Neonatal Abstinence Syndrome (NAS)

• Low birthweight – A baby who weighs less than 5 pounds 8 oz.
• Prematurity – A baby who is born before 37 weeks.
• Jaundice – A problem with the liver that makes the baby’s skin yellow.
• Seizures – A sudden surge of electrical activity in the brain.
• Sudden infant death syndrome (SIDS) -  An unexplained death in babies less than one year old.
• Problems with the infant gaining weight. 

• Breastfeeding is recommended for mom and baby if she and the baby are being followed by their health care provider and mom is in a Medication-Assisted Treatment (MAT).
• Breastfeeding increases the bonding with mom and may help calm the baby. It may also lower the number of days a baby is in the hospital.

Breastfeeding is not recommended if the mother is:

• Currently, taking an addictive substance and not receiving treatment
• Is living with HIV;
• Has Hepatitis C and has cracked or bleeding nipples.

The mother should be given long-term education about breastfeeding and substance use disorder. She should be given information about what to do if she relapses while breastfeeding.

How to Soothe a Baby with NAS
 

Clinical Guidelines

• Reece-Stremtan, S., & Marinelli, K. A. (2015). ABM clinical protocol #21: guidelines for breastfeeding and substance use or substance use disorder, revised 2015. Breastfeeding Medicine, 10(3), 135–141.

References

1. Barfield, W. (2016, August 22). Primary prevention and public health strategies to Prevent Neonatal Abstinence Syndrome. YouTube. 
2. Klaman, S. L., Isaacs, K., Leopold, A., Perpich, J., Hayashi, S., Vender, J., Campopiano, M., & Jones, H. E. (2017). Treating Women Who Are Pregnant and Parenting for Opioid Use Disorder and the Concurrent Care of Their Infants and Children: Literature Review to Support National Guidance. Journal of Addiction Medicine, 11(3), 178–190. 
3. Logan, B. A., Brown, M. S., & Hayes, M. J. (2013). Neonatal abstinence syndrome: treatment and pediatric outcomes. Clinical Obstetrics and Gynecology, 56(1), 186–192. 
4. MacMillan, K., Rendon, C. P., Verma, K., Riblet, N., Washer, D. B., & Volpe Holmes, A. (2018). Association of Rooming-in With Outcomes for Neonatal Abstinence Syndrome: A Systematic Review and Meta-analysis. JAMA Pediatrics, 172(4), 345–351. 
5. Newman, A., Davies, G. A., Dow, K., Holmes, B., Macdonald, J., McKnight, S., & Newton, L. (2015). Rooming-in care for infants of opioid-dependent mothers: Implementation and evaluation at a tertiary care hospital. Canadian Family Physician, 61(12), e555–e561.
6. Patrick, S. W., Davis, M. M., Lehmann, C. U., & Cooper, W. O. (2015). Increasing incidence and geographic distribution of neonatal abstinence syndrome: United States 2009 to 2012. Journal of Perinatology, 35(8), 650–655. 
7. Winkelman, T., Villapiano, N., Kozhimannil, K. B., Davis, M. M., & Patrick, S. W. (2018). Incidence and Costs of Neonatal Abstinence Syndrome Among Infants With Medicaid: 2004-2014. Pediatrics, 141(4), e20173520.