Neonatal abstinence syndrome (NAS)

Cardinal POINTS

  • NAS is a group of conditions caused when a infant withdraws from certain drugs (most oft opioids) he's exposed to in the womb earlier nascence.

  • Well-nigh babies with NAS get treatment in the hospital after birth. Most babies who get treatment go meliorate in a few days or weeks.

  • During treatment, your infant may exist fussy and hard to soothe. Peel-to-skin care, swaddling, being gentle and breastfeeding can help at-home your baby.

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

  • If you're pregnant and taking opioids, tell your provider right away. Don't finish taking the opioid without talking to your provider first.

What is neonatal abstinence syndrome?

Neonatal abstinence syndrome (likewise called NAS) is a group of weather condition caused when a baby withdraws from sure drugs he's exposed to in the womb earlier birth. NAS is most ofttimes acquired when a woman takes drugs called opioids during pregnancy. But it also can be caused past antidepressants (used to treat depression), barbiturates or benzodiazepines (sleeping pills). When you lot take these drugs during pregnancy, they can laissez passer through the placenta and cause serious bug for your baby. The placenta grows in your uterus (womb) and supplies your babe with food and oxygen through the umbilical cord.

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

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

The street drug heroin as well is an opioid.

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

If you're pregnant or trying to go meaning and taking whatsoever of these drugs, tell your wellness care provider correct away.

What are signs of NAS?

Signs of a condition are things someone else can meet or know about you, like yous have a rash or you're coughing. Signs of NAS tin can be different for every babe. Nearly happen within 3 days (72 hours) of birth, simply some may happen correct later on nativity or not until a few weeks afterwards nascence. They tin last from one calendar week to half-dozen months afterward birth.

If your baby has signs of NAS, call her provider correct abroad. 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 proceeds
  • Breathing problems, including animate actually fast
  • Fever, sweating or blotchy pare
  • Trouble sleeping and lots of yawning
  • Diarrhea or throwing upwardly
  • Stuffy nose or sneezing

Signs of NAS depend on:

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

What complications can NAS crusade for your babe?

Babies with NAS may have wellness weather that need treatment in the newborn intensive care unit of measurement (as well called NICU) after birth. The NICU is the nursery in a infirmary where sick newborns get medical care. In addition to having withdrawal signs, babies with NAS are at increased take chances of:

  • Low birthweight. This means your baby is born weighing less than 5 pounds, 8 ounces.
  • Jaundice. This is when your baby's skin and eyes look xanthous. It's caused when your baby'southward liver isn't fully developed or working.
  • Seizures
  • Sudden infant death syndrome (also chosen SIDS). This is the unexplained death of a baby younger than 1 year quondam. SIDS usually happens when a baby is sleeping.

We don't know a lot virtually long-term effects of NAS on a baby. We need more research to see how NAS affects a kid in the get-go few years of life and longer. We think that NAS may cause long-term issues for your babe, like:

  • Developmental delays. Developmental delays are when your kid doesn't reach developmental milestones when expected. Developmental milestones are skills and activities that most children can do at a sure age, like sitting, walking, talking, having social skills and having thinking skills.
  • Motor problems. These are problems with your infant's bones, muscles and movement.
  • Behavior and learning problems. Babies with NAS are more likely than babies who don't have NAS to be checked for learning bug and to go special didactics services in school.
  • Speech communication and linguistic communication problems
  • Sleep problems
  • Ear infections
  • Vision problems

How is your babe tested for NAS?

Your infant's provider can use these tests to see if your baby has NAS:

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

Your baby's provider also needs to know most what drugs or medicine you've used and when you final took them. You may get a urine test.

How is NAS treated?

Your infant's treatment may include:

  • Taking medicines to treat or manage astringent withdrawal symptoms. Once withdrawal is nether control, your babe gets smaller doses of the medicine over time so her body can adjust to being off the medicine. Medicines used to care for severe withdrawal include morphine, methadone and buprenorphine.
  • Getting fluids through a needle into a vein (also called intravenous or Iv) to prevent your baby from getting dehydrated. Dehydrated means non having enough water in the body. Babies with NAS tin can get dehydrated from having diarrhea or throwing up a lot.
  • Being fed higher-calorie baby formula. Some babies with NAS need actress calories to help them grow because they have problem feeding or deadening growth.

Most babies with NAS who get treatment get amend in 5 to thirty days.

During handling, your baby may be fussy and hard to soothe. Doing these things tin help calm your baby:

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

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

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

After your baby is home, have her to all of her follow-up and well-infant checkups, even if she's doing well. Your provider checks your baby at these visits for problems that may be linked to NAS, like:
•    Developmental delays and bug with motor and learning skills and beliefs
•    Issues with diet and growth
•    Problems with hearing and vision
•    Bug at habitation, including using harmful substances. This can include misusing prescription drugs and using illegal drugs.

If your baby has developmental delays, talk to her provider about early intervention services. These services tin can help children from nativity through iii years old learn important skills. Services include therapy to help a child talk, walk, learn self-help skills and interact with others. Getting services as early as possible can assist ameliorate your child'southward development. 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 state or territory.  What can you do to aid prevent NAS in your baby?

Here's what you lot tin practice:

  • If you're pregnant and you use any of the drugs that tin crusade NAS, tell your provider right abroad, but don't stop taking the drug without getting treatment from your provider start. Quitting all of a sudden (sometimes called common cold turkey) tin cause severe problems for your baby, including expiry. If you need assistance to quit using these drugs, talk to your provider about treatment. Getting treatment tin can help y'all finish using drugs and is safer for your babe than getting no treatment at all.
  • If you're pregnant and can't terminate using opioids without problems, ask your provider virtually medication-assisted treatment (also chosen MAT). NAS in babies may be easier to treat for babies whose moms get MAT during pregnancy. Medicines used in MAT include methadone and buprenorphine.
  • If you're pregnant and you go to a provider who prescribes medicine to treat a wellness condition, brand sure that provider knows you lot're meaning. You may demand to stop taking certain medicines or change to medicine that'due south safer for your baby. Ask all your wellness care providers if the medicine y'all have—even prescription drugs—can cause NAS in your baby. Even if yous employ a prescription drug exactly as your provider tells you to, information technology may cause NAS in your infant.
  • If you're pregnant or thinking nigh getting pregnant, tell your provider about whatever drugs or medicine you take. Your provider can make sure that what y'all're taking is safe for you and your baby. She also can help you become treatment for using street drugs or abusing prescription drugs if you need information technology. If you abuse prescription drugs, it means you take more than than has been prescribed for you, you take someone else's prescription drug, or you get the drug from someone without a prescription.
  • If you lot're not meaning and you lot use any drug that can cause NAS: Utilize birth control until you're fix to go significant. Birth command (too called contraception or family planning) helps keep you from getting pregnant. Examples include intrauterine devices (also called IUDs), implants, the pill and condoms.

More than information

  • Mother to Baby
  • Substance Abuse Treatment Facility Locator

Come across also: Preventing NAS in your baby infographic, Caring for a infant with NAS infographic, Prescription opioids during pregnancy, Prescription medicine during pregnancy

Terminal reviewed: June, 2019