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Neonatal abstinence syndrome (NAS) is a group of problems that occur in a newborn who was exposed to addictive illegal or prescription drugs while in the mother' s womb.
Neonatal abstinence syndrome occurs because a pregnant woman takes addictive illicit or prescription drugs such as:
These and other drugs pass through the placenta â€“ the organ that connects the baby to its mother in the womb â€“ and reach the baby. The baby becomes addicted along with the mother.
At birth, the baby is still dependent on the drug. Because the baby is no longer getting the drug after birth, symptoms of withdrawal occur.
Alcohol use during pregnancy can also cause problems in the baby. See: Fetal alcohol syndrome
The symptoms of neonatal abstinence syndrome depend on:
Symptoms can begin within 1 - 3 days after birth, or they may take 5 - 10 days to appear. They may include:
It is important to have your baby checked out by a pediatrician. Many other conditions can produce the same symptoms as neonatal abstinence syndrome.
The doctor will ask questions about the mother's drug use, such as what drugs she took during pregnancy, and when she last took them.
Tests that may be done to diagnose withdrawal in a newborn include:
Treatment depends on the infant' s overall health and whether the baby was born full-term or premature.
The health care team will watch the newborn carefully for signs of withdrawal, feeding problems, and weight gain. Babies who vomit or who are very dehydrated may need to get fluids through a vein (intravenous).
Some babies need medicine to treat withdrawal symptoms. Medicines may include:
The doctor may prescribe the infant a drug similar to the one the mother used during pregnancy and slowly decrease the dose over time. This helps wean the baby off the drug and relieve some withdrawal symptoms.
Infants with neonatal abstinence syndrome are often fussy and hard to calm. Tips to calm the infant down include:
Babies with this condition often have poor feeding. Such babies may need:
Treatment helps relieve symptoms of withdrawal. How well the baby does depends in part on whether the mother (and father) continues to use drugs.
Exposure to drugs in the womb can lead to many health problems, including:
Neonatal abstinence syndrome can last from 1 week to 6 months.
Contact your health care provider if you are pregnant and have taken any type of drugs. Also call if your baby shows symptoms of neonatal abstinence syndrome.
You can prevent this condition by avoiding drugs during pregnancy. Discuss all drug use with your health care provider. If you use drugs, stop using them before you get pregnant or as soon as possible after you find out that you are pregnant.
Ford MD, Delaney KA, Ling L, Erickson T, eds. Clinical Toxicology. 1st ed. Philadelphia, Pa: Saunders Elsevier; 2001.
Ebner N. Management of neonatal abstinence syndrome in neonates born to opioid maintained women. Drug Alcohol Depend. 2007;87:131-138.
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