December 2015
Neonatal Abstinence Syndrome (NAS): What You Should Know
Behavioral Healthcare; Nursing; Nutrition; Obestrics and Gynecology; Pediatrics
Neonatal Abstinence Syndrome (NAS): What You Should Know
What is NAS?

NAS can occur if a mother uses prescription or illegal drugs, such as narcotics, during pregnancy. The newborn can experience withdrawal symptoms that include excessive or high-pitched crying, irritability, poor feeding, sleep problems, slow weight gain and seizures.

Pennsylvania NAS Data

Pennsylvania Patient Safety Authority analysts identified 797 events involving newborns diagnosed with NAS that occurred from January 2005 through December 2014, with an increasing number of events reported each year.

Increasing Opioid (Narcotic) Use

Opioid prescribing increased in the United States from about 76 million prescriptions in 1991 to nearly 207 million in 2013, crossing all populations, including pregnant women. Addiction may occur after opioids are prescribed for chronic pain caused by an accident, fibromyalgia, or other causes.

Treatment of Babies with NAS

Treatment for the baby depends on the type of drugs taken by the mother, the newborn’s overall health, and whether the newborn was born at full term or prematurely. Depending on the type of opioid exposure, withdrawal can occur during the first day to three days after birth, and sometimes even up to five to seven days after birth with an average onset of 48 hours.

What Parents and Family Members of a Baby with NAS Should Do:
  • Listen to nursing staff about how to sooth your baby. Each baby with NAS will respond differently, however most enjoy being held and rocked, a quiet environment, along with some humming.
  • Breastfeeding is also recommended for mothers who are part of a drug treatment program. Multiple studies have confirmed that breast milk contains only minimal quantities of drugs used in the maintenance programs for drug-dependent women. Breastfeeding increases bonding between the mother and newborn, enhances a mother’s confidence and helps mothers feel more involved during their newborn’s treatment.
  • Family members and hospital staff should treat both mother and baby with compassion. Mothers may feel guilty that their baby requires treatment, and they may also feel they are being judged by the staff doctors, nurses, therapists and social workers.
  • Effective hospital programs teach mothers and family members to let go of guilt and judgment. Learn from the past, but do not dwell on it.   

For more information about NAS, go to the 2015 December Pennsylvania Patient Safety Advisory article, “Addressing the Rise in Neonatal Abstinence Syndrome: A Multifaceted Approach,” at the Authority’s website at 

©2018 Pennsylvania Patient Safety Authority