by EBSCO Medical Review Board
(Neonatal Abstinence Syndrome)

Definition

Neonatal drug withdrawal happens when a baby who has been exposed to drugs in the womb has withdrawal symptoms. This happens because the baby is no longer exposed to the drug the mother was taking.

Blood Traveling Through Mother's Placenta to Baby
baby fetus placenta
Drugs and alcohol travel through this path from mother to baby.
Copyright © Nucleus Medical Media, Inc.

Causes

This problem can be caused when a pregnant woman uses:

  • Heroin
  • Methadone
  • Amphetamines
  • Cocaine
  • Alcohol
  • Opioids
  • Benzodiazepines
  • Barbiturates
  • Antidepressants

Risk Factors

Drug, medicine, or alcohol abuse when pregnant raise the risk of this problem in a baby.

Symptoms

Symptoms can happen within hours to days after birth. It depends on the type and amount of drug used.

Problems may be:

  • Fussiness
  • Stiff muscles
  • Seizures
  • Poor feeding
  • Diarrhea
  • Vomiting
  • Yawning
  • Problems sleeping
  • Fever
  • Sneezing
  • Sweating
  • Crying a lot
  • Problems breathing

Diagnosis

The doctor will check the baby based on their symptoms and the mother's health and drug history. A physical exam will be done.

The baby will be tested for signs of drugs. This may be done with urine, umbilical cord, blood, hair, and stool testing.

Treatment

It can take weeks to months for a drug to leave a baby's body. Medicine may be given to help ease problems. The overall goals of treatment are to:

  • Monitor the baby for signs of problems, such as seizures
  • Provide support, such as fluids, oxygen, and special feedings

Prevention

A mother can prevent this health problem by not using drugs during pregnancy.

RESOURCES

National Institute on Drug Abuse  https://www.drugabuse.gov 

Substance Abuse and Mental Health Services Administration  https://www.samhsa.gov 

CANADIAN RESOURCES

Centre for Addiction and Mental Health  http://www.camh.ca 

Health Canada  http://www.canada.ca  

References

Hudak ML, Tan RC, et al. Neonatal drug withdrawal. Pediatrics. 2012 Feb;129(2):e540-e560.

Neonatal opioid withdrawal. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/neonatal-opioid-withdrawal . Updated August 6, 2019. Accessed January 3, 2019.

Revision Information

  • Reviewer: EBSCO Medical Review Board Kari Kassir, MD
  • Review Date: 09/2019
  • Update Date: 06/12/2020