In a newborn with respiratory depression due to maternal narcotics exposure (first-time user), which intervention is recommended?

• A. Administer Naloxone IV to newborn
• B. Observe and provide supportive care only
• C. Administer Narcan to the mother
• D. Intubate the newborn immediately without reversal therapy

Answer: (A)

When a newborn shows respiratory depression related to maternal opioid exposure, reversing the opioid effect in the infant is the priority. Naloxone is an opioid antagonist that rapidly displaces opioids from mu receptors, restoring respiratory drive and improving ventilation. Giving naloxone to the newborn directly addresses the reversible cause and can quickly reverse depression, reducing the risk of hypoxia. Observing and providing supportive care alone delays correction of a potentially life-threatening condition. Giving Narcan to the mother is not preferred because reversing the mother’s opioids can precipitate withdrawal and maternal instability, and it doesn’t reliably resolve the newborn’s immediate respiratory depression. Intubating the newborn right away without first reversing the opioid effect isn’t the first step; airway support is important, but reversal often restores breathing without invasive intervention. If needed, dosing can be titrated and repeated, with careful monitoring for re-sedation due to longer-acting opioids.