Myths Regarding Neonatal Abstinence Syndrome/Withdrawal in Newborns
Myth: If my baby does not withdraw in the first day or two, they aren’t likely to and can discharge home with mom. Fact: Withdrawal symptoms sometimes don’t start until3-5 days after birth so it is important that your baby is observed in the hospital for at least 5 days.
Myth: If the mother’s dosage of an opiate is high, they are more likely to withdraw. Fact: Withdrawal symptoms are not dose related. Some babies have significant withdrawal symptoms when mom is on a very low dose of opiates while others show minimal signs even though there has been high use during the pregnancy.
Myth: If mother had a prior baby who did not withdraw, this baby is not likely to withdraw. Fact: All babies are different. Some may have very mild symptoms while a sibling exposed to the same drug at the same dose may have symptoms severe enough to require treatment.
Myth: Since marijuana is legal in some states, it is safe to use while breastfeeding. Fact: Studies have shown that marijuana concentrates in breastmilk to levels 8x higher than mom’s plasma levels. This may be enough to alter long-term behavior and intellectual functioning.
Myth: Mothers cannot breastfeed while on methadone or buprenorphine in a supervised program. Fact: Breastfeeding is actually encouraged, provided mom is in a supervised program and not using other substances.
Myth: Mothers should attempt to reduce their dose or stop any opiate drugs during pregnancy. Fact: Any changes in medication dosing should be done under the care and supervision of a doctor.
Myth: Tobacco use does not make withdrawal worse. Fact: Nicotine use alone during pregnancy can result in abstinence-like symptoms and may have an added effect on the symptoms of neonatal abstinence syndrome.
Myth: Babies exposed to opiates in utero have no further issues once they have gone through withdrawal. Fact: Long term outcomes may include vision, motor, behavior and learning problems so it is important for parents to have a good relationship with their child’s doctor for continued follow up after discharge from the hospital.
Myth: Child Protective Services will automatically take the baby away from mothers if they are positive for drugs. Fact: While hospital staff are mandatory reporters to the Department of Family Services, the goal is to have the hospital, CPS and the family to work together for a safe discharge plan to keep families together.
Myth: There is nothing else that can be done to help babies besides treating them with oral morphine. Fact: Parent involvement in care is very helpful in the treatment of babies experiencing withdrawal symptoms. Skin to skin holding, dim lighting, and a quiet environment all help to alleviate symptoms and make your baby more comfortable.
Myth: Since only opiates cause withdrawal, it is ok for mothers to breastfeed if on other drugs such as methamphetamine. Fact: Almost all drugs, legal and otherwise, pass into breast milk, some at concentrated levels. Babies are fragile and could be affected by ingesting even small amounts of these substances.