Hi, this is Tom, and in this episode I'm going to be talking about neonatal abstinence

syndrome. And you can find notes at zero to finals.com slash n-as and in the zero-to-finals

pediatrics book. And you can find flashcards and questions at members.0-to tofinals.com. So let's jump straight in.

Neonatal abstinence syndrome, or NAS, refers to the withdrawal symptoms that happen in

newborns of mothers who use substances during pregnancy.

The features and management will vary slightly between substances.

Substances that can cause neonatal abstinence syndrome when consumed during pregnancy include opiates, which are the most common cause of neonatal withdrawal symptoms,

methadone, benzodiazepines, alcohol, cocaine and amphetamines.

The term poor neonatal adaptation syndrome is used to describe the withdrawal features in the newborn

associated with maternal use of antidepressants, particularly SSRIs.

Let's talk about the signs and symptoms.

Withdrawal symptoms from opiates, diazepam, SSRIs and alcohol occur between 3 and 72 hours after

birth. Withdrawal symptoms from methadone and other benzodiazepines occur between 24 hours and 21 days after birth.

Central nervous system symptoms include irritability, increased tone, a high-pitched cry,

not settling, tremors and even seizures.

Vasomotor and respiratory symptoms include nasal symptoms, tremors and even seizures.

Vesomotor and respiratory symptoms include nasal stuffiness,

sneezing, yawning, sweating, unstable temperature and pyrexia,

and tachychnya, which is fast breathing.

Metabolic and gastrointestinal symptoms include poor feeding, regurgitation or vomiting,

hypoglycemia or a low blood glucose level, and loose stools with a saw-nappy area.

Finally, let's talk about management.

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