Neonatal Abstinence Syndrome (NAS) can be described as a problem or condition prevalent in newborn children who have been exposed to addictive prescription or illegal drugs while they were developing in their mother’s wombs (Queensland Maternity and Neonatal Clinical, 2010). The condition often results after the mother of an unborn child uses opiate or narcotic drugs for example heroin, oxycodone, methadone, codeine or buprenorphine. The condition has many adverse effects on the newborn child. The condition shares similar symptoms and may be confused easily with other diseases prevalent in children (Matic, 2008). However, various tests help to diagnose the condition. The diagnosis of the condition mainly depends on a study of the kind of drugs that the mother used, and the same drug may be used in the treatment process (MacMullen, Dulski, & Blobaum, 2014). More research on the NAS condition is vital in today’s world where drug and substance abuse among expectant women is on the increase. The number of cases reported with such conditions globally is on the rise. Thus, more research is needed to show the various factors that can lead to the condition.
This paper will achieve its aim by reviewing a wide range of scholarly works on NAS with more emphasis on symptoms of the condition, diagnosis, and treatment, as well as its management. Such scholarly works play a huge role in enlightening communities on the condition as well as how to offer support to the infants suffering from it. Other key issues such as failures in prenatal parenting will also be highlighted.
Causes of Neonatal Abstinence Syndrome (NAS)
Neonatal Abstinence Syndrome is caused as a result of continued drug use by mothers of unborn babies. It is in two different types. The first type of NAS usually occurs due to maternal use of any substances that may in one way or another result into withdrawal symptoms in the newly born baby. The other type is the postnatal NAS which is secondary to the discontinuation of various types of medication such as morphine or fentanyl which are commonly used in pain therapy in the newborn children (Jones, Kaltenbach & Fischer, 2010). The substances from these drugs pass through the placenta connecting the mother to the baby in the womb. This consequently leads to addiction of the unborn baby along with the mother. Once the baby is born, he/she is still dependent on the drug as it had already been addicted to it. Since the baby cannot have it, withdrawal symptoms start to appear. The infant is therefore put under treatment to control the withdrawal symptoms that in some instances leads to the death of the children. Alcohol use and the use of other drugs too have an impact on the baby hence expectant women are highly discouraged from use of any drugs of any kind (Queensland Maternity and Neonatal Clinical, 2010). Babies born to women who use other drugs such as marijuana, nicotine, barbiturates, cocaine and amphetamines usually have long-term problems. However, no clear evidence exists to link the use of the drugs to NAS (Jones et al., 2010).
The primary symptoms of the Neonatal Abstinence Syndrome are usually dependent on some factors. These factors include the type of drug the mother used, how long she had been using the drug, how her body breaks down the drug, the amount of the drug she took, and the maturity of the baby during birth (full-term or early/premature). All these factors give the medical practitioners details of the extent of drug use thereby making it easy for them to determine the level of dependence of the baby to the drug. This, therefore, makes treatment much easier (Astho, 2014). The typical symptoms of the condition are tremors, excessive sweating, Fever, convulsions, high-pitched cry, poor feeding, diarrhea, vomiting, excessive sucking or rooting and irritability, sweating, slow weight gain, hyperactive reflexes and rapid breathing. However, these symptoms take different time durations before they are fully realized. In some instances, they take 1-3 days after birth while in other cases they may take up to a week before they fully appear (Astho, 2014).
Diagnosis and Treatment
During the process of diagnosis and treatment of the child, various tests are carried out. The tests are vital in helping assess the level of addiction of the infant. The disease also has almost similar symptoms with many other diseases, therefore conducting the various tests is vital in determining the chief cause of the problem (Astho, 2014). Once the tests are carried out, treatment can be carried out effectively with much ease. The tests include the urine test (urinalysis), which refers to the microscopic examination of the physical and chemical urine components (MacMullen et al., 2014). In the lab, the urine is examined for any traces of the drug residue. The concentration of the drug residue in the urine can also be determined.
Toxicology screening of first bowel movements is also conducted (MacMullen et al., 2014). This test is primarily done to determine the types and amounts of toxic or non-toxic drugs that a person has taken. While carrying out the tests, the mother of the infant is supposed to make it known to the doctor the kind of drugs, including the over-the-counter drugs that she has taken and the amounts. This help to assess and determine the level of dependence of the infant to the drug. The test is usually carried out using a blood test or a urine test. Another test done is the radioimmunoassay and enzyme immunoassay (ELISA). The test uses antibodies and change in color to identify various substances. It is a type of analytical biochemistry assay which uses solid-phase enzymes, immunoassay (EIA) to help detect the presence of a substance (antigen) in a wet or liquid sample (MacMullen et al., 2014). The test can be used to ascertain the presence of various drug substances present in the infant.
Another test that may be conducted is the Meconium analysis, which is primarily used to detect fetal and infant exposure to drugs and other substances. It is vital in determining the prevalence of antenatal exposure to various compounds, as well as assessing the possible effects that are associated with the compounds (MacMullen et al., 2014). All these tests mentioned above are used in the determination of the various drugs and substances that may be present in the infant’s body thereby making it possible for treatment for withdrawal to start immediately.