opioids

AAP Releases Neonatal Opioid Exposure Guidelines

The American Academy of Pediatrics has released new guidelines on caring for infants with opioid exposure and neonatal opioid withdrawal syndrome.

Among the recommendations:

  • All pregnant women should have access to medications for opioid use disorder.
  • Pregnant women with opioid use disorder should be offered antenatal counseling on the clinical signs of withdrawal and postnatal treatment.
  • When testing infants, multiple modalities, including urine, meconium, and umbilical cord tissue testing, should be considered.
  • Infants with chronic opioid exposure should be observed for at least 72 hours for the development of withdrawal.
  • Nonpharmacologic interventions should be considered the foundation of care for all infants with opioid exposure.
  • Breastfeeding should be discouraged in women with active substance use or relapses within the last 30 days.

“The opioid crisis has had a profound effect on pregnant women and their infants. Despite improvements in the identification, assessment, and treatment of neonatal opioid withdrawal syndrome, substantial knowledge gaps remain. Pediatricians are well positioned to improve outcomes for the mother-infant dyad through evidence-based practice and connection of families to public resources,” they wrote.

—Michael Potts

Reference:

Patrick SW, Barfield WD, Poindexter BB, et al; Committee On Fetus And Newborn, Committee On Substance Use And Prevention. Neonatal opioid withdrawal syndrome. Published online October 26, 2020. Pediatrics. DOI: https://doi.org/10.1542/peds.2020-029074