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Neonatal Abstinence Syndrome (NAS)

What Is NAS?

If a mother uses certain drugs called opioids while pregnant, her baby can be born with neonatal abstinence syndrome (nee-oh-NAY-tul AB-stuh-nents SIN-drome) or NAS.

NAS happens because babies get hooked on the drugs their mothers take during pregnancy. After babies are born and no longer getting the drugs from the mother's bloodstream, they go through withdrawal.

It can take a few weeks for all of the drug to leave a baby's body. If your baby has NAS, you can help keep your baby comfortable at home.

What Are Opioids?

Opioids (OPE-ee-oydz), also called narcotics, are drugs prescribed for pain. They include:

  • codeine
  • hydrocodone
  • morphine
  • oxycodone
  • meperidine
  • fentanyl

The street drug heroin is also an opioid. So is methadone, which helps people quit using heroin or other narcotics.

If a woman takes any of these drugs — even ones prescribed by a health care professional — while pregnant, it can cause problems for her baby. Babies can be born too early (premature) or with NAS.

What Happens When a Baby Has NAS?

Babies born with NAS are often smaller than most babies. They can have more health problems than babies born at a healthier weight.

A baby with NAS may be fussy, irritable, or cry a lot, usually with a high-pitched cry. Many babies have trouble sleeping, eating, and gaining weight. Babies also may:

  • shake, tremble, or move in a jerky way
  • have stiff arms and legs
  • have a big startle reflex
  • have a fever and/or sweat a lot
  • throw up or have diarrhea
  • have trouble breathing
  • have blotchy skin
  • yawn a lot
  • have a stuffy nose or sneeze a lot
  • have seizures

Not every baby will have all of these symptoms. It depends on what drugs the mother used, how long and how often she used them, and how soon before birth she took them.

How Can I Help My Baby?

Babies born with NAS need "TLC" — tender loving care.

Comforting your baby. Keep your baby away from bright lights and loud noises. Always place your baby to sleep on the back and do not over-bundle. Other ways to comfort your baby:

  • skin-to-skin contact (putting baby bare-chested on your chest) or holding the baby close to your body
  • gently rock and cuddle often but avoid patting or stroking your baby
  • swaddle and give a pacifier
  • play soothing music, hum, or sing softly

Feeding your baby. Feed your baby when he or she is hungry in a calm, quiet place. Feeding can take a lot of your baby's energy, so allow time for resting during a feeding.

Talk to the doctor about the best way to feed your baby. Mothers who use street drugs should not breastfeed their babies. If you're giving formula, make sure you give it as directed by your doctor and in the right amounts.

Change your baby's diaper after a feeding and keep the diaper area clean and dry.

What to do if your baby sucks his or her fists often. Offer a pacifier. Keep your baby's hands clean, but don't apply lotions or creams. Cover your baby's hands with mittens to protect the skin and prevent your baby from scratching his or her face.

Caring for a runny or stuffy nose. Wipe mucus away with a clean cloth. To help your baby breathe better when awake and congested, hold your baby upright and support the chest with your hand.

Never shake your baby. If you feel overwhelmed, put your baby in a safe place like a crib or bassinet and go into another room to take a break. Or ask your partner, a friend, or a family member to take over for a while.

Does My Baby Need Medical Treatment?

Some babies may need small amounts of a medicine that is like the drug the mother took during pregnancy. As time goes on, the baby will get smaller and smaller amounts until he or she can stop taking the medicine without having withdrawal symptoms.

Moms who are addicted to drugs will need treatment. Doctors, drug counselors, and social workers can provide services for both mother and baby.

Can NAS Be Prevented?

If you're pregnant or thinking about becoming pregnant, the best way to prevent NAS is to not use drugs.

If you take drugs and aren't pregnant but are planning to be, use birth control during sex until you quit. This will help give you time to get off of any drugs that could harm a baby.

If you take drugs and are pregnant, talk to your health care professional about the best way to stop. Quitting drugs all at once can cause serious problems for you and your growing baby. Your doctor may suggest medication-assisted treatment (MAT) or another method to help you quit.

Reviewed by: Tricia L. Romesberg, ARNP
Date Reviewed: 14-11-2017