Posts Tagged ‘neonatal abstinence syndrome’

Opioids and birth defects–an update

Monday, June 26th, 2017

Prescription opioids are painkillers your health care provider may prescribe if you’ve been injured or had surgery. Prescription opioids include:pills

  • Codeine and hydrocodone (brand name Vicodin®)
  • Fentanyl (brand name Actiq®, Duragesic®, Sublimaze®)
  • Morphine (brand names Kadian®, Avinza®)
  • Oxycodone (OxyContin®, Percocet®)
  • Tramadol (brand names ConZip®, Ryzolt®, Ultram®)

Heroin also is an opioid.

Using opioids during pregnancy can cause problems for your baby, including:

  • Neonatal abstinence syndrome (also called NAS). NAS happens when a baby is exposed to a drug in the womb before birth and goes through withdrawal from the drug after birth. NAS most often is caused when a woman takes opioids during pregnancy. NAS can cause serious problems for a baby, like being born too small and having breathing problems. Even if you use an opioid exactly as your health care provider tells you to, it may cause NAS in your baby.
  • Birth defects.
  • Premature birth.
  • Preterm labor. Quitting opioids suddenly (going cold turkey) during pregnancy can cause preterm labor. Preterm labor can lead to premature birth.
  • Stillbirth.

Recently the CDC’s Treating for Two: Safer Medication Use in Pregnancy researchers reviewed a number of studies that had already been published regarding opioid use during pregnancy and birth defects. They found that the studies did show that using opioids during pregnancy may be linked to birth defects including cleft lip and cleft palate, congenital heart defects, and clubfoot. But many of the studies they looked at had problems with the way the study was done and the quality of the study.

According to the CDC, “More research is needed to understand the connections between individual types of opioids and specific birth defects. Until more is known, women of childbearing age and their healthcare providers should discuss risks and benefits when considering opioid treatment.”

If you are taking a prescription opioid, or any other medication during pregnancy remember:

  • Don’t take more medicine than your health care provider says you can take.
  • Don’t take it with alcohol or other drugs.
  • Don’t use someone else’s prescription medicine.

If you’re pregnant and need help to stop using opioids, taking drugs like methadone or buprenorphine may help you quit. These drugs can help you reduce your need for opioids in a way that’s safe for you and your baby. Talk to your health care provider to see if this kind of treatment is right for you.

If you need help to stop abusing prescription drugs, talk to your health care provider. Or contact:

Have questions? Send them to our Health Education Specialists at AskUs@marchofdimes.org.

Neonatal abstinence syndrome

Monday, May 22nd, 2017

infant crying“The March of Dimes has made it a priority to help and support women and infants affected by opioid use and other substance use disorders,” says Stacey D. Stewart, president of the March of Dimes. “There are few things more tragic than an infant starting out life in drug withdrawal.  We owe it to these babies to do everything in our power to ensure they are treated appropriately and can recover fully from drug exposure.”

Neonatal abstinence syndrome (NAS) happens when newborns go through drug withdrawal shortly after birth because they were exposed to drugs in the womb. In the United States, the number of babies born with NAS has been increasing. The Centers for Disease Control and Prevention (CDC) estimates that the number of babies with NAS has tripled from 1999 to 2013.

What drugs can cause NAS?

One of the most common causes of NAS is maternal use or abuse of opioids during pregnancy. Opioids are painkillers your provider may recommend if you’ve been injured or had surgery. Some common opioids that may be prescribed include:

  • Codeine and hydrocodone (Vicodin®)
  • Morphine (Kadian®, Avinza®)
  • Oxycodone (OxyContin®, Percocet®)

Heroin is also an opioid. Using it during pregnancy can cause your baby to be born with NAS.

In addition to opioids, these drugs can lead to NAS too:

  • Certain antidepressants (prescription drugs used to treat depression)
  • Benzodiazepines (sleeping pills)

What are the signs and symptoms of NAS?

Babies may exhibit different signs of NAS. Most babies will show symptoms within 3 days (72 hours) of birth, but sometimes symptoms will appear soon after birth or a few weeks later. Signs and symptoms can include:

  • Body shakes (tremors), seizures (convulsions), overactive reflexes (twitching) and tight muscle tone
  • Fussiness, excessive crying or having a high-pitched cry
  • Poor feeding, poor sucking or slow weight gain
  • Breathing very fast
  • Fever, sweating or blotchy skin
  • Trouble sleeping and lots of yawning
  • Diarrhea or throwing up
  • Stuffy nose or sneezing

NAS can last from 1 week to 6 months after birth.

How is a baby with NAS treated?

Treatment for NAS may include:

  • Taking medicines to treat or manage severe withdrawal symptoms. Your baby’s provider may give her a medicine that’s similar to the drug you used during pregnancy. This can help relieve your baby’s withdrawal symptoms. Once these symptoms are under control, your baby gets smaller doses of the medicine over time so her body can adjust to being off the medicine. Medicines used to treat severe withdrawal symptoms include morphine, methadone and buprenorphine.
  • Getting IV fluids. Babies with NAS can get very dehydrated from having diarrhea or throwing up a lot. If a baby’s dehydrated, she doesn’t have enough water in her body. Getting fluids through an IV helps keep your baby from getting dehydrated.
  • Drinking higher-calorie baby formula. Some babies with NAS need extra calories to help them grow because they have trouble feeding or aren’t growing properly. slow growth.

