Methadone Prenatal Exposure

Adoption stems from brokenness. It's not something a mother chooses for her baby because she is in an ideal situation or environment. Because of this, there are cases where we see prenatal substance exposure. If a pregnant mother is struggling with addiction to heroin, oxycodone, or any other opioid then the safest treatment option is methadone through a medication-assisted treatment (MAT) program. 

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), methadone is safe for pregnant women combating opioid addiction. MAT has been used to treat pregnant women since the 1970s. In 1998, the American Society of Addiction Medicine (ASAM) and American College of Obstetricians and Gynecologists (ACOG) established MAT programs as the best practice treatment for pregnant women with opioid use disorders.

Medication-assisted treatment (MAT) in a medically supervised program can lead to minor NAS symptoms for a newborn, but it is far less severe than to be born with the withdrawal symptoms of heroin. Symptoms of NAS can include difficulty breathing, extreme drowsiness (sleepiness), poor feeding, irritability, sweating, tremors, vomiting and diarrhea. 

But what about the long term? There have been studies, including one that followed children up to age 3, that do not find differences in development among children who were exposed to methadone during pregnancy and those who were not. Some other studies on methadone and opioids as a general group have found more problems with learning and behavior in children exposed to opioids for a long period of time during pregnancy.

Is methadone treatment symptom free for the baby? No, but it is the best option compared to symptoms if the mother continues to use heroin or oxycodone. Although it can illicit fear for hopeful adoptive parents when we read through what could happen to a newborn who has been exposed, we must remember God's sovereignty over all of it. He is the ultimate healer, protector, and peace giver.

+ If you are interested in learning more about adoption and the services we provide at Christian Adoption Consultants, I would love to chat! Feel free to email me at meg@christianadoptionconsultants.com +

Resources:

https://www.hcrcenters.com/blog/methadone-and-pregnancy-opioid-addiction-during-pregnancy

https://mothertobaby.org/fact-sheets/methadone/

https://baartprograms.com/can-you-take-methadone-while-pregnant/

https://vertavahealth.com/methadone/pregnancy/

https://fn.bmj.com/content/89/1/F33

https://www.sciencedirect.com/science/article/abs/pii/S030121150500432X

Understanding Newborn Withdrawal

When a baby is exposed to substances in utero (including, but not limited to, heroin, meth, alcohol, antidepressants, inhalants, and methadone), they will often show symptoms of withdrawal. These symptoms can include:

• Persistent or prolonged high-pitched crying
• Central nervous system hyper irritability
• Gastrointestinal dysfunction such as vomiting or diarrhea (which can lead to weight loss)
• Excessive sucking reflex
• Sleeping problems
• Frequent yawning
• Nasal stuffiness or sneezing
• Fever
• Sweating
• Rapid breathing
• Feeding problems
• Respiratory distress
• Dehydration
• Tremors or seizures

This withdrawal is referred to as Neonatal Abstinence Syndrome (NAS) in a hospital setting. The symptoms and severity of NAS vary, and not all newborns exposed to drugs in utero will experience NAS. The severity of symptoms depends on a variety of factors like the infant’s gestational age at birth, whether the mother used nicotine or other psychoactive drugs, and the quality of care received in the hospital.

The hospital staff will use a scoring system where points are assigned for certain signs and symptoms. The scores assigned are based on the observations of the baby every 4 hours. These scores will then allow the hospital staff to make a treatment plan. The treatment plan often includes both non-pharmaceutical and pharmaceutical regimes. 

The non-pharmaceutical regimes include things that will help soothe the baby such as minimizing light and noise, swaddling, breastfeeding, and providing skin-to-skin contact with the mother.

For babies with severe withdrawal, they will require pharmaceutical treatment with a drug like morphine or methadone. The goal is to prescribe the baby with a drug similar to the one used by the mother during the pregnancy. Over a period of weeks or months, the baby is slowly weaned off of the drug in order to lessen the withdrawal symptoms. The average newborn will recover from NAS in 5 to 30 days with these treatment regimes.

+ If you are interested in learning more about adoption and the services we provide at Christian Adoption Consultants, I would love to chat! Feel free to email me at meg@christianadoptionconsultant.com. +

Resources:

https://studylib.net/doc/6994440/neonatal-abstinence-syndrome--nas-

https://fixforaddiction.com/n-a-s/

https://www.slideshare.net/SaraNoble/neonatal-abstinence-syndrome-60060197

http://www.cnn.com/2012/04/28/health/drug-babies/