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Neonatal Abstinence Syndrome (NAS)

A withdrawal picture appearing after birth in babies exposed to opioids or other addictive substances during pregnancy.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

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This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Çocuk Sağlığı ve Hastalıkları department. Book Appointment →

What is Neonatal Abstinence Syndrome (NAS)?

Neonatal abstinence syndrome (NAS) refers to neurological, respiratory, and gastrointestinal withdrawal findings appearing in the baby after birth due to maternal use of addictive substances during pregnancy (most commonly opioids, also benzodiazepines, SSRIs, alcohol).

Findings appear in the first 24-72 hours after birth; they may be delayed up to 5-7 days in some babies. Central nervous system irritability, autonomic dysfunction, metabolic changes, and gastrointestinal symptoms are classic findings.

Diagnosis is made by clinical history and the mother's history; urine and meconium toxicology screens are confirmatory. Management includes supportive measures (swaddling, quiet environment, frequent breastfeeding), standardized scoring (Finnegan score or ESC approach), and morphine or methadone treatment if needed.

Symptoms

Excessive irritability and high-pitched cry
Tremor and hyperreflexia
Sleep disturbance
Feeding difficulty and suck dysfunction
Vomiting and diarrhea
Sweating, fever, and nasal congestion
Convulsion (severe cases)

Risk Factors

Maternal opioid or methadone use
Use of benzodiazepines, alcohol, SSRIs
Polysubstance use
Lack of antenatal care
Low socioeconomic status
Mother-baby separation

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Before delivery if there is a history of maternal substance use
  • When irritability, tremor, and feeding difficulty develop in the baby after birth
  • When vomiting, diarrhea, and dehydration occur
  • When convulsion appears
  • When behavior and sleep problems persist after discharge

Treatment Methods

01
Standardized Finnegan or ESC scoring
02
Breastfeeding (if no contraindication)
03
Tight swaddling, quiet environment, and skin-to-skin contact
04
Morphine or methadone treatment
05
Second line: clonidine or phenobarbital
06
Social services and family support programs

Which Department to Visit?

You can visit our Çocuk Sağlığı ve Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Çocuk Sağlığı ve Hastalıkları Department

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.