The umbilical cord is a vital part of pregnancy. Supplying the unborn fetus with oxygenated, nutrient rich blood from the placenta, the cord is physiologically and genetically part of the fetus. It may be even useful even after the baby is born, providing clues for identifying which babies are born addicted to drugs.

When a baby is delivered, a section of the umbilical cord can now be snipped off and sent to ARUP laboratories to be analyzed for drugs and drug metabolites. ARUP was the second lab in the country to begin offering cord testing (since August 2012), which has logistical advantages to the traditional testing method for newborns and drug exposure. Meconium, another name for an infant’s first stool, used to be the preferred method of determining the presence of drugs in an infant’s system. Waiting for the stool to pass wastes valuable time, however, and the umbilical cord can be snipped and sent to the lab immediately following the birth.

Quickly identifying which infants have been exposed to drugs (and which drugs they’ve been exposed to) is vital because neonatal specialists must know what they’re dealing with before treating symptoms for withdrawal. If there is a medical reason or suspicion to believe the mother is at high risk for drug use, the delivery team may choose to send the umbilical cord for testing, which can take up to 72 hours. It varies by hospital, but generally, testing the baby for drugs doesn't require a mother's consent.

“Sometimes babies are already in the throes of withdrawal symptoms but physicians can’t determine what drugs they are dealing with until test results are available,” said Dr. Gwen McMillin, medical director of ARUP's Clinical Toxicology Laboratories, in a press release.

Like any addict who suddenly ceases their drug intake, babies have severe physiological withdrawal symptoms. Newborns born with a drug addiction suffer from neonatal abstinence syndrome, and may have symptoms like diarrhea, seizures, sensitivity to light, and hyperactive reflexes. Some babies, depending on the drug their mother was addicted to, will carry the consequences for life, experiencing brain damage and learning disabilities. The most common drug ARUP identifies is marijuana, followed by opioids, such as heroin and prescription painkillers. Sometimes, there is a mix of illicit and prescription drugs found in an infant’s system.

“The symptoms of neonatal abstinence syndrome depend on the type of drug the mother used, how long it takes for the body to metabolize and eliminate the drug, how much of the drug she was taking and for how long,” explains McMillin, who also adds that being born premature can be another variable in determining symptoms.

The American Medical Association estimates that in the U.S., one infant suffering from neonatal abstinence syndrome was born every hour in 2009.

“The work we’re doing here is about the human condition; it is about the safety of children — as the risk of child abuse and neglect increases in cases of maternal drug abuse,” McMillin said. “This is also about getting mothers the care and support they need through rehab and social services so they can take care of their children.”