How Do Babies Born To Mothers With Addiction Fare Over Time?

By Kelly Burch 08/01/18

A study explored the long-term development of babies that were born with neonatal abstinence syndrome.

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Mother and daughter using digital tablet

Every 15 minutes, a baby is born dependent on opioids in the United States. The number of infants born with neonatal abstinence syndrome (NAS), which causes the babies to experience withdrawal-like symptoms, has risen sharply during the opioid crisis, but researchers say that parents of children who are exposed to drugs in utero have reason to be optimistic. 

"Most of these children do well, and they do within the normal range,” Dr. Stephanie Merhar, a neonatologist at Cincinnati Children's Hospital, told NPR.

Merhar led a study that examined the development of 87 two-year-olds who were born with NAS.

They found that about 3% of the children had a lazy eye, and some scored just below average for cognitive, language and development skills.

Overall, however, researchers found that opioids weren’t as harmful to a child’s development as other substances, including alcohol. 

"It's not like the fetal alcohol syndrome problem, where it really affects the brain," Merhar said. "[Children with fetal alcohol syndrome] are at high risk of mental retardation and there are significant developmental delays.”

This is reassuring for parents of opioid-exposed infants, especially since mothers using medication-assisted treatment like methadone are generally encouraged to continue the treatment even once they know they are pregnant. 

However, Dr. Jonathan Davis, chief of newborn medicine at Floating Hospital for Children at Tufts Medical Center and chair of a Neonatal Advisory Committee for the U.S. Food and Drug Administration (FDA), says that more research is needed into the long-term prognosis for babies exposed to opioids in utero. He would like to see a national registry of babies born dependent on opioids so that researchers can track their long-term outcomes. 

"How are these children going to function when they get to school?" said Davis. "How are these children going to speak, socialize and interact?”

One of the most important indications for a child’s outcome can be whether their mother gets treatment for her opioid use, said Dr. Lauren Jansson, director of pediatrics center for addiction and pregnancy at Johns Hopkins Medicine in Baltimore. 

"The one solid thing we can say about children who are exposed to substances prenatally is that their mothers need treatment," said Jansson.

Amanda Williammee is one of those mothers, and she has been lucky enough to connect with a North Carolina program that allows her two-year-old daughter to be in daycare while she gets treatment and counseling. Hendrée Jones is executive director of the program, called Horizons. 

Jones said that many of the mothers in the program have a history of trauma and unhealthy family structures in addition to their substance abuse. That can make it nearly impossible for them to know how to parent. 

"There's often times an unrealistic expectation by society,” she said. "They're supposed to automatically know how 'be good mothers'—how to be nurturing mothers. That's like trying to teach somebody algebra when they've never even had addition.”

However, Jones recently led a three-year study of children exposed to opioids in utero, and said that these mothers have reason to be optimistic. 

"The children through time tended to score within the normal range of the tests that we had," Jones said.

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.

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