What to Expect if Your Baby has Neonatal Abstinence Syndrome (NAS)

A Guide to Caring for Your Baby with NAS

What is Neonatal Abstinence Syndrome (NAS)?

Neonatal Abstinence Syndrome, or NAS, is a group of drug withdrawal symptoms that can affect a baby’s nervous system, breathing and stomach after the baby are born. Less than half of methadone- or opiate-exposed infants require medication to treat their withdrawal symptoms. It is common to start seeing withdrawal symptoms starting anywhere from one to five days after a baby is born.

Signs that your baby has NAS:

  • Repeat sneezes
  • Extra sucking
  • Cries more than normal
  • Trouble sleeping
  • Trouble eating
  • Quick breathing
  • Diarrhea that causes bad diaper rash
  • Tight muscles
  • Fevers

How can you help prevent your baby from needing medication and admission to the NICU?

  • Tight wrapping: try using a Moby Wrap or sleep sack
  • Providing a quiet and calm environment – keep the TV turned off, limit visitors in the first week of life, dim the lights
  • Holding and skin-to-skin contact
  • Giving your baby a pacifier
  • Breastfeeding your baby and feeding your baby frequently
  • Applying on diaper rash cream with every diaper change

What happens if comfort measures do not help your baby’s withdrawal symptoms?

  • We will start your baby on a medication to help your baby’s symptoms
  • Once your baby’s symptoms start to improve, we will slowly begin to decrease the medicine until your infant is fully weaned off of the medication
  • Sometimes, NAS symptoms are so bad that your baby may need an extra or “rescue” dose of medicine, or a second type of medicine

Can mothers still breastfeed if they are taking methadone or subutex?

If you are only taking methadone or subutex, we encourage you to breastfeed your baby. Our lactation nurses will be available to help with breastfeeding during your baby’s hospital stay. If you take other medications or drugs, breast feeding may not be safe.

How long will your baby stay in the hospital?

Most babies going through withdrawal stay in the neonatal ICU for 2-3 weeks.

Will you be able to stay in the hospital with your baby?

If we have the space available, you will be able to stay. Staying in the hospital is good for both you and your baby. It promotes bonding and learning about your baby’s needs. In addition, staying at the hospital will allow you to breastfeed your child at each feeding.