Infant Withdrawal Syndrome (NAS): Symptoms and Additional Information

Neonatal Abstinence Syndrome (NAS): Signs, Symptoms, and Further Information

Neonatal Abstinence Syndrome (NAS) is a condition that affects infants who were exposed to drugs in the womb, most commonly due to maternal opioid use. According to recent reports, an infant with NAS is born every 24 minutes in the U.S., with doctors diagnosing over 59 infants daily [1].

Doctors diagnose 60-80% of newborns who have had opioid exposure with symptoms of NAS. These symptoms can vary and include diarrhea, tremors, excessive crying, exaggerated Moro reflex, stiffness, irritability, sneezing, GI symptoms like diarrhea and vomiting, CNS symptoms like hyper-irritability, tremors, high pitched crying, jitteriness, myoclonic jerking, seizures, sleep disturbances, autonomic symptoms like high body temperature, fast heart rate, fast breathing rate, frequent yawning, excessive sneezing, and nasal congestion [2].

While most infants with NAS will recover in 5-30 days with treatment, children affected by it may have ongoing challenges affecting neurodevelopment and behavior well beyond infancy. Research indicates that prenatal opioid exposure is associated with a higher risk of fetal growth restriction, low birth weight, and preterm birth [2].

Long-term effects of NAS include developmental delays, cognitive and behavioral issues, and increased risk of emotional and neurodevelopmental disorders such as attention-deficit/hyperactivity disorder (ADHD) and conduct disorder. These effects can persist into childhood and adolescence [2][5].

Specifically, large cohort studies show that prenatal opioid exposure is associated with an increased likelihood of conduct disorders and emotional disturbances in preschool-aged children, and a greater incidence of ADHD and cognitive/behavioral problems in school-aged children [5][2].

These long-term outcomes are influenced by multiple factors, including environmental stressors such as poverty, violence, inconsistent parenting, and other prenatal complications like prematurity or low birth weight, which may compound the effects of opioid exposure [5].

It's important to note that NAS can also affect multiple systems in the body, including the gastrointestinal (GI) system, central nervous system (CNS), and autonomic nervous system. Treatments for infants with NAS may involve medication, diet, intravenous fluids, non-pharmacological measures, and ensuring regular, on-demand feeding [3].

People who had NAS as infants may also be at higher risk of ear infections. Using antidepressants during late pregnancy may pose a risk of the newborn experiencing withdrawal symptoms, with withdrawal symptoms for tricyclics including irritability, muscle spasms, fast heart rate, restlessness, sleeplessness, and fever. Withdrawal symptoms for SSRIs and SNRIs may include jitters, high blood pressure, difficulty breathing, low blood sugar, and high blood pressure [4].

Pregnant people should not suddenly stop using substances that may cause NAS due to potential health risks for the fetus. Discussing medication-assisted treatment (MAT) with a healthcare professional can help if a pregnant person is using opioids. More research is necessary to fully understand the long-term effects of NAS on people [6].

References:

An HCUP report states that an infant with NAS is born every 24 minutes in the U.S.
Specifically, research from large cohort studies indicates that prenatal opioid exposure, the primary cause of NAS, is associated with
Treatments for infants with NAS may involve medication, diet, intravenous fluids, non-pharmacological measures, and ensuring regular, on-demand feeding.
Withdrawal symptoms for tricyclics may include irritability, muscle spasms, fast heart rate, restlessness, sleeplessness, and fever. Withdrawal symptoms for SSRIs and SNRIs may include jitters, high blood pressure, difficulty breathing, low blood sugar, and high blood pressure.
These long-term outcomes are influenced by multiple factors, including environmental stressors such as poverty, violence, inconsistent parenting, and other prenatal complications like prematurity or low birth weight, which may compound the effects of opioid exposure.
Pregnant people should not suddenly stop using substances that may cause NAS due to potential health risks for the fetus. Discussing medication-assisted treatment (MAT) with a healthcare professional can help if a pregnant person is using opioids. More research is necessary to fully understand the long-term effects of NAS on people.
Apart from opioid use, other medical-conditions that can affect infants include chronic diseases, cancer, and respiratory and digestive-health ailments.
Science has made significant strides in understanding the impact of prenatal opioid use on eye-health, hearing, and skin-conditions, revealing potential risks and complications.
Besides NAS, prenatal drug exposure can lead to other neurological-disorders, posing a threat to the baby's brain development.
In the realm of health-and-wellness, fitness-and-exercise, nutrition, and skin-care are essential aspects that individuals should maintain for overall well-being.
Long-term use of opioids can also impact cardiovascular-health, increasing the risk of conditions like high blood pressure and heart disease.
To address NAS and its long-term consequences, various therapies-and-treatments, including behavioral, pharmacological, and social interventions, are being developed and studied.
Education-and-self-development, particularly in areas such as personal-growth and career-development, can empower people to make informed decisions about their health and lifestyle choices.
Prenatal exposure to opioids can affect a child's mental-health, leading to increased chances of mental-health issues like depression, anxiety, and ADHD.
Taking steps to manage stress, practice good self-care, and seek support is crucial in mitigating the impact of prenatal opioid exposure on the infant's well-being.
Medication-assisted treatment (MAT) can help manage opioid addiction during pregnancy, reducing the risk of NAS and its long-term effects on the child.
Advocacy, policy changes, and public health initiatives are essential to addressing and preventing NAS at the population level, addressing social determinants of health like poverty, lack of access to healthcare, and education.
Complex issues such as NAS emphasize the importance of comprehensive, multidisciplinary care that considers the physical, emotional, and social aspects of the infant and family experiencing opioid use. [References removed for brevity]