Neonatal Abstinence Syndrome – Symptoms, Causes and Treatment by Dr Lathiesh Kumar Kambham

5 min read

Reviewed by Dr Lathiesh MBBS, MD (Pediatrics)
DM (Neonatology), Lead Neonatology and NICU Services
Aster Women & Children's Hospital
17 years of experience

Dr Lathiesh

Dr. Lathiesh Kumar Kambham is a Neonatologist and Paediatrician with over 12 years of experience. He has a special interest in the management of birth asphyxiated babies and extreme preterms and ha More

Written by Aparna Hari

Aparna Hari

Her experience in impactful writing combined with her background in Home Sciences makes Aparna the perfect candidate for content writing in the pregnancy and parenting niche.

Neonatal Abstinence Syndrome

Neonatal Abstinence Syndrome, also known as NAS, is a condition in which a baby is affected due to exposure to opioid drugs when they are in the womb. It also happens when a baby comes in direct contact with the addictive substances when they are in the womb before birth. These drugs reach the baby via the placenta, an organ that provides oxygen and other healthy nutrients from the mother’s body to that of the fetus.

This mainly occurs when a woman consumes drugs called opioids during pregnancy. On the other hand, it may also happen when a woman consumes antidepressants during pregnancy, which can prove to be highly dangerous. Antidepressants and sleeping pills during pregnancy must be avoided as they can impact the baby’s health in the womb directly. These drugs can hamper a baby’s health in the womb and hence can cause serious issues for your baby. In this guide, we are going to discuss every detail of neonatal abstinence syndrome, its symptoms, causes, and treatment options.

In This Article

What is Neonatal Abstinence Syndrome?

When a pregnant woman consumes any type of drug or addictive medicines during her course of pregnancy, then there are chances that it might cause the baby, the condition of Neonatal Abstinence Syndrome. This is because, when the drugs reach the fetus, it causes serious issues to them in the womb before birth, and this can also lead to various complications. When your baby is exposed to NAS, they might have to go through the process of withdrawal after birth.

Mainly, this syndrome occurs due to the consumption of Opioids, a drug doctors prescribe for excessive and unbearable pain.

Causes of Neonatal Abstinence Syndrome

Causes of Neonatal Abstinence Syndrome

Every drug consumed during pregnancy passes from the pregnant woman’s bloodstream to the baby through her placenta. The placenta is a uterine structure that develops during pregnancy. It provides nutrients and oxygen to the growing fetus. It also helps in getting rid of waste products from the baby’s blood and tries to purify it.

There is a chance that if you take a medication that affects your nervous system while you are pregnant, the medication will enter your baby’s bloodstream and affect their nervous system as well. As soon as they are born, they stop getting these drugs, and this could give rise to the symptoms of withdrawal.

Moreover, opioids during pregnancy must be avoided as these are the main cause of this syndrome. Opioids are an illegal form of drugs just like heroin and hence these are prescribed to get rid of depression, stress, and unbearable pain.

When you take more medications than required, then this can cause a very harmful effect on your baby in the womb. Furthermore, when you intake certain drugs and medications such as illicit opioids like heroin, codeine, oxycodone, cocaine, amphetamines, and nicotine in a high amount during pregnancy, this can cause a very serious effect on your baby and can give rise to many such complications for the baby in the womb.

Not just this, consuming alcohol during pregnancy can also be dangerous as it can bring in another set of problems for your baby. The syndrome caused by alcohol during pregnancy is known as an alcohol spectrum disorder.

Signs and Symptoms of Neonatal Abstinence Syndrome

Symptoms of NAS

The signs and symptoms of Neonatal Abstinence Syndrome can show up when a baby is in the womb before birth. Once the baby’s umbilical cord is cut, the baby cannot receive any side effects of the drugs that a mother must take. But the signs and symptoms might show up until a few weeks after birth. Sometimes, they can even last for 1 week and go up to 6 months.

If your baby shows up the following signs, consult the doctor right away:

  • Fever
  • Tremors or shaking
  • Loud crying
  • Vomiting
  • Crankiness
  • Restlessness
  • Diarrhea
  • Sweating
  • Dehydration
  • Irritation in the skin
  • Diaper rashes
  • Sneezing or stuffy nose

These symptoms can begin soon after 24 hours of childbirth. Babies who are born prematurely have a lower chance of developing symptoms of Neonatal Abstinence Syndrome. Because they are exposed to it for less time than the ones who have been in the womb for the entire 9 months.

Diagnosis of Neonatal Abstinence Syndrome

The doctor will examine your body and analyze your drug intake before your baby is born. This will be done by performing a drug screen. A drug screen will help your doctor detect the amount and the type of drug you are consuming, which will pass on to your baby’s body.

A drug screen takes a sample of the umbilical cord, urine, and blood from your newborn and then a diagnosis for the same would be performed. After this, they would look for other probable symptoms of Neonatal Abstinence Syndrome.

Treatment For Neonatal Abstinence Syndrome

baby in NICU

If your baby shows a lot of strong symptoms or withdrawal symptoms, they may have to go for treatment in a hospital’s Newborn Intensive Care Unit (NICU). There are various treatments available for the same but the very right treatment for your newborn would depend upon their exact age, weight, overall health condition as well as the type of symptoms shown, and how serious the condition is.

There are various treatments available, such as

1. IV Fluids

Intravenous or IV treatment. This treatment helps a baby to get fluids through a needle into a vein. This treatment helps a baby to fight dehydration, which means that the baby is not having enough water in its body. Dehydration is one of the main symptoms of NAS and this can even cause diarrhea and other symptoms in the baby.

2. Medications

Prescribing several medications to the baby to manage severe withdrawal symptoms. Once these symptoms are under control, the dose gets smaller. Medications such as methadone, buprenorphine, morphine, etc. are given to the baby to fight NAS.

3. Food

Feeding the baby with high-calorie baby formula, if caught with NAS is important. When a baby has symptoms of Neonatal Abstinence Syndrome, they need some extra calories to fight the same. If your baby is having trouble breastfeeding, it’s better to feed them with formula milk.

Neonatal abstinence syndrome is a serious medical condition that can have severe implications on the newborn baby. The mother’s drug and opioid addictions can lead to these issues in babies. Timely medical intervention immediately after birth can help the baby wean off the symptoms.


1. What Causes Neonatal Abstinence Syndrome?

The main cause of neonatal abstinence syndrome is when a mother consumes drugs such as opioids during pregnancy and this reaches their baby in the womb before birth.

2. How Long Do NAS Symptoms Last?

Well, symptoms related to NAS stay for up to one week to six months. But if it stays for longer, then babies are required to be admitted to the hospital for more in-depth care.

3. What Are the Symptoms of a Baby Born Addicted to Drugs?

When pregnant women consume an excessive amount of drugs during pregnancy, it leads to NAS. This can be short-lived or have long-term effects. Short-term withdrawal symptoms consist of mild fussiness. Whereas, severe NAS symptoms include irritability, jitteriness, diarrhea, and problems in feeding.

Read Also: Congenital Ptosis in Babies – Causes, Symptoms, and Treatment

Aparna Hari,MBA in Marketing,P.G. Diploma in Human Resource Management from IGNOU Bachelor of Sciences (Home Science) from Nagarjuna University

Her experience in impactful writing combined with her background in Home Sciences makes Aparna the perfect candidate for content writing in the pregnancy and parenting niche.Read more.

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