In a newly released clinical report, the American Academy of Pediatrics provides an overview of why systemic, enduring, coordinated and holistic approaches are needed to improve care for mother and child affected by opioid use in pregnancy. The report, “Neonatal Opioid Withdrawal Syndrome,” is published in the November 2020 Pediatrics.
“The escalation of opioid use over the past two decades has devastated families, resulting in more infants being diagnosed with opioid withdrawal shortly after they are born,” said Dr. Stephen W. Patrick, MD, MPH, MS, FAAP, lead author of the report, which was written by the Committee of Fetus and Newborn and the Committee on Substance Use and Prevention.
“We can take steps to improve healthcare for the mother during pregnancy, which leads to better outcomes for both mother and child, and, ultimately, for society. We saw an increase of 10,000 children in the foster care system from 2011 to 2017 largely due to a parent’s substance use, for instance. We must provide these families with support earlier, rather than later,” Dr. Patrick said.
The incidence of neonatal opioid withdrawal syndrome (NOWS), formerly called neonatal abstinence syndrome, rose from 1.2 to 8.8 per 1,000 hospital births between 2000 and 2016.
The AAP clinical report offers detailed recommendations for improving medical treatment and access; prenatal counseling and screening; observation of infants and their diagnosis, treatment, and discharge of the infant. Among the recommendations:
“Families will need continued support and education on opioid withdrawal, newborn care and safe sleep practices,” said Wanda D. Barfield, MD, MPH, FAAP, Director, Division of Reproductive Health at the Centers for Disease Control and Prevention and a coauthor of the report. “The pediatrician is there to help and can follow up to ensure a safe, coordinated transition home as well as other forms of support, such as counseling and connections to community resources.”