Substance Exposed Newborns: Sign, Symptoms, and Best Practices for Mother and Baby

Substance Exposed Newborns: Sign, Symptoms, and Best Practices for Mother and Baby

Substance Exposed Newborns: Sign, Symptoms, and Best Practices for Mother and Baby

Substance Exposed Newborns are infants affected by prenatal exposure to substances such as prescribed medications, alcohol, illicit drugs and tobacco.

Signs and Symptoms

Signs and symptoms of substance exposed newborns may vary depending on the type of substance used by the mother, the last time it was used, and whether the baby is full-term or premature. Symptoms of withdrawal may begin as early as 24 to 48 hours after birth, or as late as five to ten days.


  • Fetal Alcohol Syndrome
  • Physical defects
  • Heart problems
  • Intellectual disability


medication prescribed for attention deficit hyperactive disorder, methamphetamine

  • Decreased arousal
  • Heart problems
  • Brain abnormalities


  • Irritability
  • Psychomotor agitation
  • Increased respiratory rate
  • Difficulty feeding


  • Hyperactive reflexes
  • Jitteriness
  • Excessive sucking
  • Learning disabilities


  • Irritability
  • Poor feeding
  • Sleep difficulties
  • Learning disabilities


prescription pain medication, heroin

  • Body Shakes
  • Excessive crying
  • Overactive reflexes
  • Difficulty feeding and sucking


  • Irritability
  • Cognitive difficulties
  • Behavioral problems

Best Practices for Treating a Pregnant Mother

A mother without treatment may continue a cycle of using, going into withdrawal, and returning to use again. This cycle is detrimental to her unborn baby.

Prevention and treatment should promote and facilitate family, community and social support, as well as social inclusion, by fostering strong links with available childcare, economic supports, education, housing, and relevant services.

The standard of care for a pregnant mom with an opioid use disorder is medication assisted treatment. Untreated opioid use disorder during pregnancy increases the risk of fetal growth restriction, premature separation of the placenta from the uterus, preterm labor, and even fetal death. While treating the mom with medication assisted treatment may result in the infant experiencing Neonatal Abstinence Syndrome, a treatable drug withdrawal syndrome that occurs among substance-exposed newborns after birth, proper medication assisted treatment for the mother provides both mother and newborn the best chance for a healthy and safe recovery.

Best Practices for Treating a Substance Exposed Newborn


Breastfed infants with Neonatal Abstinence Syndrome tend to require less medication and spend fewer days in the hospital.


Snugly wrapping infants may also reduce their symptoms. Swaying and rocking the swaddled newborns can help calm their symptoms as well.

Reducing Stimuli

Keeping a newborn with Neonatal Abstinence Syndrome in a dimly lit room with little activity and noise may reduce the discomfort of the withdrawal symptoms.


Keeping infants born with Neonatal Abstinence Syndrome in the room with their mothers rather than transferring them to the Neonatal Intensive Care Unit (NICU) may reduce the severity of withdrawal symptoms and hospital length of stay.