Neonatal abstinence syndrome (NAS) is a term for a group of problems a baby experiences when withdrawing from exposure to narcotics. Opioids cause withdrawal in a number of babies who are exposed to substances prenatally. When a mother is using, it increases the risk for both her and her unborn child. 

Using illicit substances while pregnant can cause a number of issues for a baby, including:

• Poor intrauterine growth
• Premature birth
• Seizures
• Birth defects
• Withdrawal 
• Low birthweight
• Developmental delay

There are many symptoms for NAS, though each baby will experience these symptoms differently to varying degrees and symptoms depend on the type of substance used.

Such symptoms include:

• Tremors
• Excessive crying
• Sleep issues
• High-pitch crying
• Tight muscle tone
• Hyperactive reflexes
• Seizures
• Poor feeding
• Vomiting
• Diarrhea
• Dehydration
• Sweating
• Fever or unstable temperature

Symptoms of withdrawal might begin around 24 to 48 hours after birth, or not until five to ten days after. It is important to note that while these are some of the symptoms for NAS, they might also be symptoms for a different medical condition so it is important to consult with the doctor. 

To diagnose NAS, the mother’s drug usage is written into a report along with the use of a scoring system; the scoring system grades the severity of the baby’s withdrawal. Points are determined by the severity of withdrawal symptoms. The scoring system is beneficial when trying to figure out a proper treatment plan.

Treatment for NAS is based on several things, including:

• Gestational age, overall health, and medical history
• Extent of the condition
• Baby’s tolerance to certain medications
• Expectations for the course of the disease
• The mother’s opinion or preference 

Babies suffering from withdrawal can often be irritable, so swaddling the baby can help them feel comforted. If the baby becomes dehydrated or has severe diarrhea, intravenous fluids might be used.

Babies who experience withdrawal symptoms might need medication. Medications used for NAS include methadone for opioid withdrawal and benzodiazepines for alcohol withdrawal. Once withdrawal symptoms are controlled, the dosage is gradually decreased to wean the baby off the drug. 

Sources:

http://www.childrenshospital.org/conditions-and-treatments/conditions/n/neonatal-abstinence-syndrome-nas/treatments

https://www.stanfordchildrens.org/en/topic/default?id=neonatal-abstinence-syndrome-90-P02387