Neonatal Abstinence Syndrome Analysis

Drug use during pregnancy can lead to a number of complications in the fetus. Neonatal abstinence syndrome is one of the first apparent problems when the fetus is exposed to opioids in utero. Neonatal abstinence syndrome (NAS) or neonatal withdrawal occurs when the exposure of opioids to the fetus that the mother was using during pregnancy is abruptly stopped

(Kocherlakota, 2014). Pregnant mothers who have been taking their prescription drugs are often oblivious to the effects these painkillers can have on their babies. Although many mothers take un-prescribed drugs, the majority of those mothers take painkillers, because they believe it is safe while under a doctor’s care. Medications that can cause NAS are listed below:

Diamorphine (Heroin)

NEONATAL ABSTINENCE SYNDROME 3

Risk factors which cause neonates to develop NAS can be affected by maternal health history; history of substance abuse, maternal behaviors, track marks (or physical evidence of abuse) on mothers arms, maternal medical complications, unexplained complications during pregnancy. In a recent study by Australian and New Zealand Journal of Obstetrics and

Gynaecology, they suggest that the combination of when the mother took her last dose of opioids, infant’s gestational age, and mode of delivery provided significant statistics on which infants required treatment for NAS and which did not. They also found that higher gestational age along with higher maternal opioid dose was correlated with the necessity for NAS treatment.

Infants that were born via Cesarean section were less likely to need NAS treatment.

It is often difficult to predict if the neonate will be present with NAS and it is

Methadone can be an alternative treatment and is used more often in the United

States; it can be given only twice a day, although due to its long half life, it could be rather difficult to taper it down slowly (Kocherlakota, 2014). When the infant no longer displays severe signs of withdrawal, is feeding and sleeping well, is gaining weight, and maintains stable scores, the infant can be discharged with the parents (if deemed safe) or child protective services.

The mother and family may begin to exhibit feelings of guilt and anxiety. This can cause the mother to revert back to her original state of abuse by using opioids and inhibiting mother- infant bonding. It is crucial to prepare the parents on what to expect of infant behavior and development (Janson & Velez, 2012). Ways to accustom the parents to care for their infant is to have the parents participate in the management during their hospital stay and after discharge.

Instructing and teaching the mother about the signs and symptoms of NAS can be crucial if the symptoms happen to rebound. It is important to educate parents about sudden infant death syndrome and to emphasize the importance of keeping an ideal environment for the development of these babies (Kocherlakota,