How Neonatal Opioid Withdrawal Syndrome Is Treated and Managed
A diagnosis of Neonatal Opioid Withdrawal Syndrome (NOWS) for your newborn baby can evoke a lot of feelings, which are valid. You should be reassured that this is a well-understood condition with which hospital teams are well-equipped to help your baby through. Treatment revolves around providing comfort and relieving withdrawal symptoms, as well as supporting the healthy development of your baby and fostering family unity wherever possible.
How Is Neonatal Opioid Withdrawal Syndrome Treated?
Treatment is highly individualised, based on how well the baby is doing:
Non-pharmacological Care
Frequent Small Feeds: Babies who suffer from NOWS have the condition whenever the level of glucose in their blood is low; therefore, they require numerous and small feeds.
Breastfeeding, If Suitable: Breastfeeding can actually help improve their condition.
Your doctor will advise you on the best way forward for your baby's case.
Pharmacological Treatment
When withdrawal symptoms are severe or do not respond to non-pharmacological treatments, medications may be needed:
The medications prescribed will be given under very close medical supervision, and the dose will be tailored to how well the baby is doing.
How Long Does Treatment Last?
The length of time the baby stays in hospital can vary hugely depending on what treatment is required; some babies only require treatment for a few days, while other babies may be in hospital for weeks. Generally, a baby will either require a few days to feel 'well enough', then have a few days of careful weaning from medication before discharge home, and continue to be monitored as withdrawal symptoms resolve over the next week or two.
The Role of Parents in Treatment
Parents are not 'patients' during the care of a baby with NOWS - you are a key part of the treatment. Research consistently shows that babies with NOWS fare better when their parents are able to be actively involved in the infant's care.
How Parents Can Help
Do not forget yourself; you are equally deserving of support through this time.
What Happens After Discharge?
Going home will be a huge milestone, and there will likely be many anxieties that you would like to discuss with the care team. It will be essential that you feel prepared before the infant's discharge from the hospital.
Before Discharge: Your baby will have been in a stabilised condition for some time before discharge is considered, and there will be a clear follow-up plan.
Home Care: A low-stimulus environment will need to be maintained for the first few weeks of care. You will be advised on what things to look out for regarding a relapse in symptoms.
At Home: Your baby will be observed for any signs of recurring withdrawal symptoms at home, such as those mentioned below. Attendance at all follow-up clinics; these are incredibly important to check on your baby's progress and to address any issues, as they arise, or to anticipate potential future problems.
Signs You Should Watch Out for After Discharge
The following signs might indicate that your baby is still experiencing symptoms, or that symptoms are recurring, and require the prompt attention of the medical team. These may include.
A sudden stiffness of the baby's body or seizures
It is imperative that if your baby shows any of these signs, you contact their health professional immediately or attend a hospital for urgent assessment.
Support for the Whole Family
A baby with NOWS influences the whole family's wellbeing and experiences; it can lead to many feelings of guilt, grief, fear, love, and hope, which are quite normal and understandable.
When Should You See a Doctor?
Any of the following reasons suggests you need to speak with them:
Whether you’re pregnant, a new mom, or navigating postpartum, you don’t have to do it alone. Join our support group to connect, share, and support one another.
FAQs on How Neonatal Opioid Withdrawal Syndrome Is Treated and Managed
Can I breastfeed my baby when they have NOWS?
It is generally recommended to breastfeed if possible, as it may ease symptoms and build your mother-baby connection, but this will be determined by circumstances such as your medications. Always talk to your physician. How will I know when my baby can go home?
The medical team will thoroughly evaluate your baby before suggesting an early dismissal. They will make sure symptoms are well managed and that you are comfortable caring for your baby at home. Will my baby have lifelong problems due to NOWS?
Children with properly managed NOWS go on to be perfectly healthy. A crucial factor in outcomes is having a solid and stable environment with people who are attentive to the child's needs after dismissal.
How Is Neonatal Opioid Withdrawal Syndrome Treated?
Treatment is highly individualised, based on how well the baby is doing:
Non-pharmacological Care
- Skin-to-Skin: This is one of the most effective non-pharmacological interventions in helping a baby feel secure and has a soothing effect on the nervous system. Skin-to-skin care also has the effect of potentially reducing the severity of symptoms.
- Gentle Swaddling: Wrapping the infant snugly helps them feel secure and has an effect of decreasing tremors.
