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Neonatal Abstinence Syndrome (NAS)

Waiting Area for the NICU

Neonatal abstinence syndrome happens when babies are in contact with medications or illegal drugs in the womb. After birth, they experience withdrawal just like adults. They have a screech-like cry, claw their faces and squirm. The withdrawal process is very painful. Babies can become dependent on:

  • Painkillers
  • Anxiety medicine
  • Sleep medicine
  • Illegal drugs
  • Prescription drugs

Children's Hospital developed a special treatment protocol for babies with Neonatal Abstinence Syndrome (NAS). NAS may be a tough subject for parents, so the NICU works with the Children's Hospital Social Work Department and the Department of Children’s Services if needed. The hospital sets up follow-up care and safeguards for when babies return home.

How Children's Hospital is Fighting NAS

In 2014, 265 of 774 babies admitted to the Children's Hospital Neonatal Intensive Care Unit (NICU) were suffering from NAS. The neonatal team also cares for drug-dependent newborns at Fort Sanders Regional Medical Center and Parkwest Medical Center; whose symptoms are not severe enough to warrant NICU admission.

Faced with the growing problem of NAS, the Children's Hospital NICU staff created a better protocol for treating babies suffering from the condition. The NICU staff implemented a multifaceted treatment protocol that involves doctors, neonatal nurse practitioners, bedside nurses, social workers, a case manager, the rehabilitation team, and a pharmacist to develop this approach that involves evaluating neonates with NAS by using the Finnegan Scoring System (which analyzes a range of central nervous system, metabolic, gastrointestinal and respiratory symptoms). The resulting score allows the NICU staff to adjust treatment as needed.

The next important step is to get the initial symptoms of withdrawal under control without medication. Children's Hospital accomplishes this by keeping babies swaddled in private rooms. The rooms are kept quiet and dark, avoiding overstimulation. A specialized diet, baby swings and a group of trained volunteer cuddlers are also key to soothing babies with NAS.

If withdrawal symptoms are severe enough, doctors and nurses will administer small amounts of oral morphine based on the severity of the symptoms. The final goal of the protocol is weaning the baby off the medication as they become less dependent on a drug before he or she goes home.

Grow With Me Program

Grow With Me ProgramThe Grow with Me program is a care coordination service and outpatient clinic designed to serve at-risk children who have experienced intrauterine drug exposure or were diagnosed and treated for Neonatal Abstinence Syndrome (NAS). The focus of the Grow with Me program is to address the medical, developmental and emotional needs of a child during the first five years of life.

Learn More about the Grow With Me Clinic

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