Neonatal abstinence syndrome (NAS)

KEY POINTS

  • NAS is a group of weather condition caused when a baby withdraws from sure drugs (most often opioids) he's exposed to in the womb before nascence.

  • Well-nigh babies with NAS become handling in the hospital after nascence. Almost babies who get treatment get better in a few days or weeks.

  • During treatment, your babe may be fussy and hard to soothe. Skin-to-peel care, swaddling, being gentle and breastfeeding can aid calm your baby.

  • NAS may pb to long-term wellness and development problems, including hearing and vision issues and problems with learning and behavior.

  • If you're pregnant and taking opioids, tell your provider right abroad. Don't terminate taking the opioid without talking to your provider starting time.

What is neonatal abstinence syndrome?

Neonatal abstinence syndrome (also chosen NAS) is a grouping of conditions acquired when a babe withdraws from certain drugs he'southward exposed to in the womb before nativity. NAS is near frequently acquired when a woman takes drugs called opioids during pregnancy. Simply it also can be acquired by antidepressants (used to treat depression), barbiturates or benzodiazepines (sleeping pills). When you have these drugs during pregnancy, they can pass through the placenta and cause serious problems for your baby. The placenta grows in your uterus (womb) and supplies your baby with food and oxygen through the umbilical cord.

If you lot've been injured or had surgery, your provider may give y'all a prescription for opioids to help salvage pain. Prescription opioids include:

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

The street drug heroin also is an opioid.

You lot may hear NAS too called NOWS. NOWS stands for neonatal opioid withdrawal syndrome. NOWS is the same as NAS except it'south caused only by opioids.

If yous're meaning or trying to get meaning and taking whatsoever of these drugs, tell your health care provider correct away.

What are signs of NAS?

Signs of a condition are things someone else tin run across or know about you, similar you take a rash or you're coughing. Signs of NAS can be different for every baby. Nearly happen within iii days (72 hours) of nativity, but some may happen right after birth or not until a few weeks after nascency. They can concluding from 1 week to 6 months later on nascency.

If your baby has signs of NAS, call her provider right abroad. Signs may include:

  • Body shakes (tremors), seizures (convulsions), overactive reflexes (twitching) and tight musculus tone
  • Fussiness, excessive crying or having a loftier-pitched cry
  • Poor feeding or sucking or ho-hum weight gain
  • Breathing problems, including breathing really fast
  • Fever, sweating or blotchy skin
  • Problem sleeping and lots of yawning
  • Diarrhea or throwing upwards
  • Stuffy nose or sneezing

Signs of NAS depend on:

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

What complications tin NAS crusade for your baby?

Babies with NAS may have health atmospheric condition that demand handling in the newborn intensive intendance unit (also called NICU) later on birth. The NICU is the plant nursery in a infirmary where ill newborns get medical care. In addition to having withdrawal signs, babies with NAS are at increased adventure of:

  • Low birthweight. This means your baby is born weighing less than 5 pounds, 8 ounces.
  • Jaundice. This is when your infant's peel and eyes look yellowish. It's caused when your baby'south liver isn't fully developed or working.
  • Seizures
  • Sudden infant death syndrome (as well chosen SIDS). This is the unexplained death of a babe younger than i year old. SIDS usually happens when a baby is sleeping.

We don't know a lot about long-term effects of NAS on a baby. We demand more than research to run into how NAS affects a child in the beginning few years of life and longer. We retrieve that NAS may crusade long-term problems 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 nigh children can practice at a certain age, like sitting, walking, talking, having social skills and having thinking skills.
  • Motor problems. These are problems with your baby's basic, muscles and move.
  • Beliefs and learning bug. Babies with NAS are more likely than babies who don't take NAS to be checked for learning problems and to get special education services in schoolhouse.
  • Speech and language problems
  • Slumber problems
  • Ear infections
  • Vision bug

How is your babe tested for NAS?

