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Neonatal abstinence syndrome (NAS) occurs when a fetus is exposed to drugs in the womb, leading to withdrawal symptoms in the newborn. Symptoms vary depending on the substance used, and treatment depends on the severity of symptoms. Prevention is key, and mothers should stop using substances before or as soon as they find out they are pregnant.
Neonatal abstinence syndrome (NOS) refers to problems that can occur when a fetus is exposed to drugs while still in the mother’s womb. When a mother uses substances, they pass through the bloodstream and placenta to the fetus. After your baby is born and you are no longer receiving the substance, you may experience withdrawal symptoms, which can be severe and lead to complications. Many substances can cause neonatal withdrawal syndrome, including barbiturates, amphetamines, opiates, cocaine, marijuana, and alcohol.
The symptoms of this syndrome depend on the substance the mother was using. Symptoms also depend on the frequency and amount of substance use. A baby’s symptoms can show up one to 10 days after birth. Some common symptoms include difficulty sleeping, shaking, fever or sweating, diarrhea and vomiting, dehydration, feeding problems, excessive and high-pitched crying, seizures, patchy skin, and overactive reflexes or muscle tone. In premature babies, the most common symptoms are feeding difficulties, high-pitched crying, shaking, and rapid breathing.
Doctors have developed a scoring system for neonatal abstinence syndrome for diagnosis and to help assess severity. Doctors might also examine a child’s urine or first stool samples. Determining the substance and severity of the syndrome can help a doctor plan the course of treatment.
Treatment for this syndrome depends on the health of the baby and whether the baby was born at full term. If you have severe withdrawal, a doctor might prescribe methadone, benzodiazepines, or other medications to help control withdrawal symptoms. A baby may need intravenous fluids or high-calorie formula to help with weight gain. Babies experiencing neonatal abstinence syndrome are hard to comfort, so basic treatment will include swaddling and rocking, as well as reducing environmental disruptions such as bright lights.
If a baby receives treatment for neonatal withdrawal syndrome, it can help manage withdrawal symptoms, but exposure to the drug in the womb can still lead to numerous complications. Some babies may be born with birth defects or low birth weight. Drug use during pregnancy can also lead to premature birth or sudden infant death syndrome (SIDS). The most important factor for the prognosis is whether or not the mother continues to use substances.
With neonatal withdrawal syndrome, prevention is key. A woman should stop using substances before becoming pregnant, or at least as soon as she finds out she is pregnant. The syndrome can be avoided by not using drugs or alcohol during pregnancy.
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