Neonatal abstinence syndrome Health Article

Definition

Neonatal abstinence syndrome (NAS) is a group of problems that occur in a newborn who had been exposed to drugs while in the mother’s womb.

Alternative Names

NAS

Causes, incidence, and risk factors

Neonatal abstinence syndrome occurs because a pregnant woman takes addictive illicit or prescription drugs such as:

• Amphetamines
• Barbiturates
• Cocaine
• Diazepam
• Marijuana
• Opiates (heroin, methadone, codeine)

These and other drugs pass through the placenta – the organ that connects the baby to its mother in the womb – 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

Symptoms

The symptoms of neonatal abstinence syndrome depend on:

• The type of drug the mother used
• How much of the drug she was taking
• For how long she used the drug
• Whether the baby was born full-term or early (premature)

Symptoms can begin within 1-3 days after birth, or they may take 5-10 days to appear. They may include:

• Blotchy skin coloring (mottling)
• Dehydration
• Diarrhea
• Excessive crying or high-pitched crying
• Excessive sucking
• Fever
• Hyperactive reflexes
• Increased muscle tone
• Irritability
• Poor feeding
• Rapid breathing
• Seizures
• Sleep problems
• Slow weight gain
• Stuffy nose, sneezing
• Sweating
• Trembling (tremors)
• Vomiting

Signs and tests

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:

• Neonatal abstinence syndrome scoring system, which assigns points based on each symptom and its severity. The infant’s score can help determine treatment.
• Toxicology screen of first bowel movements (meconium)
• Urine test (urinalysis)