Neonatal Abstinence Syndrome: Risks and Long-Term Side Effects (2023)

Neonatal Abstinence Syndrome(NAS) is the exposure of drugs to a baby while the fetus is growing in the womb. The drugs taken by a pregnant mother can cause withdrawal symptoms to occur within the baby during pregnancy and after birth. The baby is also at risk of sustaining severe injuries and death during pregnancy and immediately after birth, due to its reaction to the drugs.

Additionally, there are long-term effects of babies born addicted to opiates and other drugs — like havingNAS— as the child who is exposed to the drugs can experience physical and mental challenges later on in their life. That’s why a mother taking drugs, including opioids or prescription medications, is strongly discouraged from continuing to take them. Staying healthy during pregnancy and avoiding harmful substances can help a child develop healthily in the womb and avoid developmental risks and physical challenges in the first few days and weeks after birth, and continue that healthy trend years into the child’s life.

Neonatal Abstinence Syndrome Risks and Side Effects

Prescription opiate misuse is one of the main causes of NAS, and also an epidemic throughout the country. According to the 2008 National Survey on Drug Use and Health, misuse of prescription narcotics such asoxycodonewas the second-most reported category of misused illicit substances, behind marijuana.

As drug misuse has increased in the United States over the last few years, pregnant women are no exception to this trend. The increased amount of exposure unborn children have to drugs has resulted in a higher percentage of NAS occurring in the country. In 2012, more than 380,000 unborn children were exposed to illicit drugs and nearly 6 percent of pregnant women used at least one illicit drug during their pregnancy. Nearly 1 million pregnant women smoke cigarettes, another potential risk for long-term problems with a child during and after pregnancy, and around 10 percent of women consumed alcohol during a pregnancy between 2013 and 2014. Additionally, the Centers for Disease Control and Prevention reports than in the U.S. each year, one out of every 33 babies are born with birth defects. These issues could arise from exposure to drugs while in the womb.

The lives of a baby who is born addicted to drugs and one who was never exposed to illicit substances in the womb can be similar in many ways, especially if NAS is identified early enough. There are significant risks with prenatal exposure to drugs such asmeth,heroin,cocaineor prescription medications likeXanaxor oxycontin.

Problems that children exposed to drugs in utero might experience are different for each child. Many NAS symptoms occur within days after birth, althoughthe website March of Dimesstates that some symptoms can occur as late as six months after birth. A baby with NAS might have jaundice, which can be identified by yellow eyes or skin, or a low birthweight.

Some of the other common early signs of Neonatal Abstinence Syndrome that a child might experience include:

  • Body shakes
  • Seizures
  • Overactive reflexes
  • Tight muscle tone
  • Fussiness or excessive crying
  • Poor feeding or a slow weight gain
  • Breathing problems
  • Fever, sweating or blotchy skin
  • Trouble sleeping and lots of yawning
  • Diarrhea or throwing up
  • Stuffy nose or sneezing

As the child gets older, though, there are other potential challenges they might face. The risk factors for Neonatal Abstinence Syndrome is not limited just to physical struggles. Some of the challenges a family might face include issues involving a child’s educational development and other mental aspects.

(Video) A baby’s struggle to overcome her mother’s addiction

Neonatal Abstinence Syndrome Developmental Outcomes

TheU.S. National Library of Medicine National Institutes of Healthpublished a study in 2017 on the correlation between NAS and poor performance in school. The results of the examination shows a direct link between children who suffered from NAS and slower-than-average mental development.

Children with NAS were compared to a group of kids that matched in age, socioeconomic status and gender on the National Assessment Program: Literacy and Numeracy in third, fifth, and seventh grades. The results for third grade showed that children with NAS scored lower than other children. By the time children with NAS reached seventh grade, many of them scored lower on tests than children without NAS who were in fifth grade. The study, which was done with kids from New South Wales, Australia, also reveals that the slow development continues as children with NAS reach high school.

One of the findings from the study is that certain parental strategies can diminish the effect that NAS can have on kids. However, parents who take opioids, prescription painkillers or other drugs during pregnancy run the risk of their child developing NAS. This exposure to substances before birth can have a lasting effect on their educational development.

