Congratulations mama, you have made it through your pregnancy, successfully grown your baby and are about to give them life! He or she will soon be in the world and, holy cow, there’s a lot to learn. Don’t worry, there are so many resources out there to help guide you on this new journey of motherhood so that you and your baby can grow and thrive together. Check out this site to learn more about Newborns: The Early Weeks.
If you are using Medication Assisted Treatment (MAT) or your baby was exposed to substances during your pregnancy, your baby may be diagnosed with Neonatal Abstinence Syndrome (NAS) when they are born. You may be asking, what does that mean for my baby? How can I help them get better? If you are, that’s great and that’s a sign that you are already a good mother who is concerned for their baby.
We asked Dr. Cody Smith for some advice on how you can best care for your newborn who as NAS. Here is what he suggests to new moms when he sees their babies in the hospital to treat the symptoms of NAS.
Treatment of Babies with Neonatal Abstinence Syndrome (NAS)
Many babies that are exposed to certain substances, especially opioids, in the womb will need treatment for NAS. The goals of treatment are to help the baby through their withdrawal symptoms so that they are able to eat well, be consolable, be able to sleep, and to grow. The different ways to treat a baby’s withdrawal symptoms will be discussed below.
Treatment without medication(s)
The first way is using techniques other than medications to provide comfort. These babies require a lot of tender loving care (TLC). Ways a caregiver can soothe their baby include:
- Provide skin-to-skin contact, which is also called kangaroo care, by placing a baby only in a diaper directly on their bare chest.
- Gently rock or sway the baby. Soft singing or shooshing sounds are good.
- Swaddle in a lightweight, breathable blanket or sleep sack. These babies can easily get overheated so please be cautious.
- Controlling the environment by keeping the room quiet with dim lights to decrease overstimulation. Soft, peaceful music may help.
- Breastfeeding is a wonderful way to help decrease signs of NAS and reduce your baby’s need for medicine and hospitalization. Occasionally, breastfeeding is not recommended, so please talk with your healthcare professional first.
- Use a pacifier to help calm the baby.
Sometimes babies may require special formulas or an increase in calories to help if they lose too much weight or are having trouble with their feeds. Babies that respond well to these measures are usually monitored in the hospital for 4-7 days before discharge.
Treatment with medication(s)
Most babies will respond to doing the above measures; however, some will require medications to treat NAS. If a baby with NAS requires medication, the first medicine that is started is usually an opioid such as morphine or methadone. These are usually given in small oral doses in a setting in which they can be monitored, which is sometimes the NICU. Some babies may only require 1-3 doses of medicine; however, if symptoms are not improved, they will usually be given medicine every 3-4 hours. Most hospitals follow a protocol to monitor symptoms, determine how well the treatment is working, and when the medication can be decreased or weaned. This wean usually occurs once daily. If the first medication treats the majority of the symptoms, another medicine is sometimes added. Babies that require medication are usually in the hospital from 7 to 21 days, but some may require longer stays.
The real goal of treatment is to ensure that the baby remains happy and healthy and that a caregiver can safely provide this care at home. Most babies will not need medications and can be helped by providing a calm environment and lots of TLC. The baby’s symptoms should gradually improve over the next several weeks.
M. Cody Smith, MD is a board-certified Pediatrician and Neonatologist with clinical, research, and quality improvement expertise in the area of Neonatal Abstinence Syndrome.
March of Dimes: https://www.marchofdimes.org/complications/neonatal-abstinence-syndrome-(nas).aspx
SAMHSA- Treating Babies Who Were Exposed to Opioids Before Birth
Support for a new beginning: https://store.samhsa.gov/system/files/sma18-5071fs3.pdf
Medline Plus: https://medlineplus.gov/ency/article/007313.htm
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Being a new mom is much easier, when you have a group of other new moms who you can reach out to with questions and for support!
You are not alone!
Did you know that there is a Facebook group for Mothers on MAT?