Neonatal Abstinence Syndrome – Babies Born Addicts


Warning: The topic and content of this article way be upsetting. This article has photos and videos of babies experiencing withdrawal symptoms.


What Is Neonatal Abstinence Syndrome (NAS)?

Pregnant women who use substances regularly (both drugs and alcohol) may deliver newborn babies who are born dependent on the same substances as their mother because substances are passed between mother and baby through their umbilical chord.

Studies have found that smoking cigarettes, using opioids, drinking alcohol, using cocaine and using methamphetamine while pregnant can each affect fetal development prior to birth. Babies exposed to drugs in utero may experience developmental consequences including impaired growth, birth defects and altered brain development.

Prenatal drug exposure may impact the child’s behaviour, language, cognition and achievement long term. Drug use during pregnancy may also lead to miscarriage or pre-term labor.

Based on the 2017 National Survey on Drug Use and Health (NSDUH), an estimated 194,000 pregnant women between the ages of 15 to 44 have used illicit drugs in the past month, including an estimated 161,000 who used marijuana, an estimated 32,000 who misused painkillers, an estimated 12,000 who misused tranquillisers/sedatives and an estimated 8,000 who misused cocaine.

An estimated 334,000 pregnant women between the ages of 15 to 44 (14.7%) have used tobacco in the past month and an estimated 261,000 used alcohol in the past month.

Prenatal exposure to amphetamines may cause facial clefts, heart defects and decreased fetal growth among others complications during development or after birth.

Remember – Your body is/will be generating a whole variety of hormones and chemicals, along with increased cravings and emotions.

If you’re struggling, it’s vital that you reach out for help and support straight away before you make bad decisions which could then cause further/unnecessary harm to you or your unborn baby.

You could contact your GP, drug and alcohol Keyworker, OB-GYN Doctor, Midwife or mental health professional.


How Is NAS Diagnosed?

The diagnosis of NAS is made based on a history of medicine or substance use in the mother. An accurate report of the mother’s drug and alcohol use is important.

This includes the time and date the last drug or drink was taken. The healthcare provider may use a scoring system to help diagnose and pinpoint how serious the baby’s withdrawal is.

For example, the Finnegan Neonatal Abstinence Scoring System (you can find more information about this at the bottom of this article). Points are assigned for certain signs and symptoms and the seriousness of each. This scoring may also help in planning treatment.

The healthcare provider may check meconium, urine, umbilical cord blood or all three if the healthcare professional suspects that the mother was/is using drugs or alcohol. It can also be done if the baby shows symptoms of the syndrome. Some birth centers routinely screen all babies.

The best way to diagnose NAS is by having the awareness about NAS and addiction generally. Also knowing who is likely to have it is important so that it can be dealt with at the earliest possible opportunity to minimise the distress that is experienced by the newborn or the mother.


Nature Vs Nurture

What the parent eats, drinks or uses (including prescribed medications all go to the developing foetus. Also, the parents DNA also impact the baby is a multitude of different ways.

This can also help to determine whether the developing baby will ultimately develop addictions or addictive behaviours themselves. You can learn more about nature vs nurture in our previous article by clicking here.


The Science Behind Addictions

Understanding the science behind addictions is a great starting point when it comes to overcoming your addiction. You can learn about the science behind addiction and how medicated assisted treatments (MAT) programs by clicking here.


Some More Than Others

Some drugs and medicines are more likely to cause the syndrome than others. But nearly all have some effect on the baby. When more than one drug has been used, the symptoms are often worse. These include:

  • Opioids like heroin and prescribed medicines such as codeine and oxycodone
  • Stimulants such as amphetamines or cocaine. For these drugs, the effects on a baby are more likely from the drug itself instead of withdrawal.
  • Antidepressant medicines such as selective serotonin reuptake inhibitors (SSRIs)
  • Depressants such as barbiturates, or alcohol, or marijuana
  • Nicotine from cigarette smoking

Alcohol use can also cause another group of problems called fetal alcohol spectrum disorders (mentioned in more detail below).


Symptoms Of Neonatal Abstinence Syndrome

Symptoms that the newborn is suffering from neonatal abstinence syndrome may include:

  • Crying that is excessive and/or high-pitched
  • Irritability
  • Trouble sleeping
  • Excessive sucking
  • Poor feeding, slow weight gain
  • Diarrhea, vomiting
  • Fever
  • Blotchy skin
  • Sweating
  • Quick breathing
  • Stuffy nose, sneezing
  • Hyperactive reflexes, increased muscle tone
  • Trembling, seizures

Symptoms of the syndrome may vary depending on:

  • The type of drug used
  • The last time it was used
  • Whether the baby is full-term or premature

Symptoms of withdrawal may start as soon as 24 to 48 hours after birth. Or they may start as late as 5 to 10 days after birth.


