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What is Neonatal Abstinence Syndrome (NAS)?
Written by Medicover Team and Medically Reviewed by Dr K Sindhura , Neonatologist
Neonatal Abstinence Syndrome (NAS), also known as Neonatal Opioid Withdrawal Syndrome, is a condition that affects newborn babies who were exposed to certain drugs while in their mother's womb.
When a pregnant woman uses drugs like opioids, these substances can pass through the placenta to the baby. After birth, the baby is suddenly cut off from the drug supply and may go through withdrawal.
The symptoms of NAS can start within a day or two after birth or may take up to a week to appear. The severity can vary based on the type of drug, how much was used, and how long the baby was exposed.
Treatment focuses on keeping the baby comfortable and healthy. Doctors may use special feeding techniques, quiet rooms, and sometimes small doses of medication to ease symptoms.
It's important to know that with proper care, most babies with NAS can recover fully and go on to live healthy lives. If you're expecting and have questions about medications or drug use, talking openly with a doctor can help protect both you and your baby.
What Are the Symptoms of Neonatal Abstinence Syndrome?
The Neonatal Abstinence Syndrome (NAS) symptoms can be tough on the baby, and they often appear within a day or two after delivery. Recognising these signs early helps doctors provide the right care and comfort.
Babies with NAS can have a wide range of symptoms because the body is adjusting to being without the substances to which it had become accustomed before birth. Some signs are mild, while others may be more serious and need extra medical attention.
Common signs of NAS include:
- High-pitched or excessive crying that's hard to soothe
- Trouble sleeping or staying asleep
- Shaking or tremors
- Stuffy nose or frequent sneezing
- Stiff or tight muscles
- Vomiting or diarrhea
- Feeding difficulties, like sucking poorly or refusing feeds
- Rapid breathing or breathing problems
- high-pitched crying, and seizures
- Sweating or fever
If you notice any of these symptoms in a newborn, especially if there's a known exposure to certain medicines or drugs during pregnancy, it's important to seek medical help right away.
What Are the Causes of Neonatal Abstinence Syndrome?
Neonatal Abstinence Syndrome (NAS) primarily happens when a baby is exposed to certain drugs before birth and then experiences withdrawal symptoms after delivery. This usually occurs when a pregnant mother takes substances that can pass through the placenta to the baby.
When these substances are used during pregnancy, the baby becomes dependent on them, just like the mother. After birth, the baby no longer gets the drug from the mother's bloodstream and starts to experience withdrawal.
Common causes include:
- Using painkillers without medical guidance
- Taking illegal drugs like heroin or cocaine
- Misusing medications meant to treat mental health conditions
- Not following prescribed treatment plans for opioid use disorder
- Taking certain sedatives or sleep medications during pregnancy
What Drugs Cause Neonatal Abstinence Syndrome?
Neonatal Abstinence Syndrome can be caused by several types of drugs taken during pregnancy. These drugs can cross the placenta and affect the baby's developing system, making the baby dependent on them.
Some of the most common drugs linked to NAS include:
- Opioid painkillers
- Heroin
- Methadone or buprenorphine
- Benzodiazepines
- Certain antidepressants
- Illegal stimulants
- Barbiturates
Doctors can help pregnant women manage these conditions safely and effectively. They can help you find safer options and reduce risks to your baby's health.
Get a second opinion from trusted experts and makeconfident, informed decisions.
Get Second OpinionHow Is Neonatal Abstinence Syndrome Diagnosed?
Diagnosing neonatal abstinence syndrome (NAS) starts with understanding the baby's background and watching for signs of withdrawal. Doctors look carefully at the mother's medical history and any drug use during pregnancy. They also observe the baby closely after birth for symptoms of NAS.
By combining a careful medical history with continuous observation and scoring, doctors can confidently diagnose NAS and start treatment early, giving babies the best possible start in life.
Important Tests To Diagnose Neonatal Abstinence Syndrome
While the main diagnosis for neonatal abstinence syndrome (NAS) is based on watching the baby's symptoms, doctors may also use tests to confirm drug exposure and rule out other conditions. These tests help create a complete picture so that the baby can get the best care.
Common tests include:
- Urine Test: A small sample checks for substances the mother used during pregnancy that may still be in the baby's system.
- Meconium Test: The baby's first stool can show drug exposure over a longer period before birth.
- Umbilical Cord Testing: Sometimes, the cord tissue is tested right after delivery for signs of drugs.
- Blood Tests: To check for infections, blood sugar problems, or other issues that might mimic withdrawal symptoms.
