Neonatal abstinence syndrome is a sad, sometimes unavoidable reality
By Monica Money, R.N. Jun 16, 2016
Drug addiction is not something one usually thinks about when walking by the newborn nursery, peaking in the window and seeing the precious babies in their cribs. The reality is that neonatal abstinence syndrome is one of the diagnoses that will keep a baby who is otherwise healthy in the nursery for weeks after a normal delivery.
Neonatal abstinence syndrome is a combination of symptoms that occur in the newborn after delivery when and he or she is no longer receiving the drug substances in-utero. This can include substances as mild as nicotine to as strong as heroine. The typical drugs that are seen in our area are prescription drugs, which are obtained by the mother both legally and illegally. Sometimes, a woman requires drugs even during pregnancy, due to a mental or physical condition that must be treated.
So, how does a medical practitioner know whether a baby is withdrawing from a drug? When a patient delivers her baby at Wyoming Medical Center, we screen her chart and ask the mother to tell us about all medications or drugs she may be using. That allows us to prepare to treat the baby for any problems associated with these substances. We then monitor the baby and watch for symptoms such as inconsolable crying, tight muscle tone, fevers, inability to eat and tremors. If left untreated, neonatal abstinence syndrome can become severe and could cause seizure activity in the new baby.
Treatment for the syndrome includes knowing what medication the mother was on and treating the baby with small doses of similar medication, gradually weaning the dose down until the baby doesn’t require the medication anymore. Other treatments are also necessary.
We encourage breastfeeding — with proper screening of the medication and the patient. This may sound odd, but many medications are not passed or are passed in very insignificant amounts in the breast milk. The advantages of breastfeeding often outweigh the risks of the medications possibly being transferred.
We also encourage skin-to-skin contact and rooming in — keeping mother and baby together in the same room as opposed to caring for a baby in the nursery. Our goal is to make sure that the mother knows her child and knows how to console her. Most importantly, we want mother to bond with baby because the bond she forms will be lifelong and will affect her relationship with her baby forever.
At Wyoming Medical Center, we feel that offering the most family-centered care and encouragement to the mother is the best for both mother and baby. These mothers love their babies dearly and many times are on medications that have been prescribed to them because of medical conditions out of their control. We also know that some mothers suffer addictions that are difficult to overcome. In these cases, we connect mothers to resources to help free themselves from addiction.
Addiction can be a sad reality in anyone’s life. Unfortunately, it is no stranger to the nursery. Pregnant patients should be aware that their baby may suffer due to medications and substances she takes during pregnancy and fully discuss the benefits and risks of ingesting any substance with her physician. Together, they should determine a viable plan of care during the pregnancy and after delivery.
Monica Money, R.N.
Monica Money is a registered nurse and clinical education coordinator for the nursery at the Ruth R. Ellbogen Family, Mother and Baby Center at Wyoming Medical Center. She has been at the hospital for three years and has been an OB/Nursery RN for the past 11 years. She has a bachelor of nursing degree from the University of Wyoming and is a Certified Lactation Counselor. She also directs the Neonatal Resuscitation Program Education for Wyoming Medical Center. Email her a firstname.lastname@example.org.