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Treating Neonatal Abstinence Syndrome

Neonatal Abstinence Syndrome (NAS) is the presence of withdrawal symptoms in a newborn. Symptoms of NAS include:

  • High-pitched or inconsolable crying
  • Tremors or seizures
  • Repeated awakening or difficulty sleeping
  • Irritability and discomfort
  • Tight muscle tone and hyperactive reflexes
  • Excessive yawning, sneezing, and stuffy nose

Babies who have had known opioid exposure and babies with NAS must be observed in the hospital for a minimum of five to seven days after birth. If NAS is present, two approaches to treatment may be used: nonpharmacological and pharmacological.

Nonpharmacological (without medication) Approach

If your baby’s NAS is not severe, they may recover without medication. The nonpharmacological approach is a medication-free approach which uses a peaceful atmosphere and calming techniques to help in your baby’s recovery. These techniques including low-lighting, quiet rooms, comforting and calming actions, and skin-to-skin contact. Visitation is limited to you or your support person while your baby is in recovery.

Breastfeeding can be an important part of your baby’s recovery. In addition to providing skin-to-skin contact and bonding, your breast milk contains a small amount of opioids that slowly decreases as you go through recovery yourself. This slowly weans your baby off the drug at a natural pace.

Pharmacological (with medication) Approach

If your baby has more severe withdrawal symptoms and they are unable to be managed without medication, a pharmacological approach may be needed. In this case, your baby would be moved to a neonatal intensive care unit (NICU) under the care of a neonatologist—a specialist in newborn babies.

In the NICU, your baby would receive small doses of morphine to wean them off any substances that were present at birth. The average length of stay for newborns who need morphine is 17 days from birth to discharge. Every baby is different, so your baby’s stay may be shorter or longer.

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