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.

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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/