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Updated Guidelines for Treating Babies Exposed to Drugs in the Womb

The question of how best to help babies who have been exposed to drugs in the womb — including prescription pain medications, antidepressants and illicit drugs like methamphetamine and cocaine — can be an emotionally charged issue. Bringing science to bear on the issue, the American Academy of Pediatrics has just updated its guidelines on treating these infants.

The number of babies experiencing drug-related symptoms after birth has risen by 45% since 1995, according to data compiled by the Agency for Healthcare Research and Quality. The rise may be attributed in part to increased maternal drug misuse and addiction, as well as to greater legitimate use of medication to treat pain and depression. Further, more careful surveillance for symptoms associated with maternal drug use have turned up more affected babies.

About 1% of pregnant women report recreational use of opioid painkillers like Oxycontin, according to the National Household Survey on Drug Use and Health, a number that has stayed constant since 2003. The new treatment guidelines, appearing on Monday in the journal Pediatrics, recommend that pregnant women addicted to prescription pain relievers or heroin should be maintained on either methadone or buprenorphine (Suboxone, Subutex). These recommendations are in line with prior consensus documents from the National Institutes on Health and World Health Organization.

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