TDM grand rounds: Neonatal nicotine withdrawal syndrome in an infant prenatally and postnatally exposed to heavy cigarette smoke

Federica Vagnarelli, Sergio Amarri, Giulia Scaravelli, Manuela Pellegrini, Oscar Garcia-Algar, Simona Pichini

Research output: Contribution to journalReview articleResearchpeer-review

10 Citations (Scopus)

Abstract

A heavy smoking, lactating mother delivered a baby that exhibited spontaneous tremors, fluctuations of muscular rigidity, and opisthotonus at 48 hours of life. Although the symptoms did not disappear within the following days, they could be controlled by swaddling or wrapping the baby in a blanket. The absence of any other etiology generated a suspicion of prenatal exposure to heavy tobacco smoke and potential neonatal nicotine withdrawal syndrome. This diagnosis was supported by extremely high concentration of hair nicotine and cotinine in the infant's hair and in different segments of maternal hair. The presence of non-negligible amounts of nicotine and cotinine in breast milk confirmed that the mother did not quit smoking after delivery, despite her reports. The breast-fed newborn continued to have 3 to 4 crises of spontaneous tremors and alternant muscular rigidity per day for a month. More studies are needed to establish neonatal nicotine withdrawal. © 2006 Lippincott Williams & Wilkins, Inc.
Original languageEnglish
Pages (from-to)585-588
JournalTherapeutic Drug Monitoring
Volume28
Issue number5
DOIs
Publication statusPublished - 1 Oct 2006

Keywords

  • Breast milk
  • Cigarettesmoke
  • Hair
  • Neonatal withdrawal syndrome
  • Nicotine

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