Neonatal Abstinence Syndrome (NAS) causes newborn infants to suffer the symptoms of withdrawal due to their mother’s drug or alcohol use. Created by: Katie Muska

The nine months that a fetus spends in the womb are crucial. With a variety of genetic diseases, birth defects and complications possible, the implications of what could go wrong in a typical pregnancy are innumerable. When one adds opioids or alcohol into the mix, it increases the risk of the child’s well-being during the pregnancy.

Neonatal abstinence syndrome, or NAS, includes a series of issues that occur in a newborn who has been exposed to addictive drugs while developing in their mother’s womb. NAS can be caused by two determining factors: either prenatal/maternal use of addictive substances which lead to withdrawal symptoms in a newborn, or postnatal NAS due to discontinuation of medications used for pain therapy in a newborn. The former, however, is the more common of the two.

In 2012, it was reported that an estimated 23,732 babies were born with NAS in the United States, which was a five times increase from the year 2000. According the National Institute on Drug Abuse, every 25 minutes a baby is born suffering from withdrawal symptoms. These symptoms can include high-pitched cries, restlessness, jitteriness, tremors, hypertonia, generalized convulsions and hyperactive reflexes. Other signs of NAS include sweating, fever, molting and frequent yawning.

Withdrawal times can vary depending on what the newborn is withdrawing from. For example, an infant can withdrawal from alcohol within one or two days of birth. However, it may take anywhere from 7 to 14 days to withdrawal from methadone according to Medscape.

“We have a scoring system that many of the clinical scientist use to see if they are having significant withdrawal, and if they are, we first begin by trying to control the environment,” Dr. Stephen Patrick, Assistant Professor of Pediatrics and Health Policy, said. “We do things like having a non-stimulating environment, trying to keep mom and baby together. We are allowing the mom to room in with the baby, promoting breast feeding when it is appropriate.”

The treatment for these infants varies depending on the substance they were born addicted to. For up to a week, a healthcare team will watch the newborn for signs of withdrawal, feeding problems and weight gain. Those who become dehydrated and who vomit a lot may require the use of an IV for fluids.

“For babies that have severe withdrawal, they require a treatment with a drug like morphine or methadone,” Patrick said.

With the more severe cases, the goal often time is to prescribe the baby with a drug similar to the one used by the mother during the pregnancy. Over a period of weeks or months, the baby is slowly weaned off of the drug in order to lessen the withdrawal symptoms.

It is possible that some long-term effects can also happen as a result of the drugs introduced into a baby’s system, although research has not yet developed far enough to say definitively.

“What we know from studies is that some infants have some difficulty with attention, or maybe some vision problems,” Patrick said. “But the long-term problems don’t appear to be severe, and so i think that is important as we sort of push through what the next few years look like.”

Written by: Katie Muska