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Neonatal abstinence syndrome — MRCPCH FOP MCQ

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ModerateNeonatologyNeonatal abstinence syndromeMRCPCH FOP

A 2-day-old term baby is irritable with high-pitched cry, tremor, loose stools and poor sleep. Mother received opioid substitution treatment during pregnancy and the baby has normal temperature and glucose. What is the most likely diagnosis?

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Correct answer: B — Neonatal abstinence syndrome

Irritability, tremor, gastrointestinal symptoms and maternal opioid exposure are consistent with neonatal abstinence syndrome. Sepsis remains an important differential but normal temperature, glucose and the exposure history make withdrawal most likely. Benign sleep myoclonus occurs during sleep without autonomic or feeding symptoms. The pearl is that supportive care and careful scoring are central before pharmacological treatment.

Reference: NICE CKS Drug misuse in pregnancy; BNFc neonatal withdrawal