Related Experiment Video

Updated: May 2, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
19:15

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

90.5K

How long should infants at risk of drug withdrawal be monitored after birth?

Cameron L Smirk1, Ellen Bowman, Lex W Doyle

  • 1Newborn Services, Parkville, Victoria, Australia.

Journal of Paediatrics and Child Health
|March 18, 2014
PubMed

Insights

Neonatal abstinence syndrome (NAS) often requires early admission by day 5. Shortening the post-natal observation period to 5 days may optimize hospital resources for at-risk infants.

Area of Science:

  • Neonatalogy
  • Pharmacology
  • Public Health

Background:

  • Neonatal Abstinence Syndrome (NAS) is a growing concern with significant financial and social impacts.
  • Current guidelines recommend 4-7 days of post-natal monitoring for infants at risk of NAS.
  • Prompt treatment is crucial upon symptom development.

Purpose of the Study:

  • To determine the optimal post-natal observation duration for infants at risk of NAS.
  • To evaluate the current 7-day observation period against clinical admission data.

Main Methods:

  • Retrospective review of infants (≥35 weeks gestation) treated for NAS between 2001-2010.
  • Data collected included drug exposure, admission day, and treatment day.
  • Analysis focused on admission timing relative to the standard 7-day observation period.

Main Results:

  • 210 infants were included, predominantly exposed to opiates (99%).
  • 58% of infants had exposure to multiple substances.
  • 95% of infants were admitted by day 5; 98.5% of those treated by day 7 were admitted by day 5.
  • Polydrug exposure led to earlier admission but not significantly different treatment times.

Conclusions:

  • Infants treated for NAS in this cohort were frequently admitted before day 5.
  • A shortened routine post-natal observation period of 5 days is suggested to improve hospital resource allocation.
  • Further research is needed to identify neonates requiring extended observation.
Abstract

Keywords:
drug withdrawalmonitoringneonatal abstinence syndrometreatment

More Related Videos

Application of an Amplitude-integrated EEG Monitor Cerebral Function Monitor to Neonates05:58

Application of an Amplitude-integrated EEG Monitor Cerebral Function Monitor to Neonates

Published on: September 6, 2017

41.6K
A Common Marmoset Model of Mother-Infant Intervention for Breastfeeding Disorders in the Presence of Paternal Inhibition and Maternal Neglect05:04

A Common Marmoset Model of Mother-Infant Intervention for Breastfeeding Disorders in the Presence of Paternal Inhibition and Maternal Neglect

Published on: September 22, 2023

1.3K

Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
408
Factors Affecting Drug Response: Overview01:21

Factors Affecting Drug Response: Overview

When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
3.1K
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
1.0K
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions01:24

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
423
Therapeutic Drug Monitoring: Affecting Factors01:29

Therapeutic Drug Monitoring: Affecting Factors

Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
429
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
410