What is neonatal abstinence syndrome?

Neonatal abstinence syndrome (NAS) is a group of medical complications a newborn may develop when they're exposed to opiates before birth. Exposure to opiates, such as heroin and methadone can cause developmental and physical issues with the baby's growth.

Causes of neonatal abstinence syndrome

Causes that contribute to NAS include:

  • Mother using narcotics like heroin, codeine or oxycodone
  • Mother using hydrocodone, morphine or tramadol
  • Mother using painkillers from a recent surgery
  • Mother using sleeping pills or antidepressants

Risk factors for neonatal abstinence syndrome

Any substance that a mother takes can transfer to her baby. It moves through the placenta. This is an organ that helps nourish the baby. When a baby is exposed to addictive drugs, especially within a week of delivery, they might become addicted.

The risk factors depend on:

  • The type of drug the mother uses
  • The length of time she used the drug
  • The amount of the drug the mother uses
  • The ability for the mother's body to break down the drug

Symptoms of neonatal abstinence syndrome

Babies with neonatal abstinence syndrome can show symptoms within a few days of birth. The condition can take up to a week to appear. How strong the symptoms are can depend on whether the child was born at full term or prematurely. In general, babies with NAS seem fussy and hard to calm.

Other symptoms include:

  • Blotchy skin
  • Poor feeding
  • Rapid breath
  • Slow weight gain
  • Sweating and tremors
  • Diarrhea and vomiting
  • Stuffy nose and sneezing
  • Excessive crying and sucking
  • Irritability and poor sleep habits
  • Hyperactive reflexes and increased muscle tone

Diagnosis of neonatal abstinence syndrome

There are tests that can help doctors identify and diagnose NAS. They can check the baby's blood, urine, bowel movements and even the umbilical cord for drugs. The mother can also share information about her drug use to help diagnose the condition. Doctors may test the mother's urine, too. Doctors assign the baby an NAS score. This helps them determine the right treatment.

Treatments for neonatal abstinence syndrome

NAS can also make a baby more likely to be at risk of low birth weight and jaundice. This is a condition that makes the baby's skin turn yellow. The baby may need to stay in the newborn intensive care unit at the hospital.

Treatments include:

  • Having the baby take medicines to treat or manage withdrawal symptoms
  • Giving the baby fluids through so they won't be dehydrated from diarrhea or vomiting
  • Feeding the baby formula that has higher calories than regular formula to counter the lower birth weight

With treatment, babies with NAS can get better within a week to a month. Mothers can prevent this condition by talking with their doctors if they're taking any opioids, drugs, alcohol or tobacco during pregnancy. Stopping opioids too fast can harm both the mother and the child. Work with a doctor to limit risks.

Recovery from neonatal abstinence syndrome

It can be challenging to care for a baby who is recovering from NAS. They may be difficult to soothe. Try wrapping your child snugly in a blanket. Stay in quiet, dimly lit rooms. Some children respond well to skin-to-skin contact with their mothers. Breastfeeding is a good way to offer nutrition to your child.

Recovery can last anywhere from one week to six months, even with medical treatment. Monitor your child carefully and with love and patience. This is especially important. The risk of sudden infant death syndrome (SIDS) and problems with development and behavior are greater for babies who've had NAS. Be sure to discuss any concerns you may have during pregnancy or after delivery with your doctor. This can help you keep your baby as healthy as possible.

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