- Physical Assessment: Doctors also use scoring systems during regular check-ups to track the severity of symptoms and plan treatment.
These tests, along with careful observation, help doctors make an accurate diagnosis and choose the right care plan to keep the baby safe and healthy.
How Is Neonatal Abstinence Syndrome Treated?
Neonatal Abstinence Syndrome (NAS) treatment focuses on helping babies feel safe, comfortable, and healthy while their bodies adjust.
Babies with NAS are carefully watched in the hospital. Nurses and doctors look for signs of withdrawal and make sure they're eating well and gaining weight. The goal of NAS treatment is to reduce symptoms and support growth.
Treatment approaches often include:
- Keeping the baby in a calm, quiet, and dim environment
- Swaddling to help them feel secure
- Gentle rocking or holding to comfort them
- Feeding smaller amounts more often to reduce fussiness
- Skin-to-skin contact with parents
For mild cases, these soothing techniques might be enough. But some babies with stronger withdrawal symptoms may need medicine to ease discomfort.
What Medications Are Used for Neonatal Abstinence Syndrome?
In some cases, babies with NAS have withdrawal symptoms that are too strong for comfort care. Medications can help ease these symptoms and keep babies safe while their bodies adjust.
Doctors decide on medication based on how severe the baby's symptoms are. The goal is to relieve discomfort and prevent complications. Babies are given the smallest effective dose, which is slowly reduced over time.
Common medications:
- Morphine
- Methadone
- Buprenorphine
Babies receiving medication are closely monitored in the hospital. Nurses watch for side effects and make sure babies are eating well and growing. Over time, the medication is reduced slowly so the baby can adjust without sudden withdrawal.
When to See a Doctor for Neonatal Abstinence Syndrome?
If you suspect your baby may have symptoms of neonatal abstinence syndrome (NAS), it's important to see a doctor as soon as possible.
Watch for these signs and call your doctor if you notice:
- Constant, high-pitched crying that is hard to soothe
- Shaking or tremors
- Trouble feeding or sucking
- Vomiting or diarrhea
- Difficulty sleeping or being very fussy
- Breathing too fast or with effort
- Stuffy nose or sneezing a lot
- Skin looking blotchy or too sweaty
If something feels wrong or your baby seems very uncomfortable, don't hesitate to get help. Doctors can guide you on the best care to keep your baby safe and healthy.
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What Is the Recovery Process After Neonatal Abstinence Syndrome Treatment?
Recovering from Neonatal Abstinence Syndrome (NAS) means helping your baby adjust safely after birth. This process can take anywhere from days to weeks, depending on the severity of the symptoms.
What to Expect:
- Babies may stay in the hospital for monitoring.
- Nurses will soothe babies with rocking, swaddling, and quiet spaces.
- Medications may be used to ease withdrawal symptoms.
- Feeding support to ensure the baby gains weight.
- Education for parents on caring for their baby at home.
- Regular follow-up visits to check growth and development.
What Precautions Can Help Prevent Neonatal Abstinence Syndrome?
Preventing NAS starts before and during pregnancy with healthy choices. It's about taking steps to protect your baby from the start.
Important Precautions:
- Avoid using opioids or other addictive drugs during pregnancy.
- If you need pain medicine, talk to your doctor about safer options.
- Attend all prenatal check-ups to catch issues early.
- Seek help if you're struggling with substance use, support programs are available.
- Share all medications you're taking with your doctor.
- Maintain a healthy lifestyle with good nutrition and rest.
What Are the Possible Complications of Neonatal Abstinence Syndrome?
While many babies recover well, NAS can cause some challenges that need attention. Understanding these risks helps parents prepare and get the right help early.
Possible Complications:
- Low birth weight or smaller size at birth.
- Trouble feeding or gaining weight.
- Breathing difficulties that may need monitoring.
- Irritability and trouble calming down.
- Sleep problems in the early months.
- Developmental delays or learning issues occur as the child grows.
Parents should always share any concerns with their doctor to make sure their baby gets the best start in life.
Our Experience in Treating Neonatal Abstinence Syndrome
At Medicover, we understand how worrying it can be when a newborn shows signs of withdrawal. We want parents to know they're not alone and that help is available.
Our team has years of experience caring for babies with Neonatal Abstinence Syndrome (NAS), offering gentle, expert support for both babies and families.
We understand that this is a challenging time, but we're here to support you every step of the way. Our goal is to ensure your baby receives the safest and kindest start possible, and that you feel supported throughout the journey.
