Caring for a Child with Neonatal Abstinence Syndrome (NAS)

Knowing how to care for child who is  Hypertonia (increased muscle suffering from the effects of withdrawal from tone) drugs can be frightening, confusing, or  Mottling of the skin overwhelming. These little ones suffer from  Apnea (breathing stops for periods Neonatal Abstinence Syndrome (NAS) and of time) will likely need to spend some time in the  Increased respirations (greater neonatal intensive than 60 breaths per care unit (NICU) minute without before they can go retractions) home with a  Excessive sucking caregiver. and/or rooting  Hyperactive Babies born addicted reflexes to substances start to  Seizures experience  Yawning, stuffy withdrawal within a nose, and sneezing day or two of being born. They will have Some of the more some very specific severe withdrawal symptoms, but the symptoms can seem combination of scary, but they are medication and medical care, along with manageable with medication. Some of these some tips for at-home care, can get you, and early symptoms can include tremors or the newborn, through those first weeks and trembling, myoclonic jerks, restlessness, months of life. sleeping less than three hours after a feeding, and high-pitched crying. These happen most Symptoms of Neonatal Abstinence Syndrome intensely in the first few days and weeks. In (NAS) can include: the NICU, infants may be given medicine like  Tremors (trembling) morphine, methadone, and seizure  Irritability (excessive crying) medications to help them make it through  Myoclonic jerks (sudden twitch or the withdrawals more easily. If the infant is jerk, sometimes while falling on a sedative such as morphine, they also asleep) may have an apnea monitor that has to be  Restlessness (documented as one- worn at all times to monitor their breathing three hours of sleep after feeding) and heartrate. (If you are interested in  High-pitched crying learning more about Continued on page 2

Caring for a Child with Neonatal Abstinence Syndrome, continued Page 2 how the NICU care team rate the withdrawal jerks. Infants typically like to be swaddled for symptoms in order to treat them, we have sleep, but infants with NAS can benefit from resources on NAS rating scales at the end of being swaddled all the time, with shorter this tip sheet.) periods to stretch and move around when they are awake before or after eating. Infants Other things that can help in those first few with NAS often have a hard time controlling days are: their own body temperate – another benefit of swaddling. They may need to be swaddled  A dim, quiet environment. It’s not always in just a diaper if they have excessive the easiest to achieve when you are in a sweating. Their body temperate can change NICU with other little ones and monitors, throughout the day, so you may need to play but lights can be kept down, and the it by ear. You can get swaddle blankets that curtain drawn around their area. have Velcro and are made to stay put, or  If you are able to spend time in the NICU, master the art of the swaddle with any we encourage you to do so. The more time blanket and practice! you get to spend with the Another item that baby, the may be worthwhile better you will is a swing and a get at figuring smaller bed or out what works bassinet. In for calming general, smaller, them. controlled spaces  The NICU and calm nurses spend a environments lot of time with make sure a baby these babies suffering from and will likely NAS doesn’t get be a great ally overstimulated for you as you and helps them learn how to feel safe. provide the best care for the child. Some other symptoms of NAS may seem less Just as with typical infants, babies suffering intense, but these few simple tips might help from NAS will have their own personalities keep the child in your care soothed and and preferences. The child in your care may content: prefer bouncing to rocking; they may love or  Infants with NAS can have overactive hate the car. That said, babies suffering from sucking reflexes, so use of a pacifier is NAS typically do well with a few of the same soothing and quite beneficial. considerations.  Skin to skin contact, such as a kangaroo carry, is a good way to soothe an infant In addition to a dark and quiet environment, suffering from withdrawal. infants who are going through withdrawal  A good wrap or baby sling/carrier is typically love to be swaddled. This will help priceless in the first few months. them feel safe, as well as help them stay asleep by minimizing tremors and myoclonic Feeding can be Continued on page 3

Caring for a Child with Neonatal Abstinence Syndrome, continued Page 3 difficult. Though they may have increased Resources sucking reflexes, babies with NAS are often not able to latch properly, can have  Neonatal Abstinence Syndrome swallowing issues, reflux, or other difficulties feeding. Pediatricians will often suggest  Caring for Babies with Neonatal feeding the child with a higher calorie Abstinence Syndrome formula, in smaller quantities more frequently. Sometimes you may have to try  Helping Babies Overcome Opioid different bottle and nipple combinations. If Withdrawal there is one that is working well in the NICU, you might consider using the same ones at  Assessment of Neonatal Abstinence home. Syndrome: Standard Scoring of Infants

Using the Finnegan Scoring Tool As you learn how to care for a child with

NAS, you may also want to take some time to From the Lending Library educate your support system, as well. Though it’s hard with a new baby in the family, you  Methamphetamine & Drug may want to avoid large family gatherings. Endangered Children: Breaking the Being passed between people, hearing many Cycle, DVD by Marathon County voices, and the general commotion of a larger Sheriff’s Department group of people can be too much for a newborn with NAS to deal with.  Adoption & Prenatal Alcohol and

Drug Exposure, by Richard B. Parth, Caring for an infant with NAS can be Madelyn Freundlich & David exhausting. There might be times when the Brodzinsky baby is hard to soothe and calm, and the frequent feedings and sleep schedules may  Understanding the Drug Exposed leave you feeling worn out. Please remember Child, by Ira Chasnoff, Amy Anson & that you are not alone. Be sure to care for Kai Moss Iaukea yourself; make use of the people in your circle of support, and reach out when you are feeling overwhelmed.