Neonatal Substance Withdrawal

The neonatal syndrome results from the chronic or periodic intake of alcohol during pregnancy.

fetal alcohol syndrome (FAS)

What are probable long-term complications for babies w/ FAS?

feeding problems, cognitive impairment, cerebral palsy, attention deficit disorder, language abnormalities, microcephaly, delayed growth/development, poor maternal-newborn bonding

What are common CNS withdrawal s/s in infants?

high-pitched, shrill cry; incessant crying; irritability; tremors; hyperactivity w/ an increased moro reflex; increased deep-tendon reflexes; increased muscle tone; disturbed sleep pattern; hypertonicity; convulsions

What are common respiratory s/s of withdrawal in infants?

nasal congestion w/ flaring, frequent yawning, skin mottling, retractions, apnea, tachypnea greater than 60/min, sweating, temperature greater than 37.2 C (99 F)

What are GI s/s of withdrawal in infants?

poor feeding, regurgitation, projectile vomiting, diarrhea; excessive, uncoordinated constant sucking

What are 3 s/s of heroin withdrawal in a baby?

low birth weight, SGA, manifestations of neonatal abstinence syndrome

What are babies in heroin withdrawal at higher risk for?

sudden infant death syndrome (SIDS)

What are s/s of methadone withdrawal in infants?

increased incidence of seizures, sleep pattern disturbances, higher birth weights compared w/ heroin exposure

What are s/s of marijuana withdrawal in infants?

preterm birth, meconium staining

What are long-term effects of marijuana use during pregnancy on infants?

deficits in attention, cognition, memory, and motor skills

What are s/s of amphetamine withdrawal in infants?

preterm birth, SGA, drowsiness, jitteriness, sleep pattern disturbances, resp. distress, frequent infections, poor weight gain, emotional disturbances, delayed growth and development

What are the s/s of alcohol withdrawal in infants?

jitteriness, irritability, increased tone and reflex response, seizures

What are facial signs of FAS?

small eyes, flat mid face, smooth philtrum, thin upper lip, eyes w/ a wide spaced appearance, epicanthal fold, strabismus, ptosis, poor suck, small teeth, and cleft lip or palate

Besides facial features, what are other s/s of FAS?

deafness, abnormal palmar creases, irregular hair, growth delays, sleep disturbances, heart defects

What are common heart defects in infants w/ FAS?

atrial and ventricular septal defects, tetralogy of Fallot, patent ductus arteriosus

What are s/s of tobacco withdrawal in infants?

prematurity, low birth weight

What are infants w/ tobacco withdrawal at a higher risk for?

SIDS, bronchitis, PNA, developmental delays

Why is a chest x-ray part of the standard testing for infants w/ FAS?

to rule out congenital heart defects

What are 4 things you can do to help comfort an infant in withdrawal?

small/frequent feedings, swaddle w/ legs flexed, offer non-nutritive sucking, reduce environmental stimuli (decrease lights, lower noise level)

What 2 medications are commonly used to help manage withdrawals in newborns?

morphine sulfate and phenobarbital

What should you do to compensate for poor suck reflex?

try various nipples

What should you do for infants w/ cocaine withdrawals?

avoid eye contact, use vertical rocking, and give pacifier

What drug is not contraindicated during breastfeeding?

methadone

What are 4 risks of high caffeine intake?

infertility and higher risk of miscarriage, prematurity, and low birth weight

What are woman who smoke twice as likely to experience?

delay in conception, PROM, placental abruption, or placenta previa

How much higher odds are women who smoke likely to be infertile?

30% more

What are 4 effects of smoking on fetuses?

prematurity, low birthweight, withdrawal syndrome behaviors, increased risk of SIDS

What 3 drugs increase the risk for spontaneous abortions, abruption, and preterm birth if taken during pregnancy?

methamphetamines, cocaine, ecstasy

What are 4 common s/s of cocaine use on infants?

birth defects, withdrawal, visual disturbances, delay in learning

What drug is linked to childhood cancers and IUGR?

marijuana

What drug is known for causing congenital abnormalities?

ecstasy

What does heroin use during pregnancy increase the risk for?

spontaneous AB, IUGR, stillbirth, preterm