Why Neonatal Drug Testing is Essential for Infant Health

When I check my blood pressure on my own at my local Meijer or CVS, it’s more than fine. However, I have white coat syndrome, which means that nearly every time I have my blood pressure checked at the doctor’s office, it’s unreasonably high.

But you know what that doesn’t mean? It doesn’t mean that the doctor’s office just skips checking my blood pressure because it could lead me to anxiety, misdiagnosis, or other negative consequences.

Then why, oh why, do we not test for drugs at birth in neonates? Sure, it could lead to anxiety for the parents. It could even lead to a misdiagnosis, but these days, that’s unlikely. And could there be other negative consequences? More negative than not diagnosing babies with fetal disorders? Unlikely.

I know that the messaging is that testing neonates at birth means that any that are positive will require referrals into child protective services (CPS), but that’s absolutely untrue. A positive test result doesn’t automatically lead to a CPS referral. Should it? I’m not here to debate that. What I do know, though, is that if our healthcare system treated addiction as the disease it says it is, we would be helping many more people affected by it, including moms with newborns and the newborns themselves.

The Child Abuse Prevention and Treatment Act (CAPTA) is far too often used to both criminalize moms and ignore concerns, since, on the rare occasions when a neonate is tested and that test is positive, the results are then used as a mandate to report to CPS. But that’s NOT what CAPTA requires. Of course, CAPTA also doesn’t require testing at all, so that’s how our healthcare systems ignore it all together. They just don’t test babies…problem solved.

So that baby could really have “high blood pressure,” but no one bothers to check. No harm. No foul. Except for the baby, of course.

I’ve long advocated for universal umbilical cord drug testing of all neonates. There’s absolutely no harm in testing…just as there’s no harm in my having my blood pressure checked at the doctor’s office. And testing can make a huge difference down the road…just like my BP checks.

Though Congress could have used language about “positive test” in CAPTA, they didn’t. Rather, CAPTA talks about neonates that are “affected” or have “withdrawal symptoms” (pregnancy). It also talks about “FASD,” which is why neonate testing is so vital! FASDs are hardly ever going to be diagnosed at birth. We know that only 10% of the approximately 5% of the population born with an FASD have Fetal Alcohol Syndrome with the sentient facial features. And even then, they are unlikely to be recognized at birth.

But a baby born with alcohol in its system…or any drug for that matter…don’t we want to know that? We should! That would help provide appropriate care to developing babies and their families, and it would take the guesswork out of diagnoses later!

Healthcare is intended to enhance the health and well-being of individuals and communities, inspiring hope, promoting health, delivering the best healthcare options, helping people live healthier lives. Nowhere does it say we’re here to ignore potential problems. So why do we with neonates?

References

Click to access 2024-Prenatal-Drug-Exposure-CAPTA-Reporting-Requirements-for-Medical-Professionals.pdf

Click to access Understanding-CAPTA-and-State-Obligations_2020.pdf

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