As an OBGYN, on most days I have the best job in the world, sharing good news with parents to-be, playing my humble role in bringing about the miracle of life. Then there are the other days, when the news is a bit more grim. It’s now happening more-and-more with the spread of addiction. The increase in the number of babies born with Neonatal Abstinence Syndrome (NAS) is growing at an alarming rate, as more pregnant women find themselves unable to wean themselves from opioid painkillers and heroin.
NAS occurs when a baby is born to a mother who was using opioids during pregnancy. The drug passes through the bloodstream via the placenta, from mother to child. The effects on the baby in the womb are significant; reduced oxygen flow and nutrition to the fetus, among other effects, seriously impact fetal development, often resulting in higher instances of premature birth, low birth weight, and miscarriages. Once the baby is born, the situation gets particularly gut-wrenching. The newborn goes through withdrawal, which includes excessive crying, tremors, gastrointestinal dysfunction, diarrhea, respiratory distress, sweating and sneezing, among other symptoms. Instances of NAS are dramatically on the rise as reported by The Substance Abuse and Mental Health Services Administration (SAMHSA) and articles in the August 2016 Journal of Addiction Medicine. Sadly, I’ve seen the actual evidence with my own eyes.
Babies born with NAS must be given special care. Historic techniques such as swaddling, use of a pacifier and caring for the baby in a quiet environment are helpful. It’s also been determined that breast feeding is soothing and safe because little, if any, of the opioids flow into the breast milk. Finally, in some of the most severe cases, doctors are even utilizing short acting opioids to wean the babies off their addiction. NAS affected 21,732 infants in 2012 according to the 2016 US Surgeon General report “”Facing Addiction in America””, a five-fold increase from the year 2000. This resulted in hospital stays eight-times longer, on average, at an estimated cost of $1.5 billion.
On the bright side, cases of Fetal Alcohol Syndrome (FAS) are decreasing, in the face of greater awareness. FAS occurs to a person whose mother drank alcohol during pregnancy. They struggle with many of the same issues as NAS babies (low birth weight, poor motor skills, etc.) but are not born addicted. FAS, however, is associated with numerous other problems such as behavioral issues, low intelligence, and unique, unusual head size and facial features. Unfortunately, it appears that the rapid rise of NAS is far outpacing the ground we’re gaining with FAS.
The tragic fact is that the vast majority of mothers and mothers to-be never even imagined becoming addicts. Most people hooked on opioids got started by taking prescription painkillers. It has been a difficult issue for our nation, as we’ve become more educated and aware of just how addictive opioid painkillers can be.
The issue of NAS really hits home for me on a personal level. I have a friend who gave birth nine weeks early, as a result of complications. While this development had nothing to do with NAS or FAS, it gave me a newfound understanding and appreciation for what these parents and babies experience. I watched firsthand as my friend’s daughter struggled to breathe because her immature lungs were not yet ready. She was put on a respirator and constantly struggled to dislodge the tubes. It broke my heart to see her connected to all sorts of machines and fed intravenously, because her weak stomach could not hold fluids. It was the toughest period of my entire life, viewing my friend’s baby suffering through a hospital window, as we prayed daily, impatiently waiting for her precious treasure to be healthy enough to go home. I can’t even imagine how much more painful that all would have been had her baby been going through withdrawal at the same time.
If you are addicted to opioids, I implore you to get help now before it has a serious impact on both your physical and mental health. As a pregnant woman, the implications are even more drastic because of your weakened immune system during pregnancy and the tremendous dangerous impact it has on the fetus. You cannot let it continue. Do it for your sake, do it for the sake of YOUR precious treasure, because decisions you make now will affect BOTH of you for the rest of your lives.”