The use of kratom during pregnancy can cause withdrawal symptoms in newborns

Although the kratom herbal supplement is still legal and widely available, its effects similar to those of opioids have caused significant withdrawal symptoms in at least two newborns in the United States and this should cause concern, according to researchers.

A case study of a small boy exposed to kratom during his mother's pregnancy – only the second reported American case – likely indicates a broader tendency of pregnant women to seek alternatives to opioid analgesics such as morphine, heroin and oxycodone (OxyContin)said the author of the study, Dr. Whitney Eldridge.

"I think mothers are becoming more aware of the dangers associated with the use of prescription and nonprescription opioids during pregnancy," said Eldridge, neonatologist at Morton Plant Hospital and at St. Joseph Women's Hospital, Florida.

"Since opioid use in pregnant women has increased, I fear that they see kratom as a potentially safe, legal and non-opioid alternative to removal of opioids, as its opioid-like properties are not well advertised, "added Eldridge.

In February, the US Food and Drug Administration ranked compounds in kratom as opioids, based on a computer analysis showing that it activates receptors in the brain that also respond to opioids.

But the controversy surrounding kratom – which is sold as a dietary supplement, usually to manage pain and stimulate energy – remains, as it continues to be sold as a non-opioid cure for opioid withdrawal. Experts have stated that non-opioid alternatives to treat opioid addiction continue to be researched and analyzed.

The case study, published online November 7 in the journal pediatrics, focused on a newborn boy whose mother had been taking oxycodone for seven years, but who had successfully completed drug rehabilitation. She had used oxycodone for the last time two years before the birth of her baby and her urine test was negative for drug use.

Kratom – which grows naturally in Southeast Asian countries (Indonesia, Malaysia, Papua New Guinea and Thailand) – is less potent than morphine and does not slow down breathing. But 33 hours after birth, the baby in this case study began to show symptoms consistent with opioid withdrawal, including sneezing, nervousness, excessive sucking, skin irritation around the face, and # 39; irritability.

Her mother denied using prescription medications, supplements or illegal drugs during her pregnancy, but the baby's father stated that her mother drank kratom tea daily during her pregnancy. She had bought tea for sleep and her own symptoms of opioid withdrawal.

Treated with morphine and a medicine for hypertension during the following days, his condition improved and he left the hospital at the age of 8 days.

"Before this case, I did not know about kratom and I did not know that it could be a source of weaning for [newborn babies]Eldridge said, "After caring for this baby, I started to pay attention to the advertising done for kratom and we realized that pediatricians and obstetricians need to be informed that it can affect our patients. "

Further research is needed to "make an informed decision on how to classify kratom," she suggested.

"There may be a role to play in opioid addiction, [but] Currently, there is too little data to say what role it should play, "added Eldridge. Meanwhile, pregnant women should disclose to their doctors the use of kratom as they would for alcohol or tobacco, and doctors have the responsibility to inform pregnant women of the potential impact kratom on their newborn baby ".

Dr. Martin Chavez, chief of maternal and fetal medicine at NYU Winthrop Hospital in Mineola, New York, echoed Eldridge's sentiments.

"I think what strikes the most in this case study … is that we really need to do a thorough job looking for what kind of alternative drug – whether it's over-the-counter, holistic or something that's provided by a family member – a pregnant woman, a woman can take, "said Chavez.

"The most important thing is that not being prescribed does not mean that it does not have any potential impact. [on the baby], "he added." When in doubt, when you are pregnant or have a newborn, be totally open with your clinician, not just about prescription drugs, but any other type of medication you may be taking to relieve symptoms that you feel. "