Premature Babies

Premature babies may have a lower risk for withdrawal symptoms or have less severe symptoms. They may also get better faster because they were exposed to less of the drug than full-term babies.


Fetal Alcohol Spectrum Disorder (FASD)

Alcohol use during pregnancy is associated with impaired fetal growth, birth defects and long-term impacts on growth. It may cause a fetal alcohol spectrum disorder (FASD) in the baby. The most severe type of FASD is fetal alcohol syndrome (FAS). FASDs may cause physical and psychiatric problems. Possible physical consequences of FASDs include:

  • Small head size
  • Abnormal facial features
  • Problems with vision or hearing
  • Low body weight
  • Shorter-than-average height
  • Poor coordination
  • Problems with sleep and sucking as a baby
  • Heart, kidney or bone problems

In later life, the baby with FAS may experience:

  • May develop learning difficulties or special needs
  • Problems with eyes/vision or ears/hearing
  • May continue to have heart, kidney or bone problems
  • More likely to develop addictions themselves or developing mental health conditions

Effects Of Alcohol & Drug Use During Pregnancy

Using opioids, cocaine, alcohol, nicotine, or other drugs during pregnancy may lead to:

  • Miscarriage
  • Pre-term birth
  • Low birth weight
  • Abnormal neurobehavior
  • Birth defects

A baby whose mother used certain drugs while pregnant may suffer from long-term problems due to growth failure or birth defects involving the brain, heart, kidneys or intestines. Infants exposed to drugs in utero have an increased risk of Sudden Infant Death Syndrome (SIDS).


What Is SIDS?

Sudden infant death syndrome (SIDS) – sometimes known as “cot death” is the sudden, unexpected and unexplained death of an apparently healthy baby.

In the UK, more than 200 babies die suddenly and unexpectedly every year. This statistic may sound alarming but SIDS is rare and the risk of your baby dying from it is low.

Most deaths happen during the first 6 months of a baby’s life. Infants born prematurely or with a low birthweight are at greater risk. SIDS also tends to be slightly more common in baby boys.

SIDS usually occurs when a baby is asleep, although it can occasionally happen while they’re awake.

Parents can reduce the risk of SIDS by not smoking while pregnant or after the baby is born, and always placing the baby on their back when they sleep.

You can learn more about SIDS by clicking here.


Effects On Drug Exposed Children

Substances like nicotine, alcohol, opioids, illegal drugs and certain legally prescribed medications are associated with long-term mental and behavioural effects in children exposed to them prenatally, such as:

  • Cognition
  • Language
  • Achievement
  • Behaviour
  • Further addictive behaviours
  • Thought processes
  • Likelihood of developing a mental health condition

In addition to the possible physical consequences of fetal alcohol spectrum disorders, potential psychiatric and social issues include:

  • Hyperactivity including attention deficit hyperactivity disorder (ADHD)
  • Memory and attention problems
  • Intellectual/learning difficulties or disability, including possible low IQ
  • Delays in speech, language including speech problems or comprehending sentences, meaning or tone of a conversation
  • Learning disabilities and difficulty in school or further education
  • Poor judgment and reasoning skills
  • Greater risk of developing a mental health condition or addictions or addictive behaviours

Neurobehavioral Effects on Newborns & Infants

Nicotine is linked to neurobehavioral impacts in infants and long-term effects on cognition, achievement, language and behaviour. Alcohol is associated with neurobehavioral effects in infants, and long-term impacts on cognition, language, achievement and behaviour.

Marijuana exposure prenatally is related to some infant neurobehavioral alterations and long-term effects on cognition, behaviour and/or achievement.

Babies exposed to opioids prenatally may have neurobehavioral changes as an infant and long-term behavioural effects. Prenatal exposure to cocaine is associated with some impacts on infant neurobehavior and long-term effects on behaviour, executive function and language. Methamphetamine is linked to neurobehavioral alterations in infants.


Treatments for Neonatal Abstinence Syndrome (NAS)

Babies suffering from withdrawal are irritable and often have a difficult time being comforted.

  • Swaddling or snugly wrapping your baby in a blanket may help comfort your baby
  • Babies may also need extra calories because of their increased activity and may need a higher calorie formula. Intravenous (IV) fluids are sometimes needed if your baby becomes dehydrated or has severe vomiting or diarrhea.

Some babies may need medications to treat severe withdrawal symptoms, especially for seizures (fits). Specific drugs for treating withdrawal can include:

  • Methadone for heroin and other opiate withdrawal
  • Benzodiazepines (for alcohol withdrawal)
  • Sedatives can help to settle their central nervous system if they are extremely restless or shaking
  • Intravenous (IV) fluids to replace lost fluids during vomiting and diarrhoea. They also help to flush out substances more quickly
  • NSAID’s (non-steroidal anti inflammatory drugs) are sometimes used to reduce fevers, sweating or body pains or aches

Other drugs are also being used to help relieve the discomfort and problems of withdrawal. The treatment drug is usually in the same class as the substance your baby is withdrawing from. Once the signs of withdrawal are controlled, the dosage is gradually decreased to help wean your baby off the drug (tapering/slow reductions).


Complications Associated With NAS

Even without neonatal abstinence syndrome, prenatal drug exposure can be related to later developmental delay. This may be the result of the environment in which the baby grows up as well.

Specific drugs have been linked to specific problems in the baby. These problems may include:

  • Heroin and other opioids, including methadone, can cause serious withdrawal in the baby. Some symptoms can last as long as 4 to 6 months. Seizures may also occur in babies born to opioid users
  • Amphetamines can lead to low birth weight and premature birth
  • Cocaine use can cause poor growth. It also makes complications such as placental abruption more likely
  • Marijuana use may cause lower birth weight, as well as later learning and behaviour problems
  • Alcohol use can have major effects on babies before and after birth. Growth during pregnancy and after birth is slowed. It can also cause certain problems of the head and face, heart defects, learning problems and mental problems
  • Cigarette smoking may cause low birth weight. It may also put babies at higher risk for premature birth and stillbirth

Addiction Help For Pregnant Women

Although anyone who struggles with a substance use disorder (addiction) should seek treatment, it is especially important for women who may be, are or may soon become pregnant.

Firstly, speak to your Doctor or GP to ensure that you get ongoing support throughout your pregnancy. Secondly, contact your nearest community based drug and alcohol service for more specialist help, support, treatments and therapies to help both you and the unborn baby. This may include medicated assisted treatment (MAT), counselling or hypnotherapy, meditation or mindfulness techniques, auricular acupuncture, ob-gyn Doctor, fellowship meetings such as Narcotics Anonymous (NA), Alcoholics Anonymous (AA) or Cocaine Anonymous (CA)or group/one to one meetings among others.

You can find contact information for all of these sources of help and support on our help and support page here.

Remember – Your body is/will be generating a whole variety of hormones and chemicals, along with increased cravings and emotions.

If you’re struggling, it’s vital that you reach out for help and support straight away before you make bad decisions which could then cause further/unnecessary harm to you or your unborn baby.

You could contact your GP, drug and alcohol Keyworker, OB-GYN Doctor, Midwife or mental health professional.

You could also consider attending baby or pregnancy courses to better help you prepare for birth and/or motherhood with other people in the same boat as you. Contact your ob-gyn Doctor, Midwife or birthing unit for more information about these services and others that are available in your area.


What Other Parents Who Have Gone Through NAS Have To Say.


The Finnegan Neonatal Abstinence Scoring System For Healthcare Professionals

The Finnegan Neonatal Abstinence Scoring System is the most commonly used scoring tool for newborn babies who have NAS and as part of their treatment, require monitoring.

Although the original tool has been modified frequently. Below is a modified Finnegan NAS Scoring form developed by Jansson, Velez, and Harrow. It was further modified by the Fletcher Allan Hospital of Vermont.


Remember, We Offer Counselling & Hypnotherapy Services!

Drink ‘n’ Drugs offer online & face to face counselling sessions, along with hypnotherapy, auricular acupuncture and mindfulness workshops/courses.

Our therapists are highly trained and experienced in helping you to get clean and sober and live an amazing, new life, free of the bonds to addictions to do exciting new things with those you love.

They also can help with other areas aside from addiction including:

  • Chronic (long term) pain management
  • Mental health conditions
  • Mental health crises

Our therapies are available individually or alongside your family or friends as group therapy sessions.

For more information or to contact us, visit our therapy page by clicking here.

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Published by Drink ’n’ Drugs

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