Neonatal abstinence syndrome (NAS)

Central POINTS

  • NAS is a group of conditions acquired when a baby withdraws from certain drugs (most often opioids) he'due south exposed to in the womb before nativity.

  • Almost babies with NAS get treatment in the hospital afterwards nascency. Most babies who get treatment go ameliorate in a few days or weeks.

  • During treatment, your baby may be fussy and hard to soothe. Skin-to-skin care, swaddling, existence gentle and breastfeeding can help at-home your baby.

  • NAS may lead to long-term health and development problems, including hearing and vision problems and problems with learning and behavior.

  • If you're significant and taking opioids, tell your provider correct away. Don't stop taking the opioid without talking to your provider start.

What is neonatal abstinence syndrome?

Neonatal abstinence syndrome (besides chosen NAS) is a group of conditions caused when a baby withdraws from certain drugs he'southward exposed to in the womb before nascence. NAS is near frequently caused when a adult female takes drugs called opioids during pregnancy. But information technology also can be caused by antidepressants (used to treat depression), barbiturates or benzodiazepines (sleeping pills). When y'all take these drugs during pregnancy, they can laissez passer through the placenta and cause serious problems for your babe. The placenta grows in your uterus (womb) and supplies your baby with food and oxygen through the umbilical string.

If you've been injured or had surgery, your provider may requite you a prescription for opioids to help relieve hurting. Prescription opioids include:

  • Codeine
  • Hydrocodone (name brand Vicodin®)
  • Morphine (name brands Kadian®, Avinza®)
  • Oxycodone (name brands OxyContin®, Percocet®)
  • Tramadol

The street drug heroin besides is an opioid.

You may hear NAS besides called NOWS. NOWS stands for neonatal opioid withdrawal syndrome. NOWS is the same equally NAS except it'due south caused but by opioids.

If you're meaning or trying to get pregnant and taking whatever of these drugs, tell your wellness care provider right away.

What are signs of NAS?

Signs of a status are things someone else can see or know about yous, similar you accept a rash or you're coughing. Signs of NAS can exist different for every baby. Most happen within iii days (72 hours) of birth, but some may happen correct later on birth or non until a few weeks after birth. They can last from i week to half-dozen months after birth.

If your babe has signs of NAS, telephone call her provider right away. Signs may include:

  • Body shakes (tremors), seizures (convulsions), overactive reflexes (twitching) and tight muscle tone
  • Fussiness, excessive crying or having a high-pitched cry
  • Poor feeding or sucking or slow weight gain
  • Animate problems, including breathing really fast
  • Fever, sweating or blotchy skin
  • Trouble sleeping and lots of yawning
  • Diarrhea or throwing upwardly
  • Stuffy nose or sneezing

Signs of NAS depend on:

  • What drug y'all used during pregnancy, how much you used and how long you took it
  • How your ain body breaks down the drug
  • Your baby's gestational age at birth (number of weeks of pregnancy)

What complications can NAS crusade for your babe?

Babies with NAS may have wellness conditions that need treatment in the newborn intensive care unit (also called NICU) after birth. The NICU is the plant nursery in a hospital where sick newborns get medical care. In addition to having withdrawal signs, babies with NAS are at increased risk of:

  • Low birthweight. This means your baby is born weighing less than 5 pounds, 8 ounces.
  • Jaundice. This is when your baby's peel and eyes look yellow. It'due south caused when your baby'due south liver isn't fully developed or working.
  • Seizures
  • Sudden infant expiry syndrome (besides called SIDS). This is the unexplained death of a babe younger than 1 twelvemonth old. SIDS ordinarily happens when a infant is sleeping.

We don't know a lot almost long-term furnishings of NAS on a baby. We need more enquiry to come across how NAS affects a child in the get-go few years of life and longer. Nosotros recall that NAS may cause long-term bug for your babe, like:

  • Developmental delays. Developmental delays are when your child doesn't reach developmental milestones when expected. Developmental milestones are skills and activities that most children can do at a sure historic period, like sitting, walking, talking, having social skills and having thinking skills.
  • Motor problems. These are problems with your baby's basic, muscles and motility.
  • Behavior and learning problems. Babies with NAS are more probable than babies who don't have NAS to exist checked for learning problems and to become special education services in school.
  • Speech and linguistic communication problems
  • Slumber issues
  • Ear infections
  • Vision issues

How is your infant tested for NAS?

Your baby's provider tin use these tests to run into if your infant has NAS:

  • NAS scoring system. With this system, your infant's provider uses points to grade how severe your baby's withdrawal is. Your baby's provider uses the score to decide what kind of treatment your infant needs.
  • Urine and meconium tests to bank check for drugs. Meconium is your baby's offset bowel movement.

