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Addiction, Motherhood and Neonatal Abstinence Syndrome

When a woman is addicted or dependent on drugs and medications during pregnancy, her baby is at risk for being born dependent on those medications. As a result of the current opioid epidemic, an increasing number of babies are being born dependent on opiates. These babies suffer from neonatal abstinence syndrome (NAS) and experience the effects of withdrawal in the early days and weeks of their life.

Babies with NAS may experience a wide range of symptoms, including a high-pitched cry, fevers, tremors, vomiting and even seizures. They are treated with supportive care including:

  • Swaddling
  • Breastfeeding
  • Skin-to-skin contact
  • Staying in a dimly lit and quiet environment

Some babies will need to be given medication to ease the withdrawal symptoms, and this medication will be gradually reduced over time.

Women who are in medication-assisted treatment programs take medications such as suboxone to ease their own withdrawal symptoms and support their recovery. Their babies may still be born with NAS, but it will be much easier to treat than if the woman was using prescription pain medications or heroin. It is crucial that a pregnant woman stay on maintenance medication. Maintenance medication does not create a high, and managing withdrawal symptoms and cravings enables the mother to focus on addiction recovery and taking care of her baby.

Sometimes well-meaning friends and family members will encourage pregnant women to go “cold turkey” from either the illicit drugs or the maintenance medication. This can have devastating effects on both the mother and baby. There may be risk of miscarriage, dangerous withdrawal symptoms for the mother and the fetus, and ultimately, relapse.

The stress of having a newborn can be especially difficult for mothers who struggle with addiction. They may feel ashamed of their addiction, guilty for their babies’ diagnosis, and socially isolated and stigmatized. A strong support system is important for recovering addicts – and their young families.

At Nationwide Children’s, the Neonatal care team works with families to teach supportive care and educate them about NAS and caregiving. By partnering with other local organizations and programs, we connect pregnant women and new moms with the services and support they need to give themselves and their babies a good outcome. We encourage community members to offer support and encouragement to families touched by addiction.

If you or a loved one needs help, contact the Substance Abuse and Mental Health Services Administration at www.samhsa.gov or call their hotline: 1-800-662-HELP (4357). If you’re in Ohio, contact Ohio Mental Health and Addiction Services at 1-877-275-6364 or visit their website at mha.ohio.gov.

Kristina Reber, MD
Kristina M. Reber, MD is the Associate Division Chief of Neonatology at Nationwide Children’s Hospital and an Associate Professor of Clinical Pediatrics at The Ohio State University College of Medicine. She joined the faculty at Nationwide Children’s in 1997 following an internship, residency and fellowship at the hospital.

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