Neonatal Abstinence Syndrome

Neonatal Abstinence Syndrome (NAS) is a group of symptoms that an infant may develop after exposure in the womb to many types of medications, including opioids. 

Some have suggested the term Neonatal Opioid Withdrawal Syndrome (NOWS) for NAS that occurs due to opioid exposure. Opioids include both prescribed and illicit substances, such as: methadone, buprenorphine, hydrocodone, oxycodone, fentanyl, morphine, and heroin. The prescribed medications are used for management of pain syndromes and opioid use disorder. A newborn can develop NAS/NOWS regardless of why the mother was prescribed these medications, or the dose of medication that mother was prescribed.
 
Women can schedule a prenatal consultation with a hospital based pediatric care provider to discuss the impact on the newborn of opioid exposure. The symptoms of NAS/ NOWS are variable and include fussiness, difficulty sleeping, difficulty feeding and tremors.  All infants with exposure to opioids during the pregnancy are monitored in the hospital after delivery for NAS/NOWS. We work with families to develop an individualized plan for care of your infant. Parental or family involvement is the first line of treatment for NAS/ NOWS to soothe and comfort the infant with swaddling, holding, pacifier use, and breast feeding, if medically appropriate. 

Some infants may need a second line of treatment. This is usually an opioid medication used to decrease symptoms of withdrawal. Each infant will respond differently after delivery, and the severity of withdrawal cannot be predicted prior to birth. Parents and caregivers work together to determine the best treatment plan.

To schedule a prenatal consultation, please contact:

Kathy Mahoney, RN
Woman Health Navigator
kathryn.mahoney@tuftsmedicine.org
978-942-2367 (office phone)