How opioid use affects babies: Addiction risks & family help

How Opioids Affect Babies:

Taking opioids during pregnancy can have a serious impact on your baby’s long-term health.

The Medical Impact of Opioid Use during Pregnancy

• If you take opioids during pregnancy, the opioids will travel from your blood into the womb, and into the blood of the fetus.
• Opioids come in different forms, like pills or injections. Some common names of opioids include: fentanyl, codeine, oxytocin, hydrocodone, morphine, oxycodone, tramadol, and many others. Some other drugs are also opioids, such as heroin.
• Opioids also have street names. For example, fentanyl is called many things including TNT, China White, China Girl, Apache and others.
  • Some substances are sold at gas stations and convenience stores like Kratom and 7-OH
  • “Kratom” refers to an herbal substance that can produce opioid- and stimulant-like effects It can be highly addictive and cause withdrawal symptoms.
  • There are lab-made substances like 7-OH that are highly addictive. This chemical is much stronger than morphine. Both Kratom and substance like 7-OH can lead to rapid addiction and severe withdrawal. They can have severe side effects like seizures, high blood pressure, confusion, and liver damage and they vary in strength. In other words, since they are not regulated, you don’t know what you are getting.:
• Being exposed to opioids in the womb can have short-term and long-term impacts on babies’ health.

Short- and Long-Term Impacts on Newborns

• If you take opioids during pregnancy, your baby may be born with a condition that is called Neonatal Opioid Withdrawal Syndrome (NOWS) or Neonatal Abstinence Syndrome (NAS).
• NOWS/NAS means that a baby is experiencing withdrawal symptoms after they are born. Symptoms could be problems with feeding, sleeping, crying, and seizures. Seizures from NAS are especially dangerous for babies and could lead to death, if not treated quickly.
• There’s also a risk that opioid use during pregnancy could cause poor growth or development of the fetus, or could lead to birth defects.
• Read our pediatrician’s blog post for more detailed information about what opioids are, how they can impact your health, and how taking them during pregnancy can impact your baby.

Treating and reducing NAS/NOWS: During pregnancy and after birth

If you are using opioids and you are pregnant, there are a range of treatment options. We recommend talking to a healthcare professional about what options are best for you. Click on this link for more information about what to look for in a healthcare provider.

Medical alternatives to opioids for pregnant women

• A healthcare professional might recommend medications to help you in your recovery from substance use. You might hear them called Medications for Opioid Use Disorder (MOUDs for short) or Medication Assisted Treatment (or MATs). Both of these terms refer to the same types of medicine.
  • There are several types of MOUDs/MATs, like methadone or buprenorphine.
• MATs/MOUDs can reduce your withdrawal symptoms for opioids.
  • Physical symptoms of withdrawal can be muscle aches, sweating and chills; nausea and vomiting; stomach issues; runny nose and tearing; and increased heart rate and blood pressure.
  • Psychological symptoms can be anxiety and agitation; depression; insomnia; and cravings.
  • During pregnancy, withdrawal symptoms can be harmful for you and your baby.
• MATs/MOUDs help prevent or greatly reduce withdrawal symptoms, and are also much safer for your baby than other opioids.
  • An opioid treatment provider can help you safely transition to MOUD/MAT. They will carefully select the timing and amount of medication needed to help you feel comfortable and stable.

Managing NOWS/NAS in newborns

• When pregnant women replace opioids with MATs/MOUDs, their newborn baby may experience milder NAS/NOWS symptoms.
• Some infants may need supportive medication to manage their NOWS/NAS symptoms.
• Not all infants will need medication. Other treatment options for NAS/NOWS, include: CDC Guidance
  • Placing the infant in a dark, quiet area to lessen both light and sound.
  • Swaddling the infant in a blanket.
  • Gently rocking the infant, or using other positioning or comforting methods.
  • Providing frequent, small amounts of high-calorie formula or breast milk to help with feeding problems.
  • Mothers and babies staying together in the same hospital room while babies receive treatment for NAS/NOWS.

Taking care of you: Care for pregnant women using opioids

It’s also important for women who are using opioids during pregnancy to take care of their own health and wellbeing.

