Condition Basics

What is neonatal abstinence syndrome?

Drug withdrawal in newborns (neonatal abstinence syndrome) is a set of problems that may affect a baby if certain drugs were used during pregnancy. The drugs pass through the placenta and enter the baby's bloodstream. The baby's body gets used to the drug. After birth, when the drug starts to leave the body, the baby goes through withdrawal. This may happen within hours after birth. Or it may happen later, depending on the drug.

This condition can be caused by certain prescription medicines or drugs. Some examples include opioids such as heroin, methadone, morphine, oxycodone, and hydromorphone.

How does it affect a newborn?

Babies who are going through drug withdrawal may:

• Be cranky and jittery.
• Cry a lot.
• Have trouble feeding and sleeping.
• Have stomach problems like vomiting and diarrhea.

This can be very stressful for both you and your baby. But most babies recover after the body has rid itself of the drug. How long this takes depends on the drug and how much is in your baby's body.

What can you do if you used drugs during pregnancy?

Your baby's doctor wants to give you and your baby the best care possible. So if you used drugs or took prescription medicines while you were pregnant, make sure to tell your baby's doctor. It can take courage to speak up about these things. But telling the doctor what drugs you took, how much you took, and when you took them will help the doctor watch your baby's health after birth. And the doctor will know to do more tests, if needed, as your child grows.

If you have a drug problem, talk with your doctor, counsellor, or other support person. Drug use may affect many parts of your life, including your ability to take care of yourself and your baby. Getting support can help.

How is neonatal abstinence syndrome treated?

Your baby's doctors and nurses will help you learn how to care for and bond with your baby. They'll also help you feel comfortable with the care that your baby is given. For example:

• Your baby may need special care, such as being in the neonatal intensive care unit (NICU). You may see tubes and wires attached to your baby. This may be scary for you. The hospital staff understands this. They will explain what happens and will answer your questions.
• The NICU staff will do things to soothe your baby. For example, they may wrap your baby in a blanket. This is called swaddling. They can teach you how to do this.
• The NICU staff will closely watch your baby. Your baby may get fluids and oxygen if needed. The staff will also make sure that your baby is getting enough nutrition and gaining weight.
• The doctor may give medicine to ease the effects of withdrawal and make your baby more comfortable. The medicine may be given by mouth or through a blood vessel. Your baby may be given less of the medicine over time to allow the body to adjust.

How long your baby needs to stay in the hospital depends on how severe the withdrawal symptoms are. It's hard to be apart from your baby, especially when you're worried about them. Know that the hospital staff is well prepared to care for babies with this condition. They will do everything they can to help you and your baby.

How can you care for your baby at home?

• Follow your doctor's directions for caring for your baby. Call your doctor or nurse advice line if you have questions or concerns.
• If your baby is upset, try soothing them in a darkened room.
• Try "kangaroo care." To do this, hold your baby upright, skin-to-skin on your chest, under a light blanket or loose shirt. All your baby needs to wear is a diaper.
• Swaddle your baby. Swaddling means wrapping them in a blanket. When you swaddle your baby:
  • Keep the blanket loose around the hips and legs. If the legs are wrapped tightly or straight, hip problems may develop.
  • Keep a close eye on your baby to make sure they don't get too warm.
• Never shake, slap, or hit your baby. This can cause serious or even deadly brain injuries. If you feel overwhelmed, maybe you could ask a family member or friend to give you a break.
• Keep all drugs and drug-related items, like bongs, pipes, lighters, needles, spoons, and fentanyl patches, locked up, out of sight, and out of reach of children. Exposure to even a tiny amount of any drugs, including ecstasy, methamphetamines, cocaine, heroin, and fentanyl, can make your baby or child very sick or cause death. Exposure can happen in different ways, like breathing in second-hand smoke or vapour from drugs; being exposed through breastfeeding or breastmilk; transferring from clothing, hands, or skin to a baby or child’s body, toys, soothers, bottles, and other items; during diaper changes; or accidentally eating or touching drugs. Babies and children are in contact with their caregivers and everything in their environment, so exposure can also happen in many places, like in your home and other homes, in vehicles, and in public places.
• Anyone who comes in contact with drugs or drug-related items should wash their hands and change their clothes before handling or feeding a baby or child or touching toys or other items.