Your infant's provider also needs to know nearly what drugs or medicine yous've used and when you last took them. Yous may become a urine test.

How is NAS treated?

Your babe's treatment may include:

  • Taking medicines to treat or manage severe withdrawal symptoms. Once withdrawal is under control, your baby gets smaller doses of the medicine over fourth dimension so her body can adjust to existence off the medicine. Medicines used to treat severe withdrawal include morphine, methadone and buprenorphine.
  • Getting fluids through a needle into a vein (as well called intravenous or IV) to prevent your baby from getting dehydrated. Dehydrated means not having plenty h2o in the body. Babies with NAS can get dehydrated from having diarrhea or throwing up a lot.
  • Existence fed college-calorie infant formula. Some babies with NAS need extra calories to help them grow because they have trouble feeding or tedious growth.

Most babies with NAS who go handling become better in 5 to 30 days.

During treatment, your infant may be fussy and hard to soothe. Doing these things can help at-home your babe:

  • Room in with your baby. This means yous and your babe stay in the same room together at the hospital before you have your baby dwelling house.
  • Requite your baby skin-to-pare intendance (too chosen kangaroo care). This is when yous put your infant, dressed only in a diaper, on your bare chest.
  • Be gentle with your baby. Rock your baby gently. If she's sleeping, don't wake her up.
  • Swaddle your baby (wrap him snuggly) in a blanket.
  • Keep your baby'south room quiet and the lights dim.
  • Breastfeed your baby. Feed your baby on demand. This means you feed your baby when he's hungry.
  • Give your baby a pacifier.

Your baby's provider checks your baby often in the NICU after birth to make certain he's getting better and having fewer and less severe withdrawal signs. Your baby can go dwelling from the hospital when she:

  • Is feeding well
  • Is sleeping well
  • Is gaining weight
  • Has a good NAS score

After your infant is home, take her to all of her follow-upwardly and well-babe checkups, even if she'due south doing well. Your provider checks your baby at these visits for problems that may be linked to NAS, like:
•    Developmental delays and problems with motor and learning skills and behavior
•    Problems with nutrition and growth
•    Bug with hearing and vision
•    Bug at home, including using harmful substances. This tin include misusing prescription drugs and using illegal drugs.

If your infant has developmental delays, talk to her provider about early on intervention services. These services can help children from birth through 3 years quondam learn important skills. Services include therapy to assist a kid talk, walk, learn cocky-help skills and interact with others. Getting services every bit early as possible can help meliorate your child'due south evolution. The Centers for Disease Control and Prevention has information to help you get early intervention services for your child and how to find services in your land or territory.  What tin can you do to help forestall NAS in your baby?

Here'southward what you can do:

  • If you're meaning and you utilise any of the drugs that can cause NAS, tell your provider right abroad, only don't stop taking the drug without getting treatment from your provider get-go. Quitting suddenly (sometimes chosen cold turkey) can cause severe problems for your babe, including decease. If you need help to quit using these drugs, talk to your provider near treatment. Getting handling can help y'all stop using drugs and is safer for your baby than getting no treatment at all.
  • If you're meaning and can't stop using opioids without problems, enquire your provider about medication-assisted treatment (also called MAT). NAS in babies may exist easier to care for for babies whose moms get MAT during pregnancy. Medicines used in MAT include methadone and buprenorphine.
  • If y'all're meaning and yous become to a provider who prescribes medicine to treat a wellness condition, make sure that provider knows you're pregnant. You may need to stop taking certain medicines or change to medicine that's safer for your infant. Inquire all your health care providers if the medicine you take—even prescription drugs—tin cause NAS in your baby. Even if you use a prescription drug exactly equally your provider tells you to, it may cause NAS in your baby.
  • If you're pregnant or thinking well-nigh getting pregnant, tell your provider about any drugs or medicine you take. Your provider tin can make certain that what you're taking is safe for you lot and your infant. She likewise tin can help you get handling for using street drugs or abusing prescription drugs if you need it. If you abuse prescription drugs, information technology means you take more than than has been prescribed for you, you take someone else's prescription drug, or you become the drug from someone without a prescription.
  • If you're non meaning and you lot use any drug that can cause NAS: Use birth control until yous're set up to go meaning. Birth control (also called contraception or family planning) helps continue y'all from getting pregnant. Examples include intrauterine devices (also called IUDs), implants, the pill and condoms.

More information

  • Mother to Babe
  • Substance Abuse Treatment Facility Locator

Meet also: Preventing NAS in your babe infographic, Caring for a infant with NAS infographic, Prescription opioids during pregnancy, Prescription medicine during pregnancy

Last reviewed: June, 2019