Neonatal abstinence syndrome (NAS) is a collection of signs and symptoms that indicate a newborn is experiencing withdrawal from exposure to addictive drugs while in the mother’s womb. The most common opiate drugs that are associated with NAS are heroin, codeine, oxycodone (oxycontin), fentanyl, methadone, and buprenorphine.
The occurrence of NAS is not limited to newborns of moms with illicit drug use, but could also be a result of pregnant women using prescribed medications for the treatment of pain, depression, and anxiety.
When your baby is born, your baby is still dependent on the drug. Because your baby is no longer getting the drug through you, symptoms of withdrawal may occur. Although NAS is associated the most with opiate drugs, babies exposed to alcohol, tobacco, and other drugs can also have symptoms of withdrawal.
NAS is treatable. Early identification can help you and your baby receive the right treatment.
Substance Use During Pregnancy
When you are pregnant, everything that goes into your body has the potential to have an effect on your unborn baby. Smoking, drinking alcohol, abusing prescription drugs, or using illicit drugs can all pass through the placenta and have a negative effect on you and your baby.
Opioid Use Disorder
Opioid use disorder is a treatable disease that can be caused by frequent opioid use, both prescription and non-prescription. It is sometimes called opioid addiction. Symptoms of OUD may include:
- Feeling a strong desire for opioids
- Feeling unable to stop or reduce opioid use
- Needing more opioids to get the same effect
- Spending a lot of time trying to find and use opioids
- Feeling unwell after stopping or reducing use
OUD in pregnancy increases the risk of poor maternal and neonatal outcomes.
Talk to your health care provider about Treatment
It is important to be honest with your health care provider and with your baby’s pediatrician about what you were taking during your pregnancy (prescription medications, illicit drugs, tobacco, or alcohol), how much you were using and how often. Your provider can support or link you to treatment and make sure there are preparations to treat you and your baby for withdrawal symptoms if needed.
Because symptoms may not show up for days after delivery, it is important to watch your baby closely and call your baby’s pediatrician right away if you notice any of the symptoms of withdrawal.
symptoms baby’s may experience During withdrawal
Symptoms of withdrawal may depend on the drug involved and the last time the drug was used. Symptoms can begin within 1-3 days after birth, or may take up to 10 days to appear. Symptoms may include:
- Poor feeding
- Rapid breathing
- Seizures
- Sleep problems
- Slow weight gain
- Stuffy nose, sneezing
- Sweating
- Trembling (tremors)
- Vomiting
- Blotchy skin coloring (mottling)
- Diarrhea
- Excessive crying or high-pitched crying
- Excessive sucking
- Fever
- Hyperactive reflexes
- Increased muscle tone
- Irritability
- Jitteriness
Resources for Assistance
Florida’s Coordinated Opioid Recovery (CORE) Network – CORE prioritizes a unified, proactive system of care that meets people where they are and supports them across every dimension of recovery. This innovative approach is essential to addressing the opioid epidemic with the urgency, compassion, and coordination it demands.
- Family Health Line: Call 800-451-BABY
- Healthy Start Directory
- Pregnancy Calendar: These slides show the stages of pregnancy. By looking at the parts of the fetus that are developing, you can see what parts of the fetus can be damaged by smoking, drinking or using certain drugs while pregnant.
Information for Health Care Providers
To identify cases, the Florida Department of Health currently uses a passive case ascertainment methodology that relies on linked administrative datasets and diagnostic codes that are indicative of neonatal abstinence syndrome.