In this Q&A episode of our neonatal opioid withdrawal syndrome (NOWS) series, we address challenging and nuanced clinical questions surrounding withdrawal, toxicology testing, and newborn exposures. Our host, Paul Wirkus, MD, FAAP, and guest Camille Fung, MD, review the early signs of withdrawal and discuss the process of obtaining consent for neonatal toxicology screening, clarifying when testing is considered diagnostic and how results may have reporting implications. We also explore common clinical scenarios, including the impact of maternal fentanyl administered via epidural on newborn toxicology results, and how in utero SSRI exposure may present with symptoms such as apnea, posturing, or seizure-like activity. The conversation further examines the effects of prenatal THC exposure, addressing common misconceptions, potential neonatal impacts, and the persistence of THC in breastmilk. Throughout the discussion, the emphasis remains on careful clinical assessment, clear communication with families, and a nonjudgmental, evidence-based approach to care.Have a question? Email questions@vcurb.com.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP. Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