Most babies with NAS who get treatment get better in 5 to 30 days.

Research

The March of Dimes, together with the CDC, has awarded grants to conduct one-year of surveillance on neonatal abstinence syndrome (NAS) in three states with high rates of NAS:  Vermont, Illinois, and New Mexico. The project will enable each state to conduct enhanced identification of babies born with NAS and evaluate the health services needed by these babies through one year of age.

If you or someone you know is pregnant and struggling with drug use, please share these resources:

Have questions? Text or email AskUs@marchofdimes.org

Can your meds cause drug withdrawal in your baby?

Friday, May 15th, 2015

pillsNeonatal abstinence syndrome (NAS) is a group of conditions a newborn can have if he’s exposed to addictive street or prescription drugs before birth. If you take drugs during pregnancy, they can pass through the placenta to your baby. After birth, the baby is still dependent on the drug, however, now that the drug is no longer available, the baby experiences drug withdrawal. Today, one of the most common causes of NAS is maternal use or abuse of opioids during pregnancy.

Using these drugs during pregnancy can cause NAS:

• Opioids, including the prescription medicines codeine, hydrocodone (Vicodin®), morphine (Kadian®, Avinza®) and oxycodone (Oxycontin®, Percocet®). The street drug heroin also is an opioid.
• Barbiturates, like phennies, yellow jackets and Amytal®
• Benzodiazepines, like sleeping pills, Valium® and Xanax®

Signs and symptoms of NAS:

• Body shakes (tremors), seizures (convulsions), overactive reflexes (twitching) and tight muscle tone
• Fussiness, excessive crying or having a high-pitched cry
• Poor feeding, poor sucking or slow weight gain
• Breathing fast
• Fever, sweating or blotchy skin
• Trouble sleeping and yawning frequently
• Diarrhea or vomiting  (throwing up)
• Stuffy nose or sneezing

Signs and symptoms of NAS can be different for every baby. Symptoms may appear within a few minutes after birth or as much as two weeks later. NAS can last from 1 week to 6 months after birth.

Testing and treatment:

Your provider can see if your baby has NAS by testing his first bowel movement or urine. Your provider can also use what is called a neonatal abstinence scoring system which gives points for each NAS symptom depending on how severe it is. Treatment can include medicines to manage severe withdrawal symptoms, getting fluids through a needle into the vein, or giving higher-calorie baby formula to newborns that have trouble feeding or slow growth.

How can I prevent NAS?

If you’re pregnant and you use any of the drugs that can cause NAS, tell your health care provider right away. But don’t stop taking the drug without getting treatment from your provider first. Quitting suddenly (sometimes called cold turkey) can cause severe problems for your baby, including death.

If you’re addicted to opioids, medication-assisted treatment (also called MAT) during pregnancy can help your baby. NAS in babies may be easier to treat for babies whose moms get MAT during pregnancy. Medicines used in MAT include methadone and buprenorphine.

Even if you use a prescription drug exactly as your provider tells you to, it may cause NAS in your baby. If you are pregnant or think you may be pregnant, talk to your provider about any drug or medicine you are taking.

Our website has more information on where you can find help.

Have questions? Email us at AskUs@marchofdimes.org.

Painkillers and pregnancy don’t mix

Friday, January 23rd, 2015

pregnant2Did you know that a significant number of women of childbearing age fill prescriptions for narcotic painkillers each year? If a woman becomes pregnant while taking these medications, she is at an increased risk of having a baby with birth defects.

Opioid-based (narcotic) pain medications, such as codeine, oxycodone, hydrocodone, or morphine, are used to treat moderate to severe pain. Many women are unaware that the use of these medications during pregnancy, even when used as directed, may increase their chance to have a baby with a serious birth defect of the brain, spine, or heart. They also have an increased risk of preterm birth.  Use of opioid-based painkillers during pregnancy can also cause babies to suffer withdrawal symptoms when they are born. This is a condition known as neonatal abstinence syndrome or NAS, and it is a growing problem in U.S. birthing hospitals.

A new report from the CDC found that on average, about 28% of privately insured and 39% of Medicaid-enrolled women of child-bearing age filled a prescription for an opioid between 2008-2012.

Since half of all pregnancies are unplanned, women may be prescribed opioid-based pain medications before they know they are pregnant.  “This highlights the importance of promoting safer alternative treatments, when available for women of reproductive age. We must do what we can to protect babies from exposure to opioids,” stated Coleen A. Boyle, PhD, MSHyg, Director of CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD).

“If you are using an opioid painkiller, you should also be practicing effective birth control, “ says José F. Cordero, MD, MPH, a pediatrician, birth defects expert formerly at CDC, and member of the March of Dimes Board of Trustees. “If you decide to get pregnant or do become pregnant, tell your health care provider about all the medications you are taking, right away. You may be able to switch to a safer alternative.”

The CDC’s Treating for Two: Safer Medication Use in Pregnancy initiative offers information to women and their healthcare providers about medication use during pregnancy. Go here to get more information.