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Neonatal Drug Withdrawal

(Neonatal Abstinence Syndrome)

Definition

Neonatal drug withdrawal occurs when a baby who has been exposed to drugs in the womb develops withdrawal symptoms. This occurs because the baby is no longer exposed to the drug the mother was taking. This condition can be caused by medicines, alcohol, and illegal drugs. It can take weeks to months for a baby to fully withdraw from a drug. Without treatment, this can be a life-threatening condition. If you used drugs during your pregnancy, tell your doctor right away. Your baby can be tested and treated after delivery.
Blood Traveling Through Mother's Placenta to Baby
baby fetus placenta
Drugs and alcohol travel through this path from mother to baby.
Copyright © Nucleus Medical Media, Inc.

Causes

This condition is caused when a woman uses drugs and/or alcohol while pregnant. Drugs that cause this condition include:
  • Heroin
  • Methadone
  • Amphetamines
  • Cocaine
  • Alcohol
  • Opiates
  • Benzodiazepines
  • Barbiturates
  • Antidepressants

Risk Factors

These factors increase your baby’s chances of developing this condition. Tell your doctor if you have any of these risk factors:
  • Drug, medication, or alcohol abuse while pregnant
  • Drug use or dependency

Symptoms

Depending on the type and amount of drug exposure, symptoms can develop within hours to days after birth.
Symptoms include:
  • Irritability
  • Poor feeding
  • Difficulty sucking
  • Diarrhea
  • Vomiting
  • High-pitched cry
  • Crying a lot
  • Sweating
  • Fast breathing
  • Shaking
  • Difficulty sleeping
  • Yawning
  • Sneezing
  • Stuffy nose (hard to breath through the nose)
  • Increased muscle tone
  • Fever
  • Seizures

Diagnosis

The doctor will examine your baby based on her symptoms and your medical and drug history. To diagnose your baby correctly, the doctor needs to know what drug you took during pregnancy, how much was taken, and how often. Your baby will have a physical exam. Tests may include urine tests, hair or stool tests, blood tests, and x-rays.

Treatment

Talk with your doctor about the best treatment plan for your baby. Treatment options include the following:

Close Monitoring

Your baby may need to stay in the hospital to be closely monitored. Your baby may be watched for:
  • Signs of seizures
  • Difficulty breathing
  • Other serious withdrawal symptoms

Medicines

Your baby may be given medicines to help during withdrawal. Medicines will differ based on the drug from which your baby is withdrawing.

Supportive Care

Your baby may need IV fluids, oxygen, high-calorie formula, tube-feeding, or other support.
Follow your doctor's instructions.

Prevention

To help reduce your baby‘s chances of getting this condition, take the following steps:
  • Stop taking drugs before becoming pregnant or as soon as you learn you are pregnant.
  • After you become pregnant, talk to your doctor about any drugs you have taken. Get regular prenatal care.
  • Get treatment for drug abuse problems before becoming pregnant.

RESOURCES

National Institute on Drug Abuse http://www.nida.nih.gov/NIDAHome.html

Substance Abuse & Mental Health Services Administration http://www.samhsa.gov

CANADIAN RESOURCES

Centre for Addiction and Mental Health http://www.camh.ca

Toronto Area of Narcotics Anonymous http://www.torontona.org

References

Improving treatment for drug exposed infants, treatment improvement protocol, (TIP), series 5. US Department of Health and Human Services, Drug & Alcohol Clearinghouse website. Available at: http://www.ncbi.nlm.nih.gov/books/NBK64750. Accessed January 8, 2013.

Neonatal abstinence syndrome. Children’s Hospital Boston website. Available at: http://www.childrenshospital.org/az/Site1338/mainpageS1338P0.html. Accessed January 8, 2013.

Neonatal opiate withdrawal. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated June 5, 2012. Accessed January 8, 2013.

Schub E., Cabrera G. Neonatal abstinence syndrome: an overview. EBSCO Nursing Reference Center website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=16&topicID=860. Updated August 24, 2012. Accessed January 8, 2013.

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