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Babies exposed to opioids in the womb may react differently to pain after birth

Researchers suggest they could experience a wide range of withdrawal symptoms

Photo (c) MajaMarjanovic - Getty Images
The opioid epidemic continues to affect consumers of all ages, and now researchers from Penn State are exploring how expectant mothers using these drugs could be affecting their unborn babies.

The researchers learned that babies who were exposed to opioids in the womb are much more sensitive to pain in the days immediately following birth. They say affected children typically require extra care and attention.

“These babies are responding to pain differently than babies who were not exposed, so maybe we should be paying attention to pain management earlier,” said researcher Dr. Christiana Oji-Mmuo. “If we have to do a painful procedure like a heel lance, we may have to provide extra comforting measures, both during the procedure and after if they continue to be stressed.”

Focusing on pain management

To see how opioid exposure affected newborns’ pain tolerance after birth, the researchers had 22 newborns with prenatal opioid exposure and 15 newborns without opioid exposure participate in the study.

“We wanted to see if two different tests -- skin conductance measures and facial reactions to pain -- would correlate and predict withdrawal in newborns, because we really need accurate ways to assess these babies,” Dr. Oji-Mmuo said.

The skin conductance test was used to determine the skin’s response to pain or stress. A second test involved researchers video recording babies during a routine heel stick blood test to assess for physical signs of pain or distress.

The effects of prenatal opioid exposure were evident to the researchers, as the babies who were exposed not only had stronger physical reactions to pain but also had issues calming down after the procedure was over and they were tucked safely in their bassinets.

“Even after the painful procedure was over, they continued to have higher skin conductance,” Dr. Oji-Mmuo said. “Even when the procedure was done and they’d been swaddled, they continued to have these higher measures compared to the babies who hadn’t been exposed to opioids.”

According to Dr. Oji-Mmuo, the majority of babies who are exposed to opioids in the womb are born with a condition known as neonatal abstinence syndrome (NAS), which can cause irritability, seizures, fever, trouble eating, sweating, and more.

The key is to “recognize babies who are going through withdrawal very early,” said Dr. Oji-Mmuo, who hopes that better tools for identifying babies with NAS will be developed so doctors can better treat newborns who are born with the condition.

Keeping children safe

Though this study focuses on newborns, the youngest demographic is at a serious risk of being affected by opioids, as one recent study has found that opioid poisonings among youth have nearly tripled in the last 20 years.

Despite this and countless other risks, many parents are still in favor of doctors prescribing their kids opioids for pain relief.

The researchers urge parents that opioids are never the only option for kids, and they should consult with their doctor about what the best course of treatment is in each individual case.

“Opioids may not always be the best option. It really depends on the type of surgery and how long they are required,” said Dr. Linda J. Mason. “It is, however, important for parents to know that there are many alternatives available that are as -- or more -- safe and effective for pain management. But only about a third of parents whose children were prescribed opioids even asked their doctor about pain management alternatives.”

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