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Neonatal Abstinence Syndrome (NAS): Care Instructions


Neonatal abstinence syndrome (NAS) is a set of problems that may affect a baby if certain drugs were used during pregnancy. This is also called neonatal withdrawal syndrome. The drugs pass through the placenta and enter the baby's bloodstream. The baby's body gets used to the drug. After birth, when the drug starts to leave the body, the baby goes through withdrawal. This may happen within hours after birth or later, depending on the drug.

NAS is caused by certain drugs or prescription medicines. Some examples include opioids such as heroin, methadone, morphine, oxycodone, and hydromorphone. It's important to tell your baby's doctor what medicines or drugs you took. The doctor also needs to know how much you took and when you took them. This can help the doctor give you and your baby the best care possible.

Babies who have NAS may be cranky and jittery. They may cry a lot, and they may have problems feeding and sleeping. This can be very stressful for both you and your baby. But most babies recover after their body has gotten rid of the drug. How long this takes depends on the drug and how much is in the baby's body.

Treatment will help keep your baby from getting worse while the drug is still in the body. Your baby may need special care, such as being in the neonatal intensive care unit (NICU). This may be scary for you. The hospital staff understands this. They will work with you to answer any questions you have about your baby's condition and treatment.

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

How can you care for your baby at home?

  • Follow your doctor's directions for caring for your baby. Call your doctor or nurse advice line if you have questions or concerns.
  • If your baby is upset, try soothing them in a darkened room.
  • Try "kangaroo care." To do this, hold your baby upright, skin-to-skin on your chest, under a light blanket or loose shirt. All your baby needs to wear is a diaper.
  • Swaddle your baby. Swaddling means wrapping them in a blanket. When you swaddle your baby:
    • Keep the blanket loose around the hips and legs. If the legs are wrapped tightly or straight, hip problems may develop.
    • Keep a close eye on your baby to make sure they don't get too warm.
  • Never shake, slap, or hit your baby. This can cause serious or even deadly brain injuries. If you feel overwhelmed, maybe you could ask a family member or friend to give you a break.

When should you call for help?

Call your doctor or nurse advice line now or seek immediate medical care if:

  • The baby:
    • Isn't sucking or feeding well.
    • Isn't sleeping very much.
    • Is breathing very fast.
    • Is shaking.
    • Cries a lot with a high-pitched cry and can't be comforted.
    • Has a fever.
    • Has diarrhea or is throwing up.

Watch closely for changes in the baby's health, and be sure to contact your doctor or nurse advice line if the baby has any problems.

Where can you learn more?

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Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.