In July 2018, Kentucky became one of only four states that will drug test both newborns and mothers if the healthcare provider suspects drug use. In order to combat the devastating number of newborns in the state who were exposed to addictive drugs by their pregnant mothers, lawmakers added a section to what is known as House Bill 1, or HB1, that expands the definition of child abuse to include neonatal abstinence syndrome NAS in the state of Kentucky.
According to the Kentucky Public Health Neonatal Abstinence Syndrome (NAS) Reporting Resitry, 907 babies were born with the symptoms of NAS in 2018. In other words, for every 1,000 live births in Kentucky, 16.5 suffered from NAS. The most common types of opioids reported in mothers of newborns with NAS are buprenorphine, heroin, and methadone.
Understanding Neonatal Abstinence Syndrome (NAS)
Neonatal abstinence syndrome (NAS) occurs when babies are exposed to drugs while in the womb and go through withdrawal after birth. This syndrome most often applies to babies exposed to opioid medications, but may also apply to stimulants, benzodiazepines, and other addictive drugs.
When a mother takes an opioid drug, it passes through her bloodstream, through the placenta, and into the system of her unborn baby. If the mother continues taking an addictive substance throughout her pregnancy, the baby may become addicted to the drug and experience symptoms of withdrawal shortly after birth.
Symptoms of Neonatal Abstinence Syndrome
The symptoms of NAS vary depending on the type of substance used, the last time the substance was taken, and whether the baby is born at full-term or premature. As a result, some babies will begin experiencing symptoms in as little as 24 to 48 hours after birth, while others may not show symptoms for 5-10 days. Furthermore, the symptoms will vary depending on what kind of substance the baby was exposed to.
Common symptoms of NAS include:
- High-pitched and uncontrollable crying
- Sleep problems
- Tight muscles
- Overactive reflexes
- Yawning, sneezing, and stuffy nose
- Poor feeding
Babies who are born prematurely may have less severe withdrawal symptoms that fade away faster than babies who are born at full-term.
Complications and Long-Term Side Effects of Neonatal Abstinence Syndrome
In addition to the excruciating withdrawal symptoms, babies with NAS may be at risk for the following complications:
- Poor uterus growth
- Being born too early
- Heart defects
- Jaundice (yellowing of the eyes and skin)
- Birth defects
- Low birth weight
Many babies recover fully and grow up to be healthy and happy adults. However, some experience chronic issues. Even after a baby has been treated for NAS and recovered, they may experience long term side effects. These include:
- Developmental delays
- Motor problems
- Behavioral problems
- Sleep disturbances
- Increased risk of sudden infant death syndrome (SIDS)
- Cognitive problems
- Vision problems
- Increased ear infections
Fortunately, NAS is a completely preventable problem. Mothers struggling with substance abuse who seek addiction treatment and stop using drugs, sometimes with the help of medications, can stop using early enough to prevent lasting side effects on the baby.
Under What Circumstances Will Hospitals in Kentucky Drug Test Newborns?
There are several different reasons why a hospital in Kentucky may decide to drug test a newborn. Some of the obvious include if the baby is jittery, fussy, lethargic, or having seizures or brain hemorrhages. Or, if the baby is showing symptoms of withdrawal, such as abnormal breathing or tightened muscles, the healthcare provider may order a drug test.
Some other reasons you may not think about that would inspire hospitals to drug test newborns include:
- If the mother has a history of maternal drug use or has an altered mental status
- If the mother has sought out no prenatal care (nearly 50% of mothers who are in the NAS registry did not receive adequate prenatal care.)
- Other physical symptoms that may resemble NAS
How Do Healthcare Providers Drug Test Newborns?
Drug tests can be performed on newborns using samples from their blood, urine, meconium, hair, or umbilical cord blood. In general, most hospitals in Kentucky will use urine or meconium to drug test newborns because the collection method is minimally invasive and the results come back quickly. A urine test may also be given to the mother to determine what types of substances she has been taking.
If the test results come back positive, most hospitals will begin treatment by helping keep the newborn as safe and comfortable as possible while they experience withdrawal symptoms. During treatment, newborns may receive medications like morphine or clonidine to ease their withdrawal symptoms and wean them off of opioids. Although universal testing is not a practice in Kentucky, hospitals will do so if they suspect that the mother was using drugs while pregnant with her baby.
Consequences of a Newborn Testing Positive for Drugs in Kentucky
As previously stated, exposing an unborn child to addictive substances resulting in babies born with NAS is considered child abuse in Kentucky, so there are serious repercussions. If a newborn tests positive for drugs, mothers are typically given two different options:
- Seek help from a professional addiction treatment center within 3 months of giving birth
- Lose their parental rights
If a mother refuses to go to treatment and her rights are removed, this does not mean the baby will be removed from her custody. Instead, the situation is sent to family court where the judicial system. Then, state caseworkers will make recommendations to family court judges based on the unique circumstances of each mother’s case. The family court will then work with the mother and her baby to determine a resolution.
Getting Help for Addiction
Kentucky has a higher rate of babies born with NAS compared to the national average. If you or someone you know is pregnant and abusing drugs like opioids or amphetamines, it’s time to get help. Once you get treatment and sober up, both you and your baby will be able to live happy and healthy lives. However, detoxing cold-turkey could put both you and your baby at risk, which is why you should never do so alone. Treatment centers in Kentucky that work with pregnant women are equipped with the resources needed to keep you and your baby safe while you detox from substances.
Don’t wait any longer – contact one of our dedicated treatment providers today to get connected with an addiction treatment provider near you.
Medically Reviewed: September 25, 2019
All of the information on this page has been reviewed and verified by a certified addiction professional.