Neonatal Abstinence Syndrome (NAS) – Newborn Complications (Nursing)

00:01 For the final newborn complication, we're going to talk about Neonatal Abstinence Syndrome.

00:07 Neonatal Abstinence Syndrome or NAS is really a spectrum of physiologic signs and symptoms that result specifically from opioid withdrawal.

00:18 Although NAS speaks specifically to opioids, there are other agents that can lead to withdrawal symptoms in the newborn.

00:26 And they include benzodiazepines, amphetamines, which includes methamphetamines, nicotine, caffeine, or SSRIs.

00:36 Neonatal abstinence syndrome is problematic because the drugs that are taken by the birthing person actually are transferred through the placenta in utero.

00:45 And then after the placenta is delivered and the cord is cut, there's an abrupt disruption of the drug delivery.

00:53 Symptoms of neonatal abstinence syndrome can actually appear minutes after delivery up to two weeks of age.

01:00 And they include symptoms such as a high pitched cry, or hyperirritability, sneezing, and excessive suck, sweating, hyperthermia, tremors, vomiting, excessive weight loss.

01:11 You can see there are numerous symptoms.

01:14 Most of these are going to happen within the first 72 hours, but they can last up to four to six months, which is a really long time.

01:24 This is the Finnegan Scoring System.

01:26 Again, related to opioid withdrawal.

01:28 This tracks all of the common symptoms of neonatal abstinence syndrome, and allows the nurse to record so we can track the progress of the baby as they move toward withdrawal.

01:39 Currently, there's a new momentum for a simpler, "eat, sleep, and console" assessment/scoring system.

01:47 When we think about how we can provide compassionate care for a patient? And in this case, we're talking about the baby and the birthing person who are dealing with the neonatal abstinence syndrome, we can use something like this document that came from the National Perinatal Association.

02:03 We want to use the right words.

02:05 So as this baby grows up, we have to make sure that we know and that the baby knows that they are not an addict.

02:11 They were exposed to a substance in utero, but that's not something that they caused.

02:16 Their birthing person has a substance use disorder, not them.

02:20 We also want to make sure that we get the birthing person involved in treatment.

02:24 So the baