Neonatal Abstinence Syndrome

When Infants Experience Withdrawal

Neonatal abstinence syndrome occurs when babies are exposed to addictive drugs in the womb and experience withdrawal after being born. Nearly all drugs, whether illegal or prescription drugs, cross the placenta from the mother's blood stream to the developing baby. This means that whenever an expectant mother is addicted to drugs, her unborn baby also becomes addicted. Once a baby is born, he or she no longer receives that drug from the mother and begins to experience the painful symptoms of withdrawal.

What Drugs Cause Neonatal Abstinence Syndrome?

Opiates—including heroin, methadone, codeine, morphine, and other prescription painkillers—are a common cause of newborn withdrawal. Approximately 60 to 80 percent of infants who were exposed to opiates before birth will experience withdrawal. In fact, as growing numbers of American women have become addicted to prescription pain medications, hospitals around the country have seen a concerning increase in the prevalence of neonatal abstinence syndrome.

Other substances that can cause neonatal abstinence syndrome include the following:

• Cocaine
• Benzodiazepines, including diazepam and clonazepam
• Barbiturates
• Marijuana
• Alcohol

In addition to causing withdrawal, these drugs can also have a toxic effect on the infant’s development. Maternal drug use is associated with premature birth, poor growth, seizures, birth defects, and sudden infant death syndrome (SIDS). Alcohol, in particular, can cause a cluster of birth defects called fetal alcohol syndrome. Mothers who do drugs are also at a higher risk for many health problems that will affect their babies, including contracting HIV.

What Are The Symptoms Of Neonatal Abstinence Syndrome?

Common symptoms include blotchy skin, tremors, diarrhea, vomiting, fever, irritability, difficulty breathing, and seizures. Addicted babies may have trouble with sleeping and feeding. They may cry excessively and be inconsolable. These symptoms may appear within 24 hours of the baby’s birth, or their onset may be delayed up to 10 days after the birth. Withdrawal symptoms vary depending on which drugs the mother used, the duration and frequency of the mother’s drug use, how the mother’s body metabolized the drug, and whether the child was born prematurely or at full term.

How Is Neonatal Abstinence Syndrome Treated?

Many babies going through withdrawal are comforted by being swaddled in a blanket, being gently rocked, and being kept in a quiet room with dim lighting. These babies often grow more slowly and may need to be fed a higher-calorie formula. Breastfeeding is also helpful for babies in withdrawal.

Many babies with neonatal abstinence syndrome need to be hospitalized and cared for in a neonatal intensive care unit. Medications, including methadone, morphine, and phenobarbitol, are frequently required to ease the symptoms. Doctors must take special care to dose these medications correctly for their tiny patients and then gradually wean the infants off of the medicines. Addicted newborns typically spend about two weeks in the hospital.

How Can Neonatal Abstinence Syndrome Be Prevented?

If you are pregnant and addicted to drugs, let your doctor know. Seek help so that you can give your baby a good start in life.