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COLUMBUS, Ohio — Baby M arrived in our neonatal intensive care unit the other day. Barely 24 hours old, she was clearly in pain. Her high-pitched cry pierced the unit again and again, her tiny legs twitched uncontrollably, and she couldn’t sleep. It’s difficult to comfort her — no amount of swaddling, holding, rocking, soft humming, offering her a pacifier, or other strategies soothe her.

Like the multitude of other babies in this NICU at Nationwide Children’s Hospital, Baby M was born dependent on drugs that her mother took while pregnant. It’s likely Baby M is in withdrawal from heroin or OxyContin, but we won’t really know for certain until we can talk with her mother and see her test results.


Twenty years ago, we rarely encountered babies with what is today known as neonatal abstinence syndrome in Central Ohio. Now it is so common that we will soon have an entire NICU devoted to caring for babies with it. A new report from the Centers for Disease Control and Prevention estimates that about 24,000 drug-dependent babies were born in 2013, the last year for which there are complete statistics. That’s one baby every 20 minutes.

Mothers who take drugs during pregnancy give birth to babies who are physically dependent on those same drugs. When the umbilical cord is cut at birth, the baby immediately starts to go “cold turkey.” Withdrawal from heroin or other opioid — from any addictive drug, for that matter — is hard on the body. It is heartbreaking to watch these innocent newborns struggle.

Some babies are as rigid as boards. Many jerk or twitch constantly, rub their bodies against blankets and get the equivalent of rug burn, cry for long periods, have trouble feeding, vomit after feeding, or have loose stools. Some have serious trouble breathing or go into convulsions.


The sooner treatment can begin, the better. The best thing for a drug-dependent baby is for its mother to spend time in the NICU holding and cuddling her child, especially using “kangaroo care.” This skin-to-skin, chest-to-chest way of holding a baby has been shown to help premature infants thrive and seems to help comfort babies with neonatal abstinence syndrome as well. Breastfeeding is also invaluable, both because it promotes mother-child bonding and because it gives the baby essential nourishment, antibodies, and other nutrients.

Many drug-dependent babies need more than this. We generally follow guidelines from the American Academy of Pediatrics. They recommend giving the baby the same class of the drug he or she encountered before birth, then gradually reducing the amount day by day. Morphine and methadone are the two most commonly used medications for managing the symptoms of withdrawal.

Weaning babies off drugs takes time. It depends on so many factors — how long the mother had been using drugs, her daily dose, whether she was using multiple drugs, and whether she smoked or drank a lot of caffeine. The average stay in our NICU for babies with neonatal abstinence syndrome is 17 days, but that hides a large range. Some babies stay for eight weeks or even longer.

Although our work in the NICU is focused on the babies in our care, we pay close attention to the mothers as well. Our team includes doctors, nurses, nurse social workers, pharmacists, nutritionists, psychologists, chaplains, specially trained volunteers, and physical, occupational, massage, and music therapists. At the end of the day, though, the most important part of the care team is the person who will take the baby home. So we do everything possible to make each mother feel welcome and valued and to help her understand how important she is in her baby’s development. Many mothers respond well to this nurturing.

Interacting with mothers who continue to use drugs or who don’t seem to grasp the gravity of neonatal abstinence syndrome can be a challenge. Anyone working in this field must come to terms with the fact that they can’t control what happens outside the NICU, or what happens when a baby goes home. If we have concerns that the child may be facing an unhealthy or unsafe situation, of course, we will report that to children’s services.

We hope and pray for an end to the opioid epidemic and what it does to thousands of newborns each year. Until then, we and other providers will take care of the mothers and their babies as best we can.

Gail Bagwell is an advanced practice RN and clinical nurse specialist for perinatal outreach and Amy Thomas is an RN and NICU administrative clinical leader at Nationwide Children’s Hospital in Columbus, Ohio.

  • Wish all hospitals had this approach. My daughter in law just had twins and she was using heroin. The nurses at hospital were not helpful nor kind except maybe a couple of them. I feel nurses need more education . I’m a nurse but I dont work in maternity.

  • The media still refers to these poor innocent babies as “Drug Addicted.” The stigma will follow these children throughout their lives. The public has no way to evaluate whether these babies are getting the appropriate treatments. They have to rely on public relations pieces like this one. Going by the continuing ignorance, superstition, and misinformation, it is unlikely these guidelines are being followed everywhere. Hospitals are doing news releases, where they announce they are suddenly treating these babies appropriately. These Advertorials tend to describe these babies as Addicted, since it is much more engaging, than using the word Dependent. Advertising, Public Relations, and consumer engagement are much more important than facts or data. No Physicians spoke!

