Your new grandbaby is here, and they are beautiful. But the doctors just informed you that this baby will have a rough few weeks ahead. Their little body is going through withdrawal from exposure to opiates during pregnancy.
It’s normal to feel scared for this baby’s health. You probably also feel overwhelmed by the role you need to play in this baby’s withdrawal process. There may also be anger and disappointment inside you over the choices this baby’s mother made during pregnancy. You must admit all those feelings and work through them, so you can be present and safe for this little one while their body sheds the impacts of the substances.
What is Neonatal Abstinence Syndrome?
When a baby has exposure to opiates during pregnancy, the baby can become dependent on that drug. A baby born dependent that experiences withdrawal is usually diagnosed with Neonatal Abstinence Syndrome (NAS) at birth. Examples of opiates include:
- hydrocodone (Vicodin®)
- oxycodone (OxyContin®)
- codeine
- morphine
- heroin
- fentanyl
- methadone
Who is born dependent?
It’s important to know that not all opiate-exposed babies will experience withdrawal symptoms of NAS. Two main factors impact whether the baby will be dependent:
- The time during the pregnancy that the mother used the drug.
- The dose (amount) the expectant mother used.
The severity of the baby’s long-term effects from this prenatal opiate exposure is not related to whether the baby was born dependent.
What are the symptoms of dependence?
A baby’s symptoms of dependence or Neonatal Abstinence Syndrome (NAS) can range from mild, like colic (crying and discomfort like gas bubbles), to severe, including struggles like seizures and pauses in breathing. The range of typical symptoms that an opiate-exposed baby can experience might include the following:
- Tremors or muscle spasms
- Tight muscle tone or rigidity
- Excessive sucking, even when not feeding
- Poor feeding (such as weak sucking, spitting up, and disinterest in feeding)
- Difficulty with soothing
- Struggles with the regulation of body temperature
How long does withdrawal last?
A baby with NAS typically begins to experience withdrawal symptoms shortly after birth. These symptoms usually last from 3 days to 2 weeks. Most NICU doctors will treat the symptoms with morphine. They usually set the dose to relieve the baby’s uncomfortable symptoms and then gradually taper off the amount as the baby recovers.
Tips for Helping a Baby Cope with Withdrawal from Opiates
You may be preparing to take this new grandbaby from the hospital to live with you. You might be staying at the hospital with the baby’s mother to help both mom and baby recover. Regardless, it will help calm your sense of overwhelm to know that there are caring, nurturing things you can do to help this baby through the withdrawal process.
Keep in mind humans, including baby humans, are unique in how they respond to soothing or comforting strategies. It will help you to read the baby’s cues for what works. You can try these tips but be open to changing your efforts when you sense something isn’t working.
1. Decrease the potential stimulation in the room.
Try to create a quiet environment. It’s challenging in the hospital, but white noise or something like that can help. Dim the lights or keep the room dark.
2. Focus on holding the baby.
When the baby struggles with rigid muscles or tremors, they might respond well to cuddling and rocking in a calm, rhythmic motion. Many babies with NAS also feel comforted by being swaddled. You might need to release the baby’s arms or hands out of the swaddle wrap if they seem to resist the swaddle techniques you try.
3. Try skin contact.
A baby’s heartbeat and breathing often match up to the caregivers who are holding them. Babies exposed to opiates will regulate easier when you are skin-to-skin with them. Hospitals call it kangaroo care. It’s a gentle, nurturing way to support the baby physically and emotionally through the stress of withdrawal. You can sit and rock with the baby on your chest at home or in the hospital room. And you can use a baby wrap or carrier at home.
4. Offer sucking practice.
Babies who have NAS benefit from what doctors call “nonnutritive sucking” as another means of soothing and comforting themselves. Offer a pacifier or your clean finger to help them practice this self-soothing skill. You should try a few different styles of pacifiers to get the one that this baby prefers. The hospital can help you with samples.
5. Keep it warm.
Because prenatally exposed babies often struggle to regulate their body temperature, they need a warm cozy environment. In addition to keeping them layered with blankets, you may need to set the room’s temperature higher than usual. Dress accordingly if the heat bothers you so that nothing stands in your way of holding and cuddling this little one.
6. Try a massage.
Your grandbaby might respond well to a gentle, soothing massage. You can use a fragrance, and dye-free lotion warmed up in your hands to make it easier to rub the baby down. Use long strokes that are slow and firm without being too strong. You will learn the baby’s cues for what kind of massage suits them if you pay attention. You can play gentle, soothing music during massage time if the baby responds well.
Your Care Will Make a Difference.
Being a calm, steady presence for this grandbaby during withdrawal impacts their ability to overcome the challenging symptoms. You will also create nurturing bonds between you that tell the baby you are safe and available to them as they grow. This kind of practical touch and intentional care is a beautiful foundation for an ongoing relationship that represents care and trust no matter what the child experiences later.