Neonatal Therapeutic Unit
Our Commitment to Care

Pregnancy & Drug Abuse

The CDC has identified prescription painkiller abuse as a major health threat, and the number of pregnant women who abuse painkillers is growing exponentially. Mothers who are dependent on drugs give birth to babies who are also dependent on drugs. A study published in the Journal of the American Medical Association found that the number of babies undergoing withdrawal tripled from 2000 to 2009. Currently, about two drug-dependent babies are born every hour.

These infants experience neonatal abstinence syndrome (NAS), which is a group of problems that occur in newborns exposed to addictive drugs, such as amphetamines, barbiturates, benzodiazepines (diazepam, clonazepam), cocaine and/or opiates/narcotics (heroin, methadone, codeine)  while in the mother’s womb. These substances pass through the placenta to the baby during pregnancy, and the baby becomes addicted to them, along with the mother.

The Baby's Symptoms

At birth, the baby is still dependent on the drug, and symptoms of withdrawal may occur. The symptoms of neonatal abstinence syndrome depend on the amount and type of drugs the mother used, how long she used drugs and whether the baby was born full-term or early/premature. They may begin within a few days after birth, or they may take 5 - 10 days to appear. Symptoms may include:

  • Blotchy skin coloring (mottling)
  • Diarrhea
  • Excessive or high-pitched crying
  • Excessive sucking
  • Fever
  • Hyperactive reflexes
  • Increased muscle tone
  • Irritability
  • Poor feeding
  • Rapid breathing
  • Seizures
  • Sleep problems
  • Slow weight gain
  • Stuffy nose, sneezing
  • Sweating
  • Trembling/tremors
  • Vomiting

The Neonatal Therapeutic Unit

Not all babies born with addiction need care in the highly sophisticated NICU, so they are usually admitted to our Neonatal Therapeutic Unit (NTU) They benefit most from the quiet, supportive hospital setting that the NTU offers, with an experienced staff to provide the level of care that these babies need. And because highly specialized, acute and complex care is not necessary  the cost of caring for them in the NTU is significantly lower.

Treatment

The healthcare team observes the newborn carefully for signs of withdrawal, feeding problems and weight gain. Babies who vomit or who are very dehydrated may need to get fluids through a vein (intravenously). Infants with neonatal abstinence syndrome are often fussy and hard to calm. To calm the infant down, it helps to reduce noise and lights, gently rock the baby and swaddle the baby in a blanket.

Babies with severe symptoms may need medicine, such as morphine or methadone, to treat withdrawal symptoms. The doctor may prescribe the infant a drug similar to the one the mother used during pregnancy and slowly decrease the dose over time, which helps wean the baby off the drug and relieve some withdrawal symptoms. Breastfeeding may also be helpful.

Because babies with this condition often have poor feeding or slow growth, they may need a higher-calorie formula that provides greater nutrition and/or smaller portions given more often.

What's Next

To provide the babies with the best possible care and opportunity for recovery, NTU staff and physicians involve the addicted mother, father and extended family in forming healthy habits that will continue beyond the hospital stay.

The hospital is committed to providing these infants with the most current and effective care. The staff continues to explore best practices with hospitals across the country and investigate new treatment options, care models, clinical trials and studies to better understand the possible impact of prenatal drug addiction. Adjustments to the facility, staffing and care may be made as we learn more.

Source: www.NIH.gov