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Neonatal Drug Withdrawal

(Neonatal Abstinence Syndrome)

Definition

Neonatal drug withdrawal happens when a baby who has been exposed to drugs in the womb has withdrawal symptoms. This happens because the baby is no longer exposed to the drug the mother was taking.

Causes

This problem can be caused when a pregnant woman uses:

  • Heroin
  • Methadone
  • Amphetamines
  • Cocaine
  • Alcohol
  • Opioids
  • Benzodiazepines
  • Barbiturates
  • Antidepressants

Risk Factors

Drug, medicine, or alcohol abuse when pregnant raise the risk of this problem in a baby.

Symptoms

Symptoms can happen within hours to days after birth. It depends on the type and amount of drug used.

Problems may be:

  • Fussiness
  • Stiff muscles
  • Seizures
  • Poor feeding
  • Diarrhea
  • Vomiting
  • Yawning
  • Problems sleeping
  • Fever
  • Sneezing
  • Sweating
  • Crying a lot
  • Problems breathing

Diagnosis

The doctor will check the baby based on their symptoms and the mother's health and drug history. A physical exam will be done.

The baby will be tested for signs of drugs. This may be done with urine, umbilical cord, blood, hair, and stool testing.

Treatment

It can take weeks to months for a drug to leave a baby's body. Medicine may be given to help ease problems. The overall goals of treatment are to:

  • Monitor the baby for signs of problems, such as seizures
  • Provide support, such as fluids, oxygen, and special feedings

Prevention

A mother can prevent this health problem by not using drugs during pregnancy.

RESOURCES:

National Institute on Drug Abuse
https://www.drugabuse.gov

Substance Abuse and Mental Health Services Administration
https://www.samhsa.gov

CANADIAN RESOURCES:

Centre for Addiction and Mental Health
http://www.camh.ca

Health Canada
http://www.canada.ca

REFERENCES:

Hudak ML, Tan RC, et al. Neonatal drug withdrawal. Pediatrics. 2012 Feb;129(2):e540-e560.

Neonatal opioid withdrawal. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/neonatal-opioid-withdrawal. Updated August 6, 2019. Accessed January 3, 2019.

Last reviewed September 2019 by EBSCO Medical Review Board Kari Kassir, MD  Last Updated: 6/12/2020