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weights/larger head circumference than heroin exposed babies.
While methadone exposed babies tend to have lower birth weights
than non-exposed babies, the birth weights are within the normal range
for newborns.

Exposure to any opioid in utero (heroin or methadone) increases the
rate of SIDS by 3-4 times that seen in the general population.
Methadone exposed neonates may have an increased platelet count
starting in the first or second month of life, which may persist for 6-10
months; no adverse outcomes have been described as a result of this.
Finally in utero methadone exposure may elevate the level of two
thyroid hormones (T3 and T4) during the first week of life. I have not
been able to find anything in the literature indicating that this elevation
is clinically problematic.

A number of studies have looked at the long-term effects of in utero
methadone exposure. The data indicate that there are no uniform long-
term effects of methadone maintenance treatment during pregnancy.
Infants exposed to methadone in utero have normal physical and
mental development as children. Environmental factors, family
characteristics and functioning play a significant role in a child’s
development. It should be noted that many opioid dependent patients
smoke cigarettes. Exposure to cigarettes in utero and after birth
increases the risks of SIDS (sudden infant death syndrome or crib
death), ADHD and learning disorders.

Methadone exposed babies may experience symptoms of methadone
withdrawal after birth. Symptoms may include: tremors, hyperactive
startle reflex, irritability, high-pitched cry, poor feeding, vomiting,
diarrhea, hyper-tonicity (stiff muscles), sneezing, sweating. Untreated
withdrawal may progress to seizures and death. This constellation of
symptoms in an opioid exposed baby is known as the Neonatal
Abstinence Syndrome (NAS).

According to some published literature, the frequency of NAS may be
as high as 60-80% of methadone-exposed babies. Two more recent
studies (2002 and 2005) found a NAS rate of 46%. NAS begins
within the first 14 days of life. It is usually treated with a morphine or