Home > Health A – Z > Neonatal Abstinence Syndrome

Neonatal Abstinence Syndrome

Fetal and neonatal addiction and withdrawal as a result of the mother's dependence on drugs during pregnancy. Withdrawal or abstinence symptoms develop shortly after birth. Symptoms exhibited are loud, high-pitched crying, sweating, yawning and gastrointestinal disturbances.

PubMed Health Glossary
(Source: NIH - National Library of Medicine)

What works? Research summarized

Evidence reviews

Sedatives for opiate withdrawal in newborn infants

When a sedative is needed to ameliorate symptoms in newborn infants with opiate withdrawal due to maternal opiate use in pregnancy, phenobarbitone is preferred. Use of opiates (commonly prescribed methadone or illicit heroin) by pregnant women may result in a withdrawal syndrome in their newborn infants. This may result in disruption of the mother‐infant relationship, sleeping and feeding difficulties, weight loss and seizures. Treatments for newborn infants used to ameliorate these symptoms and reduce complications include opiates, sedatives (phenobarbitone or diazepam) and supportive treatments (swaddling, settling, massage, relaxation baths, pacifiers or waterbeds). Trials of sedatives have generally been of poor quality. Individual studies have reported that use of phenobarbitone compared to supportive care alone reduces the amount time an infant needs supportive care, is better than diazepam at preventing treatment failure and reduces the severity of withdrawal in infants treated with a opiate. In infants treated with an opiate, the addition of a sedative (phenobarbitone or clonidine) may reduce withdrawal severity, although safety and efficacy need confirming. The long term effects of use of phenobarbitone on an infant's development have not been determined.

Opiate treatment for opiate withdrawal in newborn infants

An opiate such as morphine or dilute tincture of opium should probably be used as initial treatment to ameliorate withdrawal symptoms in newborn infants with an opiate withdrawal due to maternal opiate use in pregnancy. Use of opiates (commonly prescribed methadone or illicit heroin) by pregnant women may result in a withdrawal syndrome in their newborn infants. This may result in disruption of the mother‐infant relationship, sleeping and feeding difficulties, weight loss and seizures. Treatments for newborn infants used to ameliorate these symptoms and reduce complications include opiates, sedatives (phenobarbitone or diazepam) and supportive treatments (swaddling, settling, massage, relaxation baths, pacifiers or waterbeds). Trials of opiates compared to sedatives or other non‐pharmacological treatments have generally been of poor quality. Individual trials have reported that using an opiate compared to phenobarbitone may reduce the incidence of seizures, duration of treatment and nursery admission rate. However, no overall effect was found on treatment failure rate. When compared to diazepam, opiates reduced the incidence of treatment failure. Opiates such as morphine or dilute tincture of opium should probably be used as initial treatment for opiate withdrawal in newborn infants.

Methadone dose and neonatal abstinence syndrome: systematic review and meta-analysis

This review did not find a consistent statistically significant difference in the incidence of neonatal abstinence syndrome in infants of opioid-dependent pregnant women maintained on differing doses of methadone. This was a well-conducted systematic review and the authors' conclusions are likely to be reliable.

See all (34)

Summaries for consumers

Sedatives for opiate withdrawal in newborn infants

When a sedative is needed to ameliorate symptoms in newborn infants with opiate withdrawal due to maternal opiate use in pregnancy, phenobarbitone is preferred. Use of opiates (commonly prescribed methadone or illicit heroin) by pregnant women may result in a withdrawal syndrome in their newborn infants. This may result in disruption of the mother‐infant relationship, sleeping and feeding difficulties, weight loss and seizures. Treatments for newborn infants used to ameliorate these symptoms and reduce complications include opiates, sedatives (phenobarbitone or diazepam) and supportive treatments (swaddling, settling, massage, relaxation baths, pacifiers or waterbeds). Trials of sedatives have generally been of poor quality. Individual studies have reported that use of phenobarbitone compared to supportive care alone reduces the amount time an infant needs supportive care, is better than diazepam at preventing treatment failure and reduces the severity of withdrawal in infants treated with a opiate. In infants treated with an opiate, the addition of a sedative (phenobarbitone or clonidine) may reduce withdrawal severity, although safety and efficacy need confirming. The long term effects of use of phenobarbitone on an infant's development have not been determined.

Opiate treatment for opiate withdrawal in newborn infants

An opiate such as morphine or dilute tincture of opium should probably be used as initial treatment to ameliorate withdrawal symptoms in newborn infants with an opiate withdrawal due to maternal opiate use in pregnancy. Use of opiates (commonly prescribed methadone or illicit heroin) by pregnant women may result in a withdrawal syndrome in their newborn infants. This may result in disruption of the mother‐infant relationship, sleeping and feeding difficulties, weight loss and seizures. Treatments for newborn infants used to ameliorate these symptoms and reduce complications include opiates, sedatives (phenobarbitone or diazepam) and supportive treatments (swaddling, settling, massage, relaxation baths, pacifiers or waterbeds). Trials of opiates compared to sedatives or other non‐pharmacological treatments have generally been of poor quality. Individual trials have reported that using an opiate compared to phenobarbitone may reduce the incidence of seizures, duration of treatment and nursery admission rate. However, no overall effect was found on treatment failure rate. When compared to diazepam, opiates reduced the incidence of treatment failure. Opiates such as morphine or dilute tincture of opium should probably be used as initial treatment for opiate withdrawal in newborn infants.

Maintenance treatments for opiate‐dependent pregnant women

Some women continue to use opiates when they are pregnant, yet heroin readily crosses the placenta. Opiate‐dependent women experience a six‐fold increase in maternal obstetric complications and give birth to low‐weight babies. The newborn may experience narcotic withdrawal (neonatal abstinence syndrome) and have development problems. There is also increased neonatal mortality and a 74‐fold increase in the risk of sudden infant death syndrome. Maintenance treatment with methadone provides a steady concentration of opiate in the pregnant woman's blood and so prevents the adverse effects on the fetus of repeated withdrawals. Buprenorphine is also used. These treatments reduce illicit drug use, improve compliance with obstetric care and improve neonatal birth weight but they are still associated with neonatal abstinence syndrome.

See all (5)

More about Neonatal Abstinence Syndrome

Photo of a baby

Also called: Neonatal narcotic withdrawal syndrome, NAS

Other terms to know:
Gastrointestinal Tract (GI Tract)

Keep up with systematic reviews on Neonatal Abstinence Syndrome:

Create RSS

PubMed Health Blog...

read all...