Neonatal Abstinence Syndrome: Info on symptoms, diagnosis and treatment - PowerPoint PPT Presentation

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Neonatal Abstinence Syndrome: Info on symptoms, diagnosis and treatment

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Neonatal Abstinence Syndrome is a condition where babies experience withdrawal symptoms following the use of addictive illicit or prescription drugs either by the mother or when these drugs are prescribed for the baby itself. – PowerPoint PPT presentation

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Title: Neonatal Abstinence Syndrome: Info on symptoms, diagnosis and treatment


1
Neonatal Abstinence Syndrome
2
Neonatal Abstinence Syndrome
  • Neonatal Abstinence Syndrome is a condition
    where babies experience withdrawal symptoms
    following the use of addictive illicit or
    prescription drugs either by the mother or when
    these drugs are prescribed for the baby itself.
    Most commonly, it is due to the use of drugs such
    as opioids, methadone, barbiturates,
    fentanyl, diazepam or other narcotics. There
    are two types of neonatal abstinence syndrome.
    The first type is Prenatal, that is, it occurs
    due to use of drugs by the mother during
    pregnancy. The foetus becomes drug dependant and
    experiences withdrawal symptoms after birth, when
    exposure to the drug is suddenly stopped.  

3
Neonatal Abstinence Syndrome
Continue
  • The second category is Postnatal which follows
    the use of drugs for the baby in situations like
    emergency mechanical ventilation that requires
    analgesia.
  • Fentanyl  is the most common analgesic used in
    newborns It can cause neonatal abstinence
    syndrome if it is suddenly stopped. Drugs which
    are frequently implicated in the occurrence of
    Neonatal Abstinence Syndrome include
    benzodiazepines, opioids, amphetamines,
    barbiturates, heroin, methadone, oxycodone,
    cocaine, marijuana and SSRIs (Selective
    Serotonin Reuptake Inhibitors).

4
Symptoms
  • It is hard to tell which babies might get
    Neonatal Abstinence Syndrome. Some babies have
    Neonatal abstinence syndrome when a mother takes
    only small amount of drugs while other babies may
    only have Neonatal abstinence syndrome when a
    mother takes large amounts of drugs. Most babies
    born to mothers using drugs develop Neonatal
    abstinence syndrome and signs are usually seen
    within the first few days after birth. Some signs
    of Neonatal abstinence syndrome include 
  • High pitched cry
  • Tremors/jittering/shaking of arms, legs, face
  • Yawning
  • Hard time sucking during feeding times
  • Poor weight gain
  • Fast breathing

5
Symptoms
Continue
  • Frantic sucking - fists, fingers, thumbs
  • Trouble falling asleep and staying asleep
  • Fussy - hard to calm
  • Sneezing/stuffy nose
  • Tense arms, legs and body
  • Vomiting/diarrhoea
  • Skin rashes - more so in the diaper area and face
  • Warm to touch/sweating

6
Diagnosis of Neonatal Abstinence Syndrome
  • Tests to diagnose Neonatal Abstinence Syndrome
    include 
  • Neonatal Abstinence Syndrome scoring
    systems These scoring systems allot point to
    each symptom the baby presents with depending
    upon its severity. The overall score decides the
    necessity for treatment.
  • Meconium analysis Meconium is the first stool
    passed by the baby. It is the best method for
    detection of the drug used.
  • Urine analysis Urine analysis is also a widely
    used method for detection of drug exposure in the
    newborn, as it contains higher concentrations of
    the drug in comparison with the blood.
  • Hair analysis This test is not commonly used as
    it is expensive. But the sample collection is
    very easy and can be done up to 3 months after
    birth.

7
Treatments
  • Treatment of Neonatal Abstinence Syndrome
    depends upon general condition of the infant,
    severity of the withdrawal symptoms, feeding and
    weight gain issues and pre-term or full term
    baby. Steps to treat infants with neonatal
    abstinence syndrome include
  • Frequent, small portions of high calorie formula
    feeds are given for children who present with
    problems of feeding and weight gain. This helps
    with the nutrition of the baby.
  • Intravenous fluids are considered in case of
    severe vomiting in a dehydrated infant.Children
    with neonatal abstinence syndrome are often
    irritable and fussy. One can follow these steps
    to calm the baby
  • Switching off the lights and keeping a low noise
    or calm environment around them

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Treatments
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  • Minimizing handling the baby and use of pacifiers
  • Gentle rocking and swaddling also helps
  • If these measures do not ease the situation,
    drug therapy would be required. Morphine or
    methadone is commonly used in treating this
    condition. However, the choice drug to be used
    depends on the substance used by the mother
    during her pregnancy.

9
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