- Low Stimulation Environment: It can be overwhelming to have constant bright lights and noises, and the care team will attempt to keep these as low as possible.
- Rocking and Calming: Rhythmic motions can be a calming process for babies.
Your doctor will advise you on the best way forward for your baby's case.
Pharmacological Treatment
When withdrawal symptoms are severe or do not respond to non-pharmacological treatments, medications may be needed:
- Opioid Medications: These are often the medications prescribed; they are opioids, which will help to decrease withdrawal symptoms; they will be carefully calculated for use at regular intervals and weaned gradually as symptoms ease.
The medications prescribed will be given under very close medical supervision, and the dose will be tailored to how well the baby is doing.
How Long Does Treatment Last?
The length of time the baby stays in hospital can vary hugely depending on what treatment is required; some babies only require treatment for a few days, while other babies may be in hospital for weeks. Generally, a baby will either require a few days to feel 'well enough', then have a few days of careful weaning from medication before discharge home, and continue to be monitored as withdrawal symptoms resolve over the next week or two.
The Role of Parents in Treatment
Parents are not 'patients' during the care of a baby with NOWS - you are a key part of the treatment. Research consistently shows that babies with NOWS fare better when their parents are able to be actively involved in the infant's care.
How Parents Can Help
- Stay close to your baby; your presence, holding, and soothing are hugely therapeutic to an infant with NOWS, and you will likely become adept at finding just the right things to do.
- Learn the soothing techniques; ask the care team to show you how to soothe your baby and how best to swaddle and cuddle your infant.
- Participate in feeding your baby; whichever form of feeding is the appropriate one for your baby, try to make time for this. This strengthens your bond with your baby and supports their well-being and progress.
- Communicate your concerns; talk to your doctor about any fears you have for your baby. Remember, it is your baby, and you know your baby best.
Do not forget yourself; you are equally deserving of support through this time.
What Happens After Discharge?
Going home will be a huge milestone, and there will likely be many anxieties that you would like to discuss with the care team. It will be essential that you feel prepared before the infant's discharge from the hospital.
Before Discharge: Your baby will have been in a stabilised condition for some time before discharge is considered, and there will be a clear follow-up plan.
Home Care: A low-stimulus environment will need to be maintained for the first few weeks of care. You will be advised on what things to look out for regarding a relapse in symptoms.
At Home: Your baby will be observed for any signs of recurring withdrawal symptoms at home, such as those mentioned below. Attendance at all follow-up clinics; these are incredibly important to check on your baby's progress and to address any issues, as they arise, or to anticipate potential future problems.
Signs You Should Watch Out for After Discharge
The following signs might indicate that your baby is still experiencing symptoms, or that symptoms are recurring, and require the prompt attention of the medical team. These may include.
- High-pitched crying, with no evidence of pain
- Tremors and excessive jitteriness
- Feeding difficulties (failure to feed consistently, or poor sucking reflexes)
- Abnormal, rapid breathing, or difficulty breathing
- Gastrointestinal problems: persistent vomiting and loose stools
Support for the Whole Family
A baby with NOWS influences the whole family's wellbeing and experiences; it can lead to many feelings of guilt, grief, fear, love, and hope, which are quite normal and understandable.
- Speaking with a counsellor or therapist is sometimes helpful in enabling you to express some of the difficulties you are experiencing.
- Many mothers whose babies have had NOWS are finding a great deal of solace in sharing experiences.
- Getting in touch with loved ones allows people who love you to assist you when and where they can, to help you maintain energy to cope with the baby's condition.
When Should You See a Doctor?
Any of the following reasons suggests you need to speak with them:
- The baby's withdrawal seems to be getting worse rather than better.
- You are concerned about the baby's weight gain or feeding.
- You are experiencing difficulty expressing how you feel and may wish to have some emotional support.
Whether you’re pregnant, a new mom, or navigating postpartum, you don’t have to do it alone. Join our support group to connect, share, and support one another.
FAQs on How Neonatal Opioid Withdrawal Syndrome Is Treated and Managed
It is generally recommended to breastfeed if possible, as it may ease symptoms and build your mother-baby connection, but this will be determined by circumstances such as your medications. Always talk to your physician.
The medical team will thoroughly evaluate your baby before suggesting an early dismissal. They will make sure symptoms are well managed and that you are comfortable caring for your baby at home.
Children with properly managed NOWS go on to be perfectly healthy. A crucial factor in outcomes is having a solid and stable environment with people who are attentive to the child's needs after dismissal.
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