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neonatal opioid withdrawal syndrome
Etiology:
- opioid use or opioid abuse by mother
Monitor:
- newborns with chronic opioid exposure should be monitored for withdrawal symptoms for at least 72 hours
- newborns exposed to buprenorphine & sustained-release opioids may need monitoring for 4-7 days
- newborns exposed to methadone may need monitoring for 5-7 days.
Management:
- nonpharmacologic measure for all newborns with opioid exposure
- for newborns with severe opioid withdrawal syndrome, opioid taper recommended.
- breast-feeding
- when women have been in treatment for opioid use disorder (buprenorphine or methadone) for at least 90 days without relapse
- considered for women in treatment for 30-90 days without relapse.
- discourage when women have active substance use or relapse within 30 days
- if infant shows mild signs of opioid withdrawal, encourage mother to room with infant in a quiet environment [2]
- morphine or methadone indicated for moderate-severe signs of opioid withdrawal [2]
General
opiate withdrawal
References
- Patrick SW, Barfield WD, Poindexter BB & COMMITTEE ON FETUS
& NEWBORN, COMMITTEE ON SUBSTANCE USE AND PREVENTION
Neonatal Opioid Withdrawal Syndrome
Pediatrics October 2020, e2020029074
PMID: 33106341
https://pediatrics.aappublications.org/content/early/2020/10/10/peds.2020-029074
- NEJM Knowledge+ Pain Management and Opioids: Recharge