Your baby's provider can use these tests to encounter if your babe has NAS:

  • NAS scoring system. With this arrangement, your baby'southward provider uses points to course how astringent your baby's withdrawal is. Your baby'due south provider uses the score to decide what kind of handling your baby needs.
  • Urine and meconium tests to check for drugs. Meconium is your baby's first bowel move.

Your baby's provider as well needs to know about what drugs or medicine y'all've used and when you terminal took them. You may get a urine test.

How is NAS treated?

Your baby'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 time then her body can adjust to being off the medicine. Medicines used to treat astringent withdrawal include morphine, methadone and buprenorphine.
  • Getting fluids through a needle into a vein (also called intravenous or Four) to forbid your infant from getting dehydrated. Dehydrated means not having enough h2o 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 extra calories to aid them abound because they have trouble feeding or wearisome growth.

Near babies with NAS who become treatment get meliorate in 5 to thirty days.

During treatment, your baby may be fussy and hard to soothe. Doing these things can assist calm your infant:

  • Room in with your baby. This means you lot and your baby stay in the aforementioned room together at the hospital before y'all take your baby domicile.
  • Give your baby pare-to-skin care (also called kangaroo intendance). This is when you lot put your infant, dressed merely in a diaper, on your bare chest.
  • Be gentle with your babe. Stone your baby gently. If she's sleeping, don't wake her upward.
  • Swaddle your baby (wrap him snuggly) in a blanket.
  • Keep your babe'south room quiet and the lights dim.
  • Breastfeed your baby. Feed your babe on demand. This means y'all feed your baby when he's hungry.
  • Give your babe a pacifier.

Your baby'south provider checks your baby often in the NICU afterwards nascency to make certain he's getting amend and having fewer and less severe withdrawal signs. Your baby can get home from the infirmary when she:

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

Subsequently your infant is home, take her to all of her follow-upward and well-baby checkups, fifty-fifty 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 problems with motor and learning skills and behavior
•    Bug with nutrition and growth
•    Problems with hearing and vision
•    Problems at domicile, 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 can assist children from birth through 3 years one-time learn of import skills. Services include therapy to assist a child talk, walk, acquire self-help skills and interact with others. Getting services as early every bit possible can help better your child'south evolution. The Centers for Illness Control and Prevention has information to assistance y'all go early intervention services for your child and how to observe services in your state or territory.  What can you exercise to help prevent NAS in your babe?

Here'south what you can practice:

  • If y'all're pregnant and you use any of the drugs that can cause NAS, tell your provider right away, but don't stop taking the drug without getting treatment from your provider first. Quitting suddenly (sometimes called cold turkey) can cause severe issues for your baby, including death. If you lot demand help to quit using these drugs, talk to your provider well-nigh treatment. Getting handling can help you lot end using drugs and is safer for your infant than getting no treatment at all.
  • If y'all're pregnant and can't cease using opioids without problems, inquire your provider about medication-assisted treatment (likewise chosen MAT). NAS in babies may exist 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 health status, make certain that provider knows you're significant. You lot may need to stop taking certain medicines or modify to medicine that's safer for your infant. Ask all your wellness care providers if the medicine yous accept—even prescription drugs—can cause NAS in your babe. Even if y'all use a prescription drug exactly as your provider tells you to, it may crusade NAS in your infant.
  • If you're pregnant or thinking almost getting pregnant, tell your provider most whatsoever drugs or medicine you lot accept. Your provider can make sure that what yous're taking is safe for y'all and your infant. She also can aid you get treatment for using street drugs or abusing prescription drugs if you lot demand information technology. If yous abuse prescription drugs, it means you take more than has been prescribed for you, yous take someone else's prescription drug, or you get the drug from someone without a prescription.
  • If you lot're non pregnant and you employ any drug that tin can cause NAS: Use birth control until you're ready to get meaning. Nascence control (too called contraception or family planning) helps keep you lot from getting significant. Examples include intrauterine devices (likewise called IUDs), implants, the pill and condoms.

More information

  • Mother to Baby
  • Substance Abuse Treatment Facility Locator

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

Concluding reviewed: June, 2019