Hello and welcome to the Zero to Finals podcast.

My name is Tom and in this episode I'm going to be talking to you about

neonatal abstinence syndrome.

And if you want to follow along with written notes on this topic,

you can follow along at zero tofinals.com slash n-A-S

or in the neonatology section of the Zero-de-finals pediatrics book.

So let's get straight into it.

Neonatal abstinence syndrome is often shortened to NAS,

and it refers to the withdrawal symptoms that happen in neonates of mothers

that have been using substances during pregnancy.

The symptoms and management is slightly different for each substance used in the pregnancy.

Mothers should be encouraged and supported with cutting back and if possible stopping substances

that can affect the pregnancy. Although often they continue taking these substances which will lead to withdrawal in the neonate.

The substances that can cause neonatal abstinence syndrome include opiates, methadone, benzodiazepines,

cocaine, amphetamines, nicotine or cannabis, alcohol and SSRI antidepressants.

Let's talk about the signs and symptoms.

Withdrawal symptoms from most opiates, diazepam, SSRIs and alcohol occur within 3 to 72 hours after birth. Withdrawal symptoms from methadone and other

benzodiazepines occur between 24 hours and 21 days after birth. We're going to divide these

withdrawal symptoms between central nervous system symptoms, vaser motor and respiratory symptoms,

and metabolic and gastrointestinal

symptoms. The central nervous system symptoms include irritability, increased muscle tone, a high-pitched

cry, not being able to settle the baby, tremors and seizures.

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