Do Hospitals in Kentucky Drug Test Newborns?

Do Hospitals in Kentucky Drug Test Newborns? header image

Kentucky is one of only four states that conduct drug testing for both the mother and the baby if a healthcare provider suspects drug use because it’s considered child abuse when a baby is born with drugs in their system in Kentucky. This HB1 law took effect in Kentucky in July 2018.

In the state, 1.5 out of every 100 babies are born withdrawing from drugs (medically called neonatal abstinence syndrome).

What is required for a hospital to order a drug test for a newborn in Kentucky?

The ANGELS Neonatal Guidelines for conducting a drug test on a newborn or pregnant mother include: 

  1. History of maternal drug use or agitated/altered mental status in the mother
  2. No prenatal care
  3. Unexplained separation of the uterus and placenta before childbirth (placental abruption)
  4. Unexplained complications in the newborn’s central nervous system (e.g. seizures, brain hemorrhages)
  5. Symptoms of drug withdrawal in the newborn (abnormal rapid breathing, tightened muscles, excessive stooling)
  6. Changes in the behavioral state of the newborn (jittery, fussy, lethargic)

What happens if a baby tests positive for drugs in their system in Kentucky?

Because it is ruled as child abuse, mothers who birth babies addicted to drugs are given two options – get professional addiction treatment within 90 days of the baby’s birth or have their parental rights taken away. When parental rights are removed, it does not automatically result in the removal of the baby from the mother’s custody. The issue goes to family court.

What is Neonatal Abstinence Syndrome (NAS)?

NAS is a group of conditions caused when a baby withdraws from drugs due to exposure in the womb. The symptoms are similar to adult withdrawal symptoms, but with serious potential for life long issues.

What are the symptoms of Neonatal Abstinence Syndrome?

  • Tremors
  • Seizures
  • Twitching
  • Tight muscle tone (hypertonicity)
  • Abnormally rapid breathing (tachypnea)
  • Fever
  • Sweating
  • Problems sleeping
  • Excessive yawning
  • Poor feeding or sucking
  • Diarrhea
  • Vomiting
  • Sneezing
  • Stuffy nose

The symptoms that a newborn with NAS experiences depend on the type of drug(s) that the mother was abusing and their gestational age at birth. 

What are the long-term consequences of Neonatal Abstinence Syndrome (NAS)?

Some babies go on to live full, healthy lives free of health complications despite having NAS at birth. Many other babies experience chronic issues associated with this condition, such as:

  • Increased risk for sudden infant death syndrome (SIDS)
  • Developmental delays
  • Motor problems related to the bones and muscles and the function of them
  • Behavioral problems
  • Learning problems
  • Complications with vision
  • Regular ear infections
  • Problems sleeping

It is often misconstrued just how serious neonatal abstinence syndrome is both in the moment and over time.

How are drug tests conducted on newborns?

To test a newborn baby suspected of having NAS, their meconium or urine is tested to determine what type or combination of substances are in their system. A simple urine test is usually also given to the mother. If test results come back positive, treatment begins to keep the newborn as comfortable as possible during withdrawal.

What if I’m pregnant and I need help with addiction?

Get help! You and your baby are so much better off in treatment – even if you already used drugs while pregnant. Detoxing cold turkey could put you and your baby at risk and Suboxone can be an option even while pregnant.

JourneyPure has an alcohol and drug rehab in Bowling Green, Kentucky medically equipped to treat most pregnant women across the state. We’re also partnered with a sober living called Baby Steps that could be a great option to stay sober in tough first months of motherhood. (However, Baby Steps is across the border in Tennessee).


March of Dimes: “Neonatal Abstinence Syndrome.”
Lexington Herald-Leader: ” Tide of opioid-dependent newborns forces doctors at UK, other hospitals to rethink treatment.”
National Institute on Drug Abuse: “Dramatic Increases in Maternal Opioid Use and Neonatal Abstinence Syndrome.”
Internationals Journal of Pediatrics: “Drug Testing for Newborn Exposure to Illicit Substances in Pregnancy: Pitfalls and Pearls.” “New law makes it easier for state to take babies exposed to drugs by their mothers.”


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    1. Hi, Jessica. When a baby tests positive for marijuana, it is at the doctor’s discretion whether to report the case to child protective services. If reported, CPS could then launch their own investigation to see if there is further abuse or neglect taking place. However, the positive marijuana test itself is not enough evidence to prove a child is being abused or neglected.

  1. I wonder if drugs are found in the cord screen, will the baby be removed?

    1. Great question, Joan! Doctors can use tissue from the child’s umbilical cord to determine whether they have been exposed to substances. They can also use the baby’s urine, blood, meconium or hair samples. Most of the time, doctors will use the baby’s urine because collecting it is non-invasive and yields the quickest results. From there, the Kentucky Cabinet for Health and Family Services would be in charge of investigating and if necessary, taking action to remove the baby from the custody of the mother.

    2. Hi Joan! It looks like Dr. Loyd focused on the medical wording in your question. Here is something you might find helpful. In Kentucky, a positive cord screen alone does not warrant the removal of the baby from the mother. If drugs are found in the baby’s cord screen, the physician would report those results to Child Protective Services. CPS will then investigate to see if the mother is neglectful and unfit to be a parent. The positive cord screen, without further evidence of neglect, is not enough to justify taking the baby away from the mother.

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