A dramatic rise in newborns experiencing drug withdrawal after being exposed in the womb poses challenges for clinicians on how to detox these tiny victims, a new report indicates.
The American Academy of Pediatrics (AAP) has released its first updated guidelines on neonatal drug withdrawal since 1998, partly in response to the escalating abuse of both illicit and prescription drugs by pregnant women and partly in recognition of better pain management techniques for babies who are critically ill.
“There have been pockets of the country where up to 25 percent of all NICU [neonatal intensive care unit] babies at any given time are being treated for withdrawal,” said report co-author Dr. Mark Hudak, a professor of pediatrics at the University of Florida College of Medicine in Jacksonville. “The problem has percolated up and reached the attention of government and medical officials.”
The report is published online Jan. 30 in advance of appearing in the February issue of the journal Pediatrics.
Major drugs of abuse include prescription painkillers such as oxycodone, codeine, morphine and methadone, the report noted, along with stimulants such as amphetamines and cocaine and central nervous system depressants such as marijuana, alcohol and barbiturates.
Exposure during pregnancy is linked to a host of problems among newborns, including drug withdrawal upon birth — demonstrated by irritability, poor sucking, tremors, seizures, diarrhea, vomiting and shrill crying — and long-term issues such as birth defects, impaired growth and behavioral problems.