Managing Pain

• If you were taking opioids to help with pain, pregnancy is a good time to explore healthier ways to manage your pain. A pain management specialist can help you find the best option for you.
• Some people may benefit from non-addictive medications, or procedures like injections or nerve blocks.
• Other approaches can include physical therapy, doctor-recommended exercise plans, or counseling.

Mental health

• Taking care of your mental health is an important part of treating addiction.
• Sometimes, women in recovery from opioid use or other substance use find that the stress of preparing for a baby and taking care of a newborn can trigger a relapse.
• Postpartum depression can also trigger a relapse.
• Medications can help treat anxiety and depression.
• Therapy, counseling, or support groups can also be helpful for mental health. It’s important to talk to your health care provider about these options.

For pregnant women already in treatment for substance use:

• If you are on MAT/MOUDs (such as Buprenorphine or Methadone), it is best to let your doctor know.
• It is not safe for you or your baby to stop MAT/MOUDs “cold turkey.”
• Your doctor can help you maintain your treatment while also having a healthy baby.

Navigating Resources: Support for Families Impacted by Opioid Use in Pickens and Anderson Counties

If you live in Pickens or Anderson Counties in South Carolina, consider checking out the Managing Abstinence (MAiN) Program.

What is MAiN?

• MAiN is shorthand for Managing Abstinence in Newborns, which is a clinical treatment program developed over 20 years ago at Greenville Memorial Hospital for newborns at risk for opioid withdrawal after birth.
• MAiN provides medical care and support for pregnant women who are using opioids during pregnancy, while giving birth in the hospital, and up to five years afterwards.

How does MAiN help babies?

• MAiN works with you to create a medical treatment plan during pregnancy to minimize your baby’s risk for NOWS/NAS.
• MAiN provides expert care in the hospital for your baby. A doctor will monitor your baby’s NAS/NOWS symptoms during your hospital stay and will help with symptom management.
  • A doctor will decide if medication is necessary for your infant and begin weaning your infant from medication while in the hospital. If your infant does not need medication, the doctor will monitor your baby closely.
  • The MAiN care team will provide parenting education to help you understand and care for your baby’s specific health needs and so that you may know how to care for your baby at home.
• A research study found that babies with NOWS/NAS who are part of the MAiN program have shorter hospital stay than babies with NOWS/NAS who do not receive care from MAiN.

How does MAiN help mothers?

During pregnancy

• MAiN is committed to providing compassionate care to pregnant women who are using opioids. Click here to learn more about our non-judgmental approach.
• During pregnancy, we talk with you to learn about your medical needs and create a medical care plan that is customized for you. This could include help finding an addiction rehabilitation or treatment center.
• A nurse or doctor will also meet with you to explain NAS/NOWS and answer any questions you may have about your birthing experience and care for your infant, all the way through hospital discharge
• We also work with you to make a plan for connecting you with personalized resources, based on what would you need. This could include connections to services, such as job placement, legal assistance, and food assistance.

During birth at the hospital

• At the hospital, we support you through the birthing process, and your baby receives medical care from a doctor who specializes in treating babies with NAS/NOWS.
  Depending on your baby’s needs, treatment options could include:
  • Medication for your baby, rooming-in with your baby and at home weaning from medication. But not all babies may need medications.
• When you leave the hospital, we send you home with infant care supplies including diapers, pacifiers and infant safety items.

After you give birth

• After you give birth, we can support you for up to five years. During that time, you can reach out to our Nurse Navigator for many types of support.
  • Nurse navigators are specially trained in understanding how opioid use can affect families. Each MAiN Nurse Navigator will follow a small number of families and hopes to be a true resource for them.
  • A nurse navigator can meet with you at your home, any meeting place you feel comfortable, or by phone. She can counsel you on breastfeeding and taking care of your infant. She can assist you with finding any resources you and your baby might need.
  • Our team can also provide access and support to a wide range of community services and resources. Some of these include:
    • Job placement, through organizations like The Urban League of the Upstate, the Share Action Community partnership, and the LADDER program.
    • Housing, through organizations like United Way of Pickens, Greenville and Anderson Counties, County Housing Authorities, and regional Non-profits and Faith based agencies.
    • Legal assistance, through United Way of Pickens County’s tough times toolkit.
    • Food, through food pantries such as Potters Clay Fellowship, Shine soup kitchen, Golden Harvest, and others. Click here for a map of SC food banks.