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Baby at Risk for Neonatal Abstinence Syndrome (NAS): Care Instructions


Neonatal abstinence syndrome (NAS) is a set of problems that may affect a baby if the mother used certain drugs while she was pregnant. Examples of these drugs are heroin, methadone, morphine, buprenorphine, and hydromorphone. Sometimes they are prescription medicines.

The drug passes through the mother's placenta and enters the baby's bloodstream. The baby's body gets used to the drug. After birth, when the drug starts to leave the baby's body, he or she may go through withdrawal. This may happen within hours after birth or days or weeks later. It depends on the drug.

If NAS develops, the baby may become upset and jittery or have seizures. He or she may cry a lot and have problems feeding and sleeping. And the baby may have stomach problems like vomiting and diarrhea. But most babies recover after the drug leaves their body. How long this takes depends on the drug and how much is in the body.

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 the baby at home?

  • Follow your doctor's directions for caring for the baby if symptoms occur.
  • If the baby is upset, soothe him or her in a darkened room.
  • If the baby seems to be restless or tense, try "kangaroo care." To do this type of care, hold the baby upright, skin-to-skin on your chest, under a light blanket or loose shirt. All the baby needs to wear is a diaper.
  • Ask your doctor if it is okay to swaddle your baby. Swaddling means wrapping him or her in a blanket. When you swaddle the baby:
    • Keep the blanket loose around the hips and legs. If the legs are wrapped tightly or straight, hip problems may develop.
    • Be sure you don't make the child too warm.
  • Take a break. Ask a family member or friend to give you a break if you feel overwhelmed.
  • Never shake, slap, or hit a baby or put anything over his or her face.

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?

Go to

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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.