  • Hi… I know I am going to get nothing but negative replies here but still I need to say this… I am 30 week pregnant and took illegal drugs until I was 22 weeks pregnant I am not on a stable prescription.. I only found out I was pregnant at 22week as I was told I would never have kids so to me this is something very special.. I know I have put my unborn baby threw some serious risks and for that I will never forgive myself. At the moment I am doing everything i possibly can to reduce my prescription as quickly and safely as possible so when my baby is born I can hopefully be total free of my prescription or on a lower dosage. Reading this story is absolutely heart-breaking and what makes it harder is knowing in 12 weeks time I am going to be giving birth to a baby who is going to be dependant due to my own stupidity and as I stated previous for that I will never forgive myself I just hope I can be given the chance to help my child threw this cein I’m the one who has out him threw this in the first place.

    • sorry i just need to correct a few mistakes
      3rd line i wrote i am not on a stable prescription…. it was meant to say i am now on a stable prescription
      correction on last line… cein I’m the one who has put him threw this in the first place… not cein I’m the one who has out him threw this in the first place.

    • Do you need to stay on the prescription until you give birth or is there any way that if you stop taking any prescription now that your baby won’t be dependent and go through withdrawal? I am just curious because I’m not sure how it works . Thinking of you!

  • No it doesnt affect them for life. Not every mother takes illegal drugs or cares more about getting high than their baby. Same people who want to punish these mom’s instead of helping them are the same losers drinking a half gallon of vodka and driving their kids around drunk. Hypocrites.

  • I am raising my little grandson, I got him at 11 days old. His mother abused drugs and liquor her whole pregnancy . She only went to the doctor 1 time. He had withdrawals until he was 6 months old. Hes almost 27 months now. He started acting like he was going through withdrawals again yesterday morning. It looked like withdrawals again or having mini seizures, he was tested at 3 months for seizures and it was negative. How is this possible after so long?

  • I believe they should arrested the mother for taking drugs when pregnant, as they haven’t given these poor babies a good start at life and it’s not there fault. Time to make it law,then they may just think twice. Jail time.

    • Thats very easy for you to say but until you have been in some of our shoes you really don’t know. I was that mother with a baby born addicted. I was in put in jail. My baby was taking from me and I lost my job, my home, my stability to be able to raise my baby my car, my animals,cell phone. Everything I had aquired for the baby due to people breaking in while I was in jail. Now I’m a felon and have no way of getting housing, a job that pays well enough to find a decent apartment that I could afford but I couldn’t get the apartment because I’m a felon. I didn’t wake up one day and say I want my baby addicted. I had a miracle child. I LOVE my baby so much. I prayed for that baby. I was in an extremely abusive relationship with an addict. My parents are dead i had no help. The friends that had a place I could stay wouldn’t let me stay and here I was finally gonna be a mom and my living situation was hell! It wasn’t even until the last few weeks that I even did drugs. I was already being accused. I wasn’t excepted anywhere and my husband was constantly having affairs with girls like him. I wanted his attention. I needed his attention. I thought if he did it to me he would love me and want me. And he would gst clean and we could be happy. It worked. He stayed by my side. Cried when he gave it to me and was attentive. And I thought for sure anyday he was going to going to see tbe light and stop but it only got worse from there. My baby was addicted to the drugs and I was addicted to the attention. Sounds horrible I know but it’s the truth. It’s the reality of this epidemic. It’s nobodies fault but my own and I only blame myself but going to jail and being away from my baby. My beautiful miracle baby didn’t make me think about not doing that again it put me right back in the same mindset that got me started. Now that my baby is still being raised by someone other me as I try to jump through hoops of DSS makes me wanna do drugs. It’s so hard to not have him. Going to drugsl classes when I was never an addict anyway. Being told when, where and how long I can see my baby 5 month old (2 hours a week) trying to find a job that will hire me. Being turned down for something I’m technically over qualified for because of my arrest. Then I have mental health and parenting classes and victim classes. And I have to do community service hours. I can’t even work a full time job and do those requirements and say for a home for us. It’s extremely overwhelming. There has to be a better way than jail. Jail isn’t the right fit and it’s definitely not a rehab that most need. It took an already bad situation and made it worse. Now I’m on food stamps and wic and Medicade and yet again my baby suffers the most. We belong together not separate. Jail doesn’t fix drug users. It creates a bigger be problem for all involved. My baby and I together should have been sent together to a place for any treatment they thought I needed. I have thought of suicide many times because no matter what I do it’s not enough for DSS. And according to my counciling center I’m a head of the game and a lot further along than most. I have passed 9 random drug test and I still my son 2 hours a week. JAIL IS NOT FOR ADDICTS!! ITS NOT FOR MOTHER’S WITH NEW BORNS. maybe for repeat offenders but not for addicts.

    • I would say yes they need to get punished, My grandchild was born 12th March 2018 and he is in hospital with the same problems, I thinks they should put these kids in a safety environment until the mother is tested clear for drugs. a baby should not to be put in her care as she is still taking drugs and how are they going to look after this child if they are in that state of mind. No use baby is going through this pain and then when it goes home it still among s the drug use. I am very sad for this baby. Help have to come to these little ones, my heart is breaking for this child, for me this child will only be a burden to them, will they be able to take fully charge of this child.

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