Neonatal Abstinence Syndrome and Auditory Processing

An auditory processing disorder is a person’s inability to understand speech. While there has not been any evidence to suggest a deficiency in auditory processing among babies exposed to drugs during pregnancy, one study published on theU.S. National Library of Medicine National Institutes of Healthsuggests that somatosensory networks might be disrupted from exposure to buprenorphine. This means that newborns experiencing NAS might have an affected development of their sensory nervous system.

Even without a significant amount of evidence correlating an affected auditory processing development to NAS, exposure to drugs can cause significant developmental issues for children. Any time a pregnant woman ingests drugs, whether it is illegal substances or a prescription medication such as oxycodone or another opiate, they run a major risk of developing NAS within their unborn child.

Neonatal Abstinence Syndrome, ADHD and Autism

Findings from research done for a published work titled “Substance Abuse: Research and Treatment,” which was published on thewebsite Psychiatry Advisor, shows that children who have been exposed to opiates or other illicit substances during pregnancy have a higher risk of possessing symptoms commonly associated with attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) compared to children who were not exposed to opiates or similar substances. This information details how staff members at the Haukeland University Hospital in Norway evaluated 57 school-age children who were exposed to opiates or other drugs for potential risks of ADHD and ASD.

“The authors noted, however, that a previous study had found that adults with substance use disorders had a higher rate of ADHD symptoms, suggesting that ADHD was an independent risk factor for substance abuse,” the article reads, adding that “the mean level of symptoms associated with ASD was increased in exposed children as well, with more than one-third of exposed children (showing symptoms of ASD), mainly on the social difficulties subscale. The authors also noted that they found children with overlapping ADHD and ASD symptoms in the exposed group, lending support to the suggestion of neurodevelopmental vulnerability in exposed children.”

The findings from the study lend credence to the idea that children prenatally exposed to drugs and other harmful substances should receive early mental health assessments to properly identify ADHD and ASD.

(Video) When babies are born withdrawing from opioids

Treatment for Babies With Neonatal Abstinence Syndrome

The website March of Dimes states that newborn babies who receive NAS treatment within five to 30 days of birth often experience improvements and a reduction in withdrawal symptoms and side effects. While this does not guarantee a complete recovery from NAS, seeking treatment as quickly as possible and identifying NAS immediately can help prevent physical issues and permanent injuries. There are specific ways to test for NAS, including:

  • A NAS scoring system, which gives points for each symptoms depending on how severe it is for the child.
  • A Meconium test, which is done with the baby’s first bowel movement.
  • Urine testing

If NAS is detected in a baby, there are specific treatment options available to help prevent long-lasting effects. These include:

  • Taking medicines to mitigate or block withdrawal symptoms, which will dissipate over time and require a smaller dosage of medicine as a way of tapering the child off the substance.
  • Receiving fluids through a needle into a vein to prevent dehydration, which can occur since babies who have NAS often have diarrhea or vomit more often than normal and can lack enough internal liquids.
  • Drinking higher-calorie baby formula to help with feeding and proper growth in the initial days following birth.

If a woman is addicted to drugs such as opiates or is currently taking a prescription medication but is attempting to get pregnant, or already is pregnant, help is available. The child can develop NAS from exposure to these drugs through the mother’s misuse, but rehabilitation and recovery from any type of drug addiction is possible. Even if it’s a prescription painkiller such as oxycodone, itcan have a damaging effect on a fetus’ growth and development during pregnancy.

The Recovery Villagecan help women taper off from regular drug misuse, whether they are illegal substances or prescription medication, to help their pregnancy stay as safe as possible. Call today for information on which steps to take to begin thedrug rehabilitation processand remove drug dependency and addiction from your life.

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Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.


1. Stories Not Secrets: Neonatal Abstinence Syndrome
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2. Treating Neonatal Abstinence Syndrome
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3. Changing How We Treat Neonatal Abstinence Syndrome
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5. Ep. 5: The Tiniest Victims of the Opioid Crisis - Neonatal Abstinence Syndrome
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6. Federal Efforts to Mitigate Neonatal Abstinence Syndrome in the U.S.
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