Substance use disorders, also commonly known as addiction, can affect anyone at any time, no matter who you are, where you live, or what your financial status is. Addiction does not discriminate. It affects all genders and people of different marital statuses.  It also affects infants whose mothers are struggling with substance use.

The National Institute on Drug Abuse (NIDA) notes that every 15 minutes, a baby is born suffering from opioid withdrawal.  In addition, approximately one in three women of reproductive age filled an opioid prescription between 2008 and 2012, as indicated by the Centers for Disease Control and Prevention (CDC). 

The federal agency also states that self-reported data in 2019 indicated that roughly “7% of women reported using prescription opioid pain relievers during pregnancy. Of those, 1 in 5 reported misuse of prescription opioids,” meaning they were obtained from a non-healthcare source or used them for reasons other than pain relief.

It is vital to learn what neonatal abstinence syndrome (NAS) and neonatal opioid withdrawal syndrome (NOWS) are because doing so will lead to understanding infant withdrawal and what that entails for your newborn.

What is Neonatal Abstinence Syndrome?

The March of Dimes states that NAS is a “group of conditions caused when a baby withdraws from certain drugs (usually opioids) he’s exposed to in the womb before birth.” The widely known organization also notes that NAS can be caused when a mother is taking antidepressants, barbiturates, or benzodiazepines.

Drugs such as these pass through the placenta, which grows in the woman’s uterus, and supply the baby with food and oxygen through the umbilical cord. If an expectant woman is injured and is prescribed opioids for pain, she may be given codeine, hydrocodone, morphine, oxycodone, or tramadol. Pregnant women using heroin can cause an infant to be born with neonatal opioid withdrawal syndrome or NOWS.

NAS and NOWS can also possibly occur if a woman is trying to get pregnant and is taking any of the above-mentioned medications or heroin.

When the mother uses a substance, both mother and baby will become chemically dependent on the drug, which will lead to uncomfortable withdrawal symptoms when the drug use ends. When the infant is born, it will no longer be getting the drug through its mother, so it will experience withdrawal symptoms.

Addiction is a chronic disease that affects the reward center of the brain. This causes intense compulsions to keep using the drug. The compulsions can be nearly impossible to ignore, even when a woman is pregnant or trying to get pregnant. 

NAS or NOWS can also occur if a woman is going through an addiction treatment program and using a prescription drug, such as buprenorphine or methadone. Both are opioids used in the treatment of opioid addiction. A treatment program like this can last for several months and up to a year. If a woman becomes pregnant during this time while on treatment, it could lead to NAS or NOWS.


Neonatal Abstinence Syndrome Symptoms or Signs

It is essential to understand that symptoms can start as soon as 24 to 48 hours after birth or as late as five to 10 days after birth, according to Stanford Children’s Health, a part of the Stanford University Health system. Full-term infants may feel any or all of these symptoms:

  • Too much crying or high-pitched crying
  • Poor feeding or sucking
  • Trembling
  • Sweating
  • Vomiting or diarrhea
  • Sleep problems
  • Seizures
  • Yawning, stuffy nose, and sneezing
  • Fever or unstable temperature
  • Overactive reflexes
  • Tight muscle tone

Possible Complications From NAS

Substance use during pregnancy can cause many infant health problems other than NAS. It is crucial to fully understand the effects of neonatal abstinence syndrome. Some of the other medical conditions an infant can have are:

  • Low birth weight
  • Birth defects
  • Premature birth
  • Development and behavior problems
  • Small head circumference
  • Sudden infant death syndrome, commonly known as SIDS

How is Neonatal Abstinence Syndrome Treated?

Treatment depends on the child’s age, symptoms, general health, and how severe NAS is for the infant.

Infants going through withdrawal will be irritable and difficult to comfort. Swaddling the infant may help. Babies will also need more calories added to feedings due to increased activity stemming from their withdrawal symptoms. An infant may also require intravenous (IV) fluids if they are diagnosed with dehydration or have severe diarrhea or vomiting.

If an infant has a seizure, it will need medication to control it. Other medicines can be given to a baby to ease its withdrawal symptoms. These are in the same class of drugs as the ones the mother used before birth. When the withdrawal signs are controlled, the medication amount will be slowly decreased. This is weaning the infant off the drugs and is the safest way to help your baby.

Addiction Treatment for Pregnant Women

Women with a substance use disorder who are trying to get pregnant or are pregnant can take active steps now to prevent their newborn from suffering from neonatal abstinence syndrome and experiencing withdrawal symptoms.

Addiction can greatly impact pregnancy. Withdrawal from substances can add stress to a pregnant woman, which affects the baby. With that said, substance use when pregnant is known to cause medical, developmental, and behavioral difficulties for the baby.

Sometimes, expectant women may fear telling their doctors about their regular substance use, thinking that they might be separated from their infant. However, it is necessary that all of the medical professionals you receive care from have all the information needed to provide you with the best possible solutions. Please consider the steps below:

  • Have an honest discussion with your health care providers about the safest ways to stop using substances.
  • Discuss alternatives for pain relief, insomnia, depression, or anxiety. There are several healthy treatments and steps you can take to alleviate most of the symptoms of these conditions.
  •  If you are planning to get pregnant and use substances, use a condom with your partner until you taper off the substances completely.

Finding Substance Use Treatment When Pregnant

Addiction treatment is individualized to the person and is regularly tailored throughout therapy to be sure it fits the person’s needs. Pregnancy can complicate pregnancy, and it might seem troublesome to find substance use treatment when expecting a baby.

NIDA recommends that addiction treatment lasts 90 days or more to be fully effective. Women who need to be on methadone maintenance will likely be on it for 12 months, which is considered the minimum time. Keep in mind that the medical and addiction professionals you receive care from will work with you to determine the best course of substance use treatment for you and your infant.

If you are expecting a baby and want to stop using substances, Serenity at Summit can help. There are evidence-based addiction treatment options for everyone, and the licensed addiction and medical professionals will work with you to ensure you receive care that is safe for you and your fetus.

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