A mother who uses drugs during pregnancy may have a baby born with a dependency. After birth, when the baby is no longer getting drugs from the mother through the circulatory system, he may go through a period known as neonatal drug withdrawal. During this time, the baby exhibits certain symptoms, including shaking or trembling, irritability, and an increase in overall crying. He may also show symptoms such as vomiting or sneezing, which may take time to resolve.
How much a baby manifests signs of neonatal drug withdrawal depends on the type of drug the mother used during her pregnancy and whether she stopped at some point before delivery. Newborns exhibit signs of withdrawal because their bodies develop a physical dependence on the drugs. When a mother takes drugs that are depressants, such as heroin, morphine or alcohol, the baby’s brain responds by creating stimulants that offset the effects of the drugs. By removing the drug at birth, the baby’s brain may continue to produce stimulants as he becomes acclimated to his new surroundings.
Signs of neonatal drug withdrawal are manifested by overproduction of stimulants in the brain. As a result, the baby may show signs of muscle tremors, jitteriness and increased crying that is difficult to soothe. Other body systems are affected, and the baby may have gastrointestinal issues, including vomiting, diarrhea, or difficulties with eating. The baby may breathe at a faster rate and develop other unusual manifestations, such as frequent yawning or sneezing and nasal congestion.
Babies undergoing neonatal drug withdrawal may act as if they are hungry, yet they are difficult to feed. They frequently arch back in frustration during feeding times or may have an uncoordinated suck-and-swallow reflex. Despite feeding difficulties, the appearance of hunger comes from the frequent need to suck on a pacifier or root toward an object within reach. The sucking reflex produces a calming effect for a baby who may anxiously be trying to soothe himself.
Some babies born to mothers with known drug use during pregnancy and who are exhibiting signs of withdrawal may need to be monitored for frequency of symptoms. Observing signs of withdrawal during the first days of life provides a baseline of symptoms and can help to determine if improvement occurs. Providing support through swaddling and pacifier use may help to reduce some symptoms of irritability. Some babies may need fluid or electrolytes through an intravenous line if withdrawal symptoms affect nutritional status, such as in those situations of severe vomiting or diarrhea.