What is neonatal abstinence syndrome?

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Neonatal abstinence syndrome occurs when infants are exposed to certain medications and/or drugs before they are born. After birth, the infant may go through withdrawal when they are no longer exposed to the medication or drug. When the infant shows signs of withdrawal we call this neonatal abstinence syndrome or NAS.

What causes neonatal abstinence syndrome?

Almost every drug and medicine pass from the mother’s bloodstream through the placenta to her unborn infant. Some prescription medications and illicit drugs can cause the unborn infant to become dependent. At birth, the infant continues to need the drug. But because the drug is no longer available, the infant goes through withdrawal. Some drugs and medicines are more likely to cause NAS than others. Opiates are a class of drugs that commonly cause NAS. Some examples of opiates include heroin, methadone, suboxone, Subutex, Vicodin, Percocet, oxycodone, Oxycontin and codeine.

Who is at risk for neonatal abstinence syndrome?

Pregnant women who use opiates may have infants who develop neonatal abstinence syndrome. Women who have a substance use disorder may also be less likely to get prenatal care. This can increase the chance of complications for both mother and infant.

What are the symptoms of neonatal abstinence syndrome?

Symptoms of withdrawal may start as soon as 24 to 48 hours after birth and usually peak by day 5. Or they may start as late as 5 to 10 days after birth. Below are the most common symptoms of the NAS. Symptoms may be slightly different for each infant. Symptoms of withdrawal in full-term infants may include:

• Trembling or extreme shakiness
• Too much crying or high-pitched crying
• Sleep problems
• Tight muscle tone
• Overactive reflexes
• Yawning, stuffy nose, and sneezing
• Poor feeding and sucking
• Vomiting or diarrhea
• Sweating
• Fever or unstable temperature
• Premature infants may have a lower risk for withdrawal symptoms or have less severe symptoms.