Long-Term Effects of Neonatal Abstinence Syndrome
Neonatal Abstinence Syndrome (NAS) is the exposure of drugs to a baby while the fetus is growing in the womb. The drugs taken by a pregnant mother can cause withdrawal symptoms to occur within the baby during pregnancy and after birth. The baby is also at risk of sustaining severe injuries and death during pregnancy and immediately after birth, due to its reaction to the drugs.
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Additionally, there are long-term effects of babies born addicted to opiates and other drugs — like having NAS — as the child who is exposed to the drugs can experience physical and mental challenges later on in their life. That’s why a mother taking drugs, including opioids or prescription medications, is strongly discouraged from continuing to take them. Staying healthy during pregnancy and avoiding harmful substances can help a child develop healthily in the womb and avoid developmental risks and physical challenges in the first few days and weeks after birth, and continue that healthy trend years into the child’s life.
One of the main causes of NAS is prescription opiate misuse, which is an epidemic in rural areas throughout the country. According to the 2008 National Survey on Drug Use and Health, misuse of prescription narcotics such as oxycodone was the second most reported category of misused illicit substances, behind marijuana.
As drug misuse has increased in the United States over the last few years, pregnant women are no exception to this trend. The increased amount of exposure unborn children have to drugs has resulted in a higher percentage of NAS occuring in the country. In 2012, more than 380,000 unborn children were exposed to illicit drugs and nearly 6 percent of pregnant women used at least one illicit drug during their pregnancy. Nearly 1 million pregnant women smoke cigarettes, another potential risk for long-term problems with a child during and after pregnancy, and around 10 percent of women consumed alcohol during a pregnancy between 2013 and 2014. Additionally, the Centers for Disease Control and Prevention reports than in the U.S. each year, one out of every 33 babies are born with birth defects. These issues could arise from exposure to drugs while in the womb.
The lives of a baby who is born addicted to drugs and one who was never exposed to illicit substances in the womb can be similar in many ways, especially if NAS is identified early enough. There are significant risks with prenatal exposure to drugs such as meth, heroin, cocaine or prescription medications like Xanax or oxycontin.
Problems that children exposed to drugs in utero might experience are different for each child. Many NAS symptoms occur within days after birth, although the website March of Dimes states that some symptoms can occur as late as six months after birth. A baby with NAS might have jaundice, which can be identified by yellow eyes or skin, or a low birthweight.
Some of the other common early signs of Neonatal Abstinence Syndrome that a child might experience include:
- Body shakes
- Seizures
- Overactive reflexes
- Tight muscle tone
- Fussiness or excessive crying
- Poor feeding or a slow weight gain
- Breathing problems
- Fever, sweating or blotchy skin
- Trouble sleeping and lots of yawning
- Diarrhea or throwing up
- Stuffy nose or sneezing
The U.S. National Library of Medicine National Institutes of Health published a study in 2017 on the correlation between NAS and poor performance in school. The results of the examination shows a direct link between children who suffered from NAS and slower-than-average mental development.
Children with NAS were compared to a group of kids that matched in age, socioeconomic status and gender on the National Assessment Program: Literacy and Numeracy in third, fifth, and seventh grades. The results for third grade showed that children with NAS scored lower than other children. By the time children with NAS reached seventh grade, many of them scored lower on tests than children without NAS who were in fifth grade. The study, which was done with kids from New South Wales, Australia, also reveals that the slow development continues as children with NAS reach high school.
One of the findings from the study is that certain parental strategies can diminish the effect that NAS can have on kids. However, parents who take opioids, prescription painkillers or other drugs during pregnancy run the risk of their child developing NAS. This exposure to substances before birth can have a lasting effect on their educational development.
An auditory processing disorder is a person’s inability to understand speech. While there has not been any evidence to suggest a deficiency in auditory processing among babies exposed to drugs during pregnancy, one study published on the U.S. National Library of Medicine National Institutes of Health suggests that somatosensory networks might be disrupted from exposure to buprenorphine. This means that newborns experiencing NAS might have an affected development of their sensory nervous system.
Even without a significant amount of evidence correlating an affected auditory processing development to NAS, exposure to drugs can cause significant developmental issues for children. Any time a pregnant woman ingests drugs, whether it is illegal substances or a prescription medication such as oxycodone or another opiate, they run a major risk of developing NAS within their unborn child.
Findings from research done for a published work titled “Substance Abuse: Research and Treatment,” which was published on the website Psychiatry Advisor, shows that children who have been exposed to opiates or other illicit substances during pregnancy have a higher risk of possessing symptoms commonly associated with attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) compared to children who were not exposed to opiates or similar substances. This information details how staff members at the Haukeland University Hospital in Norway evaluated 57 school-age children who were exposed to opiates or other drugs for potential risks of ADHD and ASD.
“The authors noted, however, that a previous study had found that adults with substance use disorders had a higher rate of ADHD symptoms, suggesting that ADHD was an independent risk factor for substance abuse,” the article reads, adding that “the mean level of symptoms associated with ASD was increased in exposed children as well, with more than one-third of exposed children (showing symptoms of ASD), mainly on the social difficulties subscale. The authors also noted that they found children with overlapping ADHD and ASD symptoms in the exposed group, lending support to the suggestion of neurodevelopmental vulnerability in exposed children.”
The findings from the study lend credence to the idea that children prenatally exposed to drugs and other harmful substances should receive early mental health assessments to properly identify ADHD and ASD.
The website March of Dimes states that newborn babies who receive NAS treatment within five to 30 days of birth often experience improvements and a reduction in withdrawal symptoms and side effects. While this does not guarantee a complete recovery from NAS, seeking treatment as quickly as possible and identifying NAS immediately can help prevent physical issues and permanent injuries. There are specific ways to test for NAS, including:
- A NAS scoring system, which gives points for each symptoms depending on how severe it is for the child.
- A Meconium test, which is done with the baby’s first bowel movement.
- Urine testing
- Taking medicines to mitigate or block withdrawal symptoms, which will dissipate over time and require a smaller dosage of medicine as a way of tapering the child off the substance.
- Receiving fluids through a needle into a vein to prevent dehydration, which can occur since babies who have NAS often have diarrhea or vomit more often than normal and can lack enough internal liquids.
- Drinking higher-calorie baby formula to help with feeding and proper growth in the initial days following birth.