What is drug withdrawal in newborns?
Drug withdrawal in newborns (also called neonatal abstinence syndrome) is a set of problems that may affect a child if the mother used certain drugs while she was pregnant. These drugs may include prescription medicines or illegal drugs. Some examples are heroin, methadone, morphine, buprenorphine, and hydromorphone.
The drugs in the mother's blood pass through the placenta and enter the baby's bloodstream. They affect the baby in much the same way as they affect the mother. The baby's body gets used to the drug. After birth, when the drug starts to leave the body, the baby goes through withdrawal. This may happen within hours after birth or later, depending on the drug.
What happens during withdrawal from drugs in newborns?
Babies born with the effects of drugs may:
- Be irritable and jittery.
- Cry a lot.
- Have problems feeding and sleeping.
- Have stomach problems like vomiting and diarrhea.
This can be stressful for you and your baby. But most babies recover after the body has rid itself of the drug. How long this takes depends on the drug and how much is in your baby's body.
What can you do if you're pregnant and have used drugs?
It's important to tell your baby's doctor what drugs you took, how much you took, and when you took them. This can help the doctor give your baby the best care possible.
If your doctor knows that you used drugs or took prescription medicines while you were pregnant, he or she can watch your baby's health both before and after birth. And the doctor will know to do more tests, if needed, as your child grows.
Your doctor may be able to spot severe drug effects in your baby at birth. But less severe effects, such as behaviour or learning problems, may not be noticed until your child is in school. So your doctor will check for problems to see if your baby is growing and developing as expected. Finding problems early gives your baby the best chance to reach his or her potential. And treating the problem early may help prevent mental and behavioural health problems as well as problems in school.
If you have problems with drug use, talk with your doctor, counsellor, or other support person. Doing this can help you see and address how drugs may affect many parts of your life, including your pregnancy.
How is drug withdrawal in newborns treated?
Treatment will help keep your baby from getting worse while the drug is still in the body.
Your baby may need special care, such as being in the neonatal intensive care unit (NICU). This may be scary for you. You may see tubes and wires attached to your baby. The tubes supply air, fluid, and medicines to your baby. The wires are attached to machines that help the doctor keep track of your baby's vital signs. These include temperature, blood pressure, breathing rate, and pulse rate.
The NICU staff will closely watch your baby. Your baby may get fluids and oxygen if needed. Your doctor will also make sure that your baby is getting enough nutrition and gaining weight.
The doctor may prescribe medicine to ease the effects of withdrawal and make your baby more comfortable. The medicine may be given by mouth or through a blood vessel. Your baby may be given less of the medicine over time to allow the body to adjust.
Your baby may need to spend days to months in the hospital to treat the symptoms of withdrawal.
How can you care for your baby at home?
Caring for a baby born with the effects of drugs takes patience.
Watch for things that can bother your baby.
- If your baby is irritable, soothe him or her in a darkened room.
- If your baby cries a lot, swaddle or wrap him or her snugly in a baby blanket. Or you can rock or walk around with your baby. Cuddle him or her close to your chest.
- If your baby has diaper rash, change diapers more often. Gently wash the area with warm water, and use a diaper cream on the area.
- If your baby has problems feeding, give smaller amounts more often.
Caring for a fussy baby can be tough at times, especially if your baby cries no matter what you do. When this happens, maybe you could ask a family member or friend to help out for a little while and give you a break.
Your doctor will give you instructions for caring for your baby. Be sure to follow all of your doctor's instructions closely.
Other Works Consulted
- Wallen LD, Gleason CA (2010). Perinatal substance abuse. In CA Gleason, SU Devaskar, eds., Avery's Diseases of the Newborn, 9th ed., pp. 111–128. Philadelphia: Saunders.
Current as of: May 27, 2020
Author: Healthwise Staff
Medical Review: John Pope MD - Pediatrics
Kathleen Romito MD - Family Medicine
Jennifer Merchant MD - Neonatal-Perinatal Medicine