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Neonatal Abstinence Syndrome

When You Are Pregnant
During pregnancy, almost every drug in your blood can pass to your baby. This means your baby shares the medications, drugs, and substances you take while you are pregnant.

What is Withdrawl?
At birth, your baby no longer gets the substances he or she was used to getting from your blood during pregnancy. When the effects of the substances all of a sudden stop, your baby may develop symptoms called withdrawal. If the substances are taken often, mostly in the third trimester, withdrawal symptoms can develop in the baby after birth. Not all babies exposed to drugs or substances during pregnancy will have withdrawal symptoms.

Signs of Withdrawl:
• Crying more than normal
• Shaking or trembling
• Stuffy nose
• Drooling/Spitting
• Diarrhea
• Diaper rash
• Poor feeding
•Tense arms, legs, and back
• Sweating
• Trouble Sleeping
• Yawning
• Sneezing
• Fast breathing
• Fever

What is Neonatal Abstinence Syndrome
Neonatal Abstinence Syndrome (NAS) is a condition or group of problems that a baby experiences while going through withdrawal.

NAS most commonly occurs in babies exposed to their mother’s regular doses of Narcotic pain medications during pregnancy. Your doctor will advise you to continue this substance during your pregnancy, as going through withdrawal symptoms may put you and your baby at risk during your pregnancy.

Most babies that withdraw show signs within 24-72 hours after birth, however some symptoms may not appear for 7-8 days. Withdrawal symptoms can vary from mild to severe and can last from 1 week to 3 months. Babies behave in their own way and may get better from NAS symptoms with comfort measures and medications in their own time.

How Do We Screen Babies Exposed to Substances
A urine and meconium (the baby’s first stool) sample will be sent to the lab. That will help us understand if the baby has any substances in their system.

How Do We Treat It?
We measure your baby’s symptoms using the Finnegan Neonatal Abstinence Scoring Tool. A score below 8 means that your baby has mild symptoms of withdrawal.

About 20-30% of infants with NAS will respond to supportive treatment and will not require medications. However, if your baby’s symptoms increase, he or she may need medication and additional care that can only be provided in the Special Care Nursery.

Your Baby's NAS Score Helps the Healthcare Team Decide:
• How your baby is adjusting after birth
• If your baby requires medicine to help the withdrawal symptoms
• Medication such as morphine may be given in low doses to help your baby’s symptoms of NAS and reduce the possibility of seizures from withdrawal. The medication will help the baby relax without becoming too sleepy.
• The process of scoring, assessing, and reducing the medication continues until the baby has stopped having signs of withdrawal. Each baby is different in how they respond to being weaned off the medicine.

What Can You Do To Help Your Baby

Provide a calm environment
• Use a soft voice
• Limit people who want to visit
• Only wake him or her to feed
• Hold your baby skin-to-skin
• Bundle your baby
• Limit blankets
• Keep the lights low
• Rock your baby slowly
• Let your baby sleep

Your love and care is very important to your baby. You also have an important role on your baby’s health care team, helping to:
• Watch your baby for symptoms of withdrawal
• Provide comfort measures to reduce your baby’s symptoms