increase your chances of rest, make arrangements for help with your baby, household and meals before your baby is born.


Cornelius, M.D. & Day, N.L. 2000. The Effects of Tobacco Use During and After Pregnancy on Exposed Children in Relevance of Findings for Alcohol Research Vol. 24, No. 4, 242-249.

Coovadia, H.M. & Wittenberg, D.F., eds. 1998. Paediatrics & Child Health: A Manual for Health Professionals in the Third World (4th edition). Cape Town: Oxford University Press.

Stoppard, M. 2005. Family Health Guide: The essential home reference for a lifetime of good health. London: Dorling Kindersley.

Leary, P.M. 1990. Creative Parenting: How to use the concept of attachment parenting to raise children successfully from birth to adolescence. Cape Town: Struik Timmins.