Refers to the withdrawal symptoms that happens in neonates of mothers that used substances in pregnancy

Aetiology

Substances that cause NAS

• Opiates
• Methadone
• Benzodiazepines
• Cocaine
• Amphetamines
• Nicotine or cannabis
• Alcohol
• SSRI antidepressants

Clinical features

• CNS: irritability, tremors, seizures
• Vasomotor and respiratory: sweating, unstable temperature, tachypnoea
• Metabolic and GI: poor feeding, regurgitation/vomiting, hypoglycaemia

Management

• Mothers that are known to use substances should have an alert on their notes so that when they give birth the neonate can have extra monitoring and management of NAS
• Babies are kept in hospital with monitoring on a NAS chart for at least 3 days (48 hours for SSRI antidepressants) to monitor for withdrawal symptoms
• The neonate should be supported in a quiet and dim environment with gentle handling and comforting
• Medical treatment options are available for moderate to severe symptoms