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, make sure to tell your doctor right away. Your baby can then be tested and treated as soon as she is born.
Blood Traveling Through Mother's Placenta to Baby
Causes
This condition is caused when a woman uses drugs and/or alcohol while pregnant. Things that cause this condition include:
- Heroin
- Methadone
- Amphetamines
- Marijuana
- 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:
Symptoms
Depending on the type and amount of drug exposure, symptoms can develop within hours to days after birth. If your baby has any of these symptoms, do not assume it is due to this condition. They may be caused by other conditions. Tell your doctor if your baby has any of these symptoms:
- 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 check 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. The doctor will also do a physical exam on your baby. 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 so that he can 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 your baby is withdrawing from.
Supportive Care
Your baby may need IV fluids (given through a needle), oxygen, high-calorie formula, tube-feeding, or other support as he recovers.
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.
- Once pregnant, talk to your doctor about any drugs you have taken, and get regular prenatal care.
- Seek 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.net/about_camh/
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://ncadi.samhsa.gov/govpubs/bkd110/5d4.aspx and http://ncadi.samhsa.gov/govpubs/bkd110/5d7.aspx/ . Accessed September 9, 2009.
Neonatal abstinence syndrome. Children’s Hospital Boston website. Available at: http://www.childrenshospital.org/az/Site1338/mainpageS1338P0.html . Accessed September 9, 2009.
Neonatal abstinence syndrome. University of Virginia Health System website. Available at: http://www.healthsystem.virginia.edu/uvahealth/peds_hrnewborn/nas.cfm . Accessed September 9, 2009.
Neonatal opiate withdrawal. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated August 18, 2009. Accessed September 9, 2009.
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 . Published June 19, 2009. Updated June 26, 2009. Accessed September 9, 2009.
Last reviewed December 2010 by Kari Kassir, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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