All About NAS: Neonatal Abstinence Syndrome

The medical term neonatal abstinence syndrome (NAS) refers to babies prenatally exposed to drugs. Just like a grown adult, a newborns struggle during the withdrawal process from narcotics. It is hard for a newborn to transition to life outside the womb, much less survive without the drugs they have learned to depend on. Today there is education available for parents on symptoms, early complications, lifelong complications, and the treatment available for NAS.

NAS Symptoms

–Trembling

–Irritability (excessive crying)

–Mottling

–Myoclonic Jerks

–High-pitched crying

–Hypertonia (increased muscle tone)

–Apnea

–Increased respiration (greater than 60 breaths per minute without retractions)

–Hyperactive reflexes

–Seizures

–Excessive sucking/rooting

–Poor feeding and ineffective suck

–Yawning/stuffy nose/sneezing

–Vomiting

–Diarrhea

–Sweating

–Dehydration

–Fever/unstable temperature

Symptoms of NAS can begin as early as 24 to 48 hours after birth, or as late as five to 10 days after delivery. Parents, guardians, and caretakers need to know that symptoms of NAS can be detected outside the standard timeframe. Medical professionals stress that every withdrawal case is unique from baby to baby.

Early Complications

–Stillborn baby

–Miscarriage

–Premature birth

–Low birth weight

–SIDS

–Infections

These are some basic NAS related complications that newborns may face. There are many other NAS complications a newborn can face depending on what substances they are exposed to.

Lifelong Complications

For NAS babies, the problems and hurdles they face throughout life are specific to the substances they were exposed to in utero.

–Amphetamine/Methamphetamine:

Facial clefts
Heart defects
Learning disabilities
Developmental delays
ADD/ADHD
Behavioral Issues ex. unprovoked fits of anger

–Cocaine:

Lower IQ
Developmental delays
Difficulty with informational processing
Born with smaller heads
Birth defects- especially ones that affect the urinary tract and/or heart

–Heroin:

Researchers are still trying to figure out the long term effects of prenatal heroin exposure. It is without question babies exposed to heroin in the womb will go through an intense withdrawal process.

-*Marijuana:

Early childhood behavior issues
Affects memory and attentiveness

–Cigarettes:

Congenital heart defects-resulting in surgeries, long hospital stays, and disabilities
Cleft palates

*Lifelong effects of prenatal marijuana exposure are often associated with the symptoms listed above, however, there are still active studies in place to 100% verify the accuracy in these claims.

Treatment of NAS Babies

More often than not babies with neonatal abstinence syndrome have a temporary increase in metabolic function. Babies who have an increase in metabolic function must be switched to a higher calorie formula or IV fluids. When the withdrawal case is severe, a physician may authorize for the infant to be medicated with morphine, phenobarbital, and/or methadone to wean the infant. An infant with NAS may ONLY be given medication during the withdrawal process under the supervision of the physician.

It is an incredibly painful process for NAS infants to adapt to life after birth. When your baby is feeling irritable and screaming at the top of their lungs what they yearn for is comfort and love. Swaddling, motorized swings, and holding them helps to give them that sense of security that everything will be ok.