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Neonatal Abstinence Syndrome (NAS)

Reviewed by: Mary L. Gavin, MD

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What Is NAS?

If a mother uses some kinds of drugs while pregnant, her baby can be born with neonatal abstinence syndrome (nee-oh-NAY-tul AB-stuh-nents SIN-drome) or NAS.

NAS happens because babies get hooked on the drugs their mothers take during pregnancy. After babies are born and no longer getting the drugs, they go through withdrawal.

It can take a few weeks for all of the drug to leave a baby's body. If your baby has NAS, you can help keep your baby comfortable at home.

What Are Opioids?

Opioids (OPE-ee-oydz), also called narcotics, are drugs prescribed for pain. They include:

  • codeine and hydrocodone
  • morphine
  • oxycodone

The street drug heroin is also an opioid. So is methadone, which helps people quit using heroin or other narcotics.

If a woman takes any of these drugs — even ones prescribed by a health care professional — while pregnant, it can cause problems for her baby. Babies can be born too early (premature) or with NAS.

What Happens When a Baby Has NAS?

Babies born with NAS are often smaller than most babies. They can have more health problems than babies born at a healthier weight.

A baby with NAS may be fussy, irritable, or cry a lot, usually with a high-pitched cry. Many babies have trouble sleeping, eating, and gaining weight. Babies also may:

  • shake, tremble, or move in a jerky way
  • have a fever and/or sweat a lot
  • throw up or have diarrhea
  • have trouble breathing
  • have blotchy skin
  • have a stuffy nose or sneeze a lot
  • have seizures

Not every baby will have all of these symptoms. It depends on what drugs the mother used, how long she used them, and whether the baby was born early.

How Can I Help My Baby?

Babies born with NAS need "TLC" — tender loving care. They should be fed when hungry, held often, and kept away from bright lights and loud noises.

Other ways to comfort your baby:

  • skin-to-skin contact (putting baby bare-chested on your chest)
  • rock and cuddle often
  • swaddle and give a pacifier
  • for a stuffy nose, use a clean cloth to wipe mucus away
  • keep lights dim
  • play soothing music or sing softly
  • gentle massage

Never shake your baby. If you feel overwhelmed, put your baby in a safe place like a crib or bassinet and go into another room to take a break. Or ask your partner, a friend, or a family member to take over for a while.

Some babies may need small amounts of a medicine that is like the drug the mother took during pregnancy. As time goes on, the baby will get smaller and smaller amounts until her or she can stop taking the medicine without having withdrawal symptoms.

Moms who are addicted to drugs will need treatment. Doctors, drug counselors, and social workers can provide services for both mother and baby.

Can NAS Be Prevented?

If you're pregnant or thinking about becoming pregnant, the best way to prevent NAS is to not use drugs.

If you take drugs and aren't pregnant but are planning to be, use birth control during sex until you quit. This will help give you time to get off of any drugs that could harm a baby.

If you take drugs and are pregnant, talk to your health care professional about the best way to stop. Quitting drugs all at once can cause serious problems for you and your growing baby. Your doctor may suggest medication-assisted treatment (MAT) or another method to help you quit.

Reviewed by: Mary L. Gavin, MD
Date reviewed: March 2017