Newborns exposed to substances like opioid drugs during pregnancy may have special needs. After birth, they may have withdrawal symptoms. This is called neonatal opioid withdrawal syndrome (NOWS).
Babies with NOWS may cry a lot. They may have trouble sleeping and eating. And they may also tremble or even have seizures. Withdrawal symptoms in a newborn require extra care.
These babies need more support to thrive. UPMC Women's Services provides compassionate, personalized care for each baby and family. We understand that babies do best when they can remain within the comfort of their families.
We monitor all newborns for signs of NOWS. Our experienced care teams use a special model of care known as Eat, Sleep, Console (ESC) to manage NOWS. We provide this unique care protocol to help the birthing parent and baby start their life together under the best possible circumstances.
When a person uses drugs or alcohol during pregnancy, they expose their baby to those same substances. It's called prenatal drug exposure. If the substance is heroin or some other opioid drug, doctors may sometimes call it newborn narcotic exposure.
Prenatal drug exposure is associated with poor health outcomes for both the parent and babies. Babies exposed to drugs during pregnancy are at higher risk for low birth weight, congenital disorders, preterm birth, and even stillbirth.
When adults become addicted to opioid drugs and stop using them, they can go through withdrawal. Symptoms can include anxiety, diarrhea, and vomiting. Many people report feeling like they have a bad case of the flu.
Babies exposed to drugs are not immune from withdrawal. Over time, intrauterine drug exposure can also lead to withdrawal symptoms in a newborn. Doctors call the symptoms of drug-exposed babies neonatal abstinence syndrome (NAS). In cases of opioid or opiate exposure, they may call it neonatal opioid withdrawal syndrome (NOWS). Either way, these are serious conditions that require monitoring and treatment.
Researchers are still learning about the long-term symptoms of drug-exposed babies. There is still much we don't know.
We do know that substance-exposure-related conditions, including congenital disorders and preterm birth, can have a long-term impact on a child's health. Children exposed to drugs during pregnancy are also more likely to have learning disabilities and developmental delays.
Studies have shown that substance-exposed newborns also have an increased risk of sudden infant death syndrome (SIDS). SIDS is the sudden and unexplained death of a child under the age of one year, often during sleep.
NAS can also result in physical issues, including motor problems. Babies may have issues with their bones and muscles that can lead to problems with movement. They may also have speech and language issues.
Some substance-exposed babies will have chronic ear infections throughout childhood. Other children exposed to drugs during pregnancy may have one of a variety of different vision problems.
Many research studies show that drug exposure interferes with normal brain development. These studies suggest that changes may occur in brain areas involved with learning, memory, and emotional processing and regulation.
The result is that many babies exposed to drugs in the womb may experience cognitive, psychological, and behavioral issues. Proper intervention can help reduce these and other harms.
This is why it is so essential to treat NAS early. Monitoring babies for NAS symptoms immediately after birth — and treated as needed — helps them avoid some long-term issues. Or, if they do experience them, make them less likely to be severe.
UPMC's role as a health care provider is to keep women and their babies as healthy as possible. We are not here to punish women who are asking for help.
Our programs are family-focused and recognize the importance of keeping mothers and their babies together as they recover and go on to have happy, healthy futures. We also work with your county's children and youth agency to help prevent older children from being removed from the home while their mothers are in treatment.
NAS and NOWS include a group of symptoms often seen in babies exposed to opioids or other substances.
Symptoms can include:
Not every baby exposed to opioids will show the same symptoms — nor will babies who develop symptoms have every single symptom listed above. The severity of symptoms will also vary. However, it is essential to closely monitor babies exposed to drugs to ensure they get the treatment they need after birth.
It is also important to note that withdrawal symptoms may not start immediately after birth. For some babies, the symptoms may not begin for five to ten days. That is yet another reason why it is so important to monitor babies to determine whether they need treatment is so important.
When a person has used substances during pregnancy, it's important that their doctor knows. The ob-gyn and care team want the best for every child. They can help ensure drug-exposed babies can get the treatment they need to grow and thrive.
It is hard to pinpoint which drug causes the most severe withdrawal symptoms in newborns. Any drug can be a risk to the unborn child if used in an abusive way. Some drugs are more dangerous than others.
Opioids like fentanyl, codeine, and oxycodone, for example, have been linked to severe complications in newborns. Illicit street drugs like heroin, methamphetamine, and cocaine are also dangerous. They can lead to high rates of NAS as well as other health issues in newborns.
Prescription drugs, including antidepressant medications, can also lead to withdrawal, especially when abused. And when pregnant people mix different types of drugs, whether they are illegal or prescription, they may lead to NAS.
Medication-assisted treatment for opioid use disorder with methadone, suboxone, or buprenorphine is safe and recommended for pregnant people struggling with substance use. These medications can lead to withdrawal symptoms in a newborn, but staying on them is safer for the pregnant person and the baby than the risk of overdose or the use of illegal drugs.
Every parent wants the best for their baby. If a parent has used drugs during pregnancy or if a newborn tests positive for drugs at birth, it is crucial that they get the right care. UPMC Womens Services offers comprehensive, judgment-free care for substance-exposed newborns at UPMC Magee-Womens.
Our skilled care teams treat each baby and family individually. Our nurses monitor each baby for at least five days after birth for withdrawal symptoms. They will also teach you how to comfort and care for your baby.
Our goal is to ensure that your baby can manage those symptoms while still doing all the things newborns need to do: eat, gain weight, sleep, and thrive.
As long as your baby is born at 35 weeks or more and does not require intensive care, they will stay with you in the labor and delivery ward while you both are in our care.
Once we discharge you from the hospital, we will move your baby to Pediatrics for continued monitoring. You will be able to stay in the room with your baby there, too.
Babies are incredibly resilient. The good news is that, with the right care and your love and support, most babies can get through withdrawal. If your baby is eating and sleeping well — and is easily consoled — you may be able to go home together in as few as five days.
If the symptoms become severe or risk leading to complications like dehydration, our experienced physicians may prescribe them medications, including liquid oral morphine or liquid oral methadone. These prescriptions may require a longer stay in the hospital.
It is important to remember that every baby is different. Whatever they need, you will always be part of any decisions about their care and treatment.
UPMC Women's Services relies on a care model called the Eat, Sleep, Console (ESC) protocol. The goal of ESC is to help babies with NOWS stay with their families as they recover from withdrawal symptoms.
One of the best treatments for babies with NOWS is having loving parents nearby. Parents provide feelings of comfort and safety.
Like other newborns, babies with NOWS love to be swaddled. It makes them feel like they are back in the womb or cuddling close to someone they love. Babies with NOWS also do well in dark, quiet areas. Bright lights and loud noises are overstimulating and can interfere with sleep.
Our experienced nurses will educate you about common NOWS symptoms — and how to care for them. They will teach you how to comfort and console fussy babies. And also how to feed your baby, either by breast or bottle. The program can also arrange for lactation consultants as needed.
By the end of the five-day monitoring period, new parents will learn important skills to help their babies eat and sleep and to console them when needed.
Do all the things you would normally do to care for your newborn:
We understand that you may not be able to stay with your baby during their entire hospital stay. You may have other children or commitments. Please let the staff know if you need to leave for an extended time.
We can plan for nursing support staff or specially trained volunteer cuddlers to hold and comfort your baby while you are away.
Last reviewed by a UPMC medical professional on 2024-09-05.
