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Questions About Opioid Withdrawal and Your Newborn

If you are pregnant and have an opioid dependency, it’s important to seek help at a medication-assisted treatment program as early as possible, regardless of any fears you may have. This will put you ahead of the game. During your pregnancy, your treatment will probably involve medication such as Suboxone, also known generically as Buprenorphine with Naloxone. Additionally, you may have questions about opioid withdrawal and your newborn.

You may encounter people questioning why you should opt for Suboxone treatment during pregnancy instead of continuing to use pain medication. However, the answer is clear: choosing Suboxone is much better for your baby, as the withdrawal process for a newborn is significantly easier than with pain medication. As a parent, it is your responsibility to prioritize your child’s well-being, even before they are born.

It’s common for pregnant women who use drugs to feel ashamed and avoid seeking help. Many of them are young, under the age of 24, and worry about being judged by others. Additionally, they fear that their partners will be angry if they learn about their opiate use, and they may be concerned that Children’s Services will remove their newborn or other children from their home. There is also the fear of legal consequences. However, starting medication-assisted treatment during pregnancy means you will have a team of professionals supporting you through the process.

According to the National Center on Substance Abuse and Child Welfare, around 10 to 11 percent of pregnancies involve a mother who has a substance use disorder, resulting in approximately 440,000 affected infants. While data on opioid withdrawal and newborns is not entirely clear, the American College of Obstetricians and Gynecologists (ACOG) cites a source suggesting that one percent of pregnant women use opiates. However, a urine analysis conducted on pregnant women at a metropolitan teaching hospital showed a rate of 2.6 percent, which is more than twice the self-reported amount.

What Can Happen to Your Baby?

Studies have shown that babies born to addicted mothers may have birth defects. For example, research suggests that infants born to mothers addicted to codeine may have an increased risk of heart defects. However, the same study found no such link between heroin or pain medication addiction and heart defects in newborns. Additionally, the use of any type of opiate during pregnancy may result in neural tube defects, such as spina bifida, and rare abdominal wall defects in the newborn

Pregnancy and opiate addiction can lead to additional potential complications for the fetus. According to the ACOG, mothers who are chronic heroin users have higher rates of low birth weight babies, premature separation of the placenta from the uterus (known as abruptio placentae), premature labor, meconium in the uterus, and fetal death.

Neonatal Abstinence Syndrome

Neonatal Abstinence Syndrome (NAS) is the term used to describe the range of symptoms associated with opioid withdrawal in newborns. NAS can affect 55 to 94 percent of infants born to mothers who are addicted to opioids, representing a significant range of cases. The severity of the addiction and resulting withdrawal symptoms depend on the type of drug the mother has been using, the daily dosage, and the duration of use.

Symptoms of Neonatal Abstinence Syndrome (NAS) include splotchy skin, irritability, excessive crying, diarrhea, hyperactive reflexes, excessive sucking or poor feeding, sleep problems, sweating, trembling, vomiting, stuffy nose, increased muscle tone, fever, and even seizures. Studies have shown that children born addicted, but who have now reached school age tend to struggle more in the classroom, both behaviorally and academically. They may also be negatively affected by the ongoing drug-using culture within the household. However, symptoms tend to be less severe in babies whose mothers received medical supervision and took Suboxone or methadone during the pregnancy.

Easier Opioid Withdrawal in Newborns

In the past, the American College of Obstetricians and Gynecologists recommended methadone as a treatment option for pregnant women. However, recent research over the past decade suggests that Suboxone may provide a safer and gentler alternative for newborns.

A study involving 309 infants found that 62 percent of them developed neonatal abstinence syndrome, with 48 percent requiring treatment. For babies whose mothers were using Suboxone, the syndrome typically appeared within 3 to 4 days after birth and lasted for 2 to 2.5 weeks. However, if the mothers had started Suboxone treatment during pregnancy, the babies fared better. Additionally, babies whose mothers used Suboxone required fewer hospitalization days for treatment.

While the numbers of pregnant women using opioids are increasing by the thousands each year, the good news is that Suboxone withdrawal appears to affect fewer newborns and they tend to have a less severe experience. Unfortunately, the bad news is that the prevalence of opioid withdrawal in newborns is alarmingly high, with the National Institute on Drug Abuse estimating that it occurs once every hour of the day and affects over 14,000 infants each year in the United States.

Your buprenorphine or methadone clinic doctor will take note of your due date and be eager to know if your newborn suffers from opioid withdrawal. It’s reassuring to know that you, as the mother, can take steps to ease your baby’s experience. Keep in mind that getting into treatment as early as possible during your pregnancy will keep your obstetrician on high alert and have pediatric specialists on standby in the delivery room.

Additional Research Offers Hope

Newborn mothers are often afraid to disclose their drug use for fear of losing custody of their children. In some cases, they even attempt to conceal symptoms of opioid withdrawal in their babies by disposing of diapers containing contaminated stools. However, recent studies are now using umbilical cords to examine these babies. A previous study showed approximately 25 percent of cords from drug-using mothers’ babies were found positive for THC and just slightly less for opioids. For all other drugs, the percentage of positive cords was less than 10 percent.

If you’re concerned about what doctors might say regarding opioid withdrawal in your baby, it’s important to know that this testing cannot determine when you last used drugs or if you used them during your first trimester. The best way to protect your newborn and provide optimal opioid withdrawal newborn treatment is to enter Suboxone treatment during your pregnancy. Additionally, you should seek out the necessary services to stabilize your household. It’s crucial not to be afraid of medication-assisted treatment when pregnant; in fact, not seeking treatment could be more harmful. Don’t hesitate – contact your local methadone program for more information. The time to act is now.

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