Recognizing And Managing Neonatal Abstinence Syndrome

The use of heroin, cocaine, and other illicit drugs has become a public health concern especially during pregnancy. Maternal substance abuse has become an issue during the crack epidemic in the 1980’s; however, there is an alarm rate of infants born addicted to heroin. More than 3.7% women have indicated the uses some form of illicit drugs during their pregnancy, as well as 1.9 % reports binge drinking (Bhuvaneswar el at., 2008; Grant el at., 2009). With this in mind, more than 375,000 infants are born to maternal substance abusers each year costing over $100,000 in medical expenses covered by the state (Reitman, 2002).

Prenatal exposure of a child to harm due to the mother’s use of an illegal drug or other substance.

Substance abuse during pregnancy can have a negative force on the health and wellness of not only the fetus, but that of the mother. The harmful effects of medications, alcohol and illegal drugs on an unborn child can be devastating and can have significant consequences to its use. Sometimes the effects can be faced and treated, and other times the outcome is a lifelong challenge. During the prenatal period, it is important that new mothers are informed of the different types of abuse, how they may affect the fetus, and the adverse conditions their child may be faced with before and after birth.

In 2014, after seeing a significant increase in babies born with neonatal abstinence syndrome (NAS), Tennessee began criminally charging pregnant women who use drugs (Sakuma, 2014). Supporters of the new legislation refer to it as a “velvet hammer” used to convince the pregnant drug users into going into treatment, or doing jail time. However, critics are concerned that this legislation will be just another barrier for a group of women who are already at risk, (Sakuma, 2014).

Through the years, substance misuse in the United States has turned into an industrious issue influencing numerous people. In 2008, it was assessed that 17.8 million Americans beyond 18 years old where substance subordinate. Women who use medications during pregnancy can have an enduring impact on fetal. Medications can have an impact of maternal and child wellbeing, yet there are a lot of different variables, which influence it, poor social environment, nourishment, cleanliness, and sexual abuse. Regenerative interruption connected with heroin utilization has been shown in both and women and even low dosages of opiates can impede ordinary ovarian capacity and ovulation. The harm that goes hand in hand with substance utilization comes either straightforwardly from the impact of the medication itself or from issues identified with development and/or unexpected labor. The entanglements of jumbling components clamorous way of life, poor nourishment, liquor utilization and cigarette smoking influence the appraisal of the impacts of cocaine in pregnancy. In obstetric practice, 100% of pregnant women utilizing cocaine or heroin are cigarette smokers. Cigarette smoking is presumably the most well known manifestation of substance utilizes and is noteworthy corresponding considering ladies who use unlawful medications. Babies whose moms smoked in pregnancy have a tendency to have lower conception weights and diminished length, cranial and thoracic

The use of controlled substances throughout pregnancy is a very prevalent issue among society today. Controlled substances have devastating effects on not only the mothers using the substances, but also infants while they are in utero and after they are born. Many infants born to mothers, who are abusing drugs, suffer from life threatening illnesses and are forever affected through adulthood. Specifically, heroin is a common drug form that is often used during pregnancy and results in the life threatening effects mentioned above.

The U.S. Supreme Court has upheld in the past that a person cannot be prosecuted for being a drug addict. People can be prosecuted for the sale or possession of an illegal drug but prosecuting someone for the illness of drug addiction is a breach of the 8th Amendment’s bar on cruel punishment. Usually cases involving pregnant drug-addicted women arise when a doctor reports that a woman tested positive or appears to have a drug problem. Rarely are there cases where the woman is arrested for possession and then charged with child abuse. For example, if I told my doctor I had a drug addiction, I wouldn’t get reported. Just as

The National Health Institute (NIH) explains that addictive drugs such as amphetamines, cocaine, barbiturates, diazepam, and opiates consumed during pregnancy pass from mother to the fetus by crossing the placenta. This causes the baby to become addicted to these drugs along with the mother. Once born, the newborn no longer receives these drugs which then results in NAS (“Neonatal abstinence syndrome”, 2012a).

Risk Factors: addiction in mother, no prenatal care, no support system for mother, high stress levels in mother

In today’s society people are talking about babies being born to drugs, and how could a mother do that to their unborn child. Drug addiction is a very serious issue that needs more research. We are still learning the effects of substance abuse. One problem that needs to be looked at is are there enough Rehabilitation Centers, to help the women who are addicted to these different street drugs. Also doctor and nurses should not judge these women but instead give them the best prenatal care that can be provided. We need to see what harm and side affects it has on the mother and baby, so that we can be able to understand better how to treat these women and get them off drugs before they do harm their babies.

(n.d.) also conducted a study focused on infants that were exposed to buprenorphine or methadone while in utero. Unlike MacMullen et al. (2014) their focus was on predicting how the symptoms of NAS might manifest in the exposed newborns. Since the 1970s (MacMullen et al., 2014) methadone has been the treatment of choice for mothers with opioid dependence during pregnancy, the use of this drug allows for a decrease in withdrawal symptoms for the child after birth. The main categories of symptoms include central nervous system hyperirritability, gastrointestinal dysfunction, respiratory distress and vague autonomic symptoms (MacMullen et al., 2014). Although methadone has been being used for many years buprenorphine has only been used since 2002 in the United States (MacMullen et al., 2014). Their research was consistent with Kaltenbach et al. (n.d.) in that infants born to buprenorphine-exposed mothers had lower scores for NAS than those born to methadone-exposed mothers, but still had varying severities of symptoms and scores across all infants. For at least 10 days after birth, an expert scored the newborns on a modified Finnegan scale every 4 hours. The results showed that high birth weight was often a predictor for high NAS scores, along with lower NAS scores for infants delivered by cesarean section. MacMullen et al. (2014) were unable to find any connection between the use of methadone and buprenorphine to indicators of symptoms of NAS. The main

I have worked at the UIHC as a nursing assistant on the Mother Baby Care Unit since beginning college two years ago. While working at the hospital, I have endured several situations that have challenged my personal values and how I feel as a health care professional. One of these instances, which happens all too often on our unit, is when a baby has been born with fetal alcohol syndrome or has been exposed to drugs in utero. Drinking alcohol and doing illegal drugs during pregnancy is something I do not support, especially because these actions harm an innocent baby. It is extremely difficult to witness the tremors, high pitched cry, and inconsolability of a newborn going through the withdrawal process. Regardless of how I feel about this unfortunate

As of now what is known about Opiate drug usage is that pregnant women using this drug give birth to babies with neonatal abstinence syndrome. Babies being born going through withdrawal because the fetus is no longer receives the drug. It was found that neonatal abstinence syndrome is passed when the drug is in the mother's bloodstream which then passes through the placenta into the fetus. Symptoms of neonatal abstinence syndrome in babies vary depending on how much opiate was used during the pregnancy. It includes premature birth, seizures, birth defects, and developmental delays as they grow. Babies who are born full term suffer from tremors, irritability, sleep problems, high-pitched crying, tight muscle tone, poor feeding, dehydration,

Many women, including teens, abuse drugs while they are pregnant. This rate is especially high to those who are homeless, underprivileged, or live in a broken home. In order for drug abusers to even have a chance at beating their addiction they have to have support whether it’s family, friends, or boyfriend/spouse. They must also let the abuser now all the consequences to themselves and the unborn child. There are many consequences when using drugs during pregnancy such as miscarriage, health risks to baby, and health risks to the mother. And learning disabilities and brain damage to the fetus.

Derrington (2013) developed the Drug-Exposed Infant Identification Algorithm (DEIIA) to identify prenatal drug exposure in infants, the percentage of those who were referred to and eligible for the Part C Early Intervention in Massachusetts. In order to develop (DEIIA) the author had to use data from the population based Pregnancy to Early Life Longitudinal (PELL) system. PELL contained information such as birth certificates, maternal and infant hospital records, and Early Intervention (EI) service records. From 1998 to 2005 there were a total of 629,269 in-state deliveries to Massachusetts residents in maternity hospitals. The DEIIA used two types of indicators: positive toxicology screens on the birth certificate and International Classification