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What is NAS?

  • Neonatal Abstinence Syndrome (NAS) consists of signs of withdrawal in infants who are exposed to drugs (prescription or illicit) during pregnancy.
  • Symptoms usually develop within 1-7 days after birth.
  • Premature babies may not show the same signs of withdrawal that term babies do.
  • Medication may be needed in the hospital and after discharge to help your baby with NAS.
  • As your baby’s symptoms improve, your healthcare provider will wean medication slowly.

What Are the Symptoms of Withdrawal?

Signs of withdrawal include:

  • Jitteriness
  • Increased muscle tone
  • Fussiness, irritability
  • Loud, frequent crying
  • Sleeping difficulties
  • Hyperactive reflexes
  • Frequent yawning and sneezing
  • Difficulty feeding
  • Poor weight gain
  • Excessive sucking
  • Dehydration, vomiting, diarrhea
  • Skin breakdown to buttocks, knees, or face
  • Abnormal skin temperatures
  • Nasal stuffiness
  • Possible seizures

Calming Suggestions

  • Create a routine for your baby.
  • Offer pacifier to calm your baby and help with organizing sucking pattern in preparation for feeding.
  • Feed your baby in a quiet, low-lit room, but allow natural light during the day.
  • Allow your baby to sleep, but make sure they wake up to feed.
  • Swaddle, gently rock or sway, use skin-to-skin contact and talk softly to your baby.
  • Talk to your baby when calm and add activities as tolerated. Remember, as your baby grows and feels better, they will enjoy more interaction.

When to Take Baby to Emergency Room

  • Fever (temp. 100.4 or greater)
  • Extreme irritability
  • Poor feeding
  • Seizures

When to Call Your Baby’s Doctor

  • Diarrhea
  • Rapid breathing
  • Sweating
  • Vomiting

Follow Up

Babies can continue to have mild symptoms of withdrawal for up to 6 months after leaving the hospital. It is important to keep follow up appointments.

Staying Calm for Caregiver

  • Place baby in a safe place.
  • If you feel upset, walk away and take deep breaths for a few minutes.
  • Never shake your baby or put anything over your baby’s face to quiet your baby.
  • Ask for help! Call a family member, friend or your healthcare provider if you feel upset, angry, scared or just need help.
  • Remember to place baby on their back to sleep at all times in crib or bassinet. Never place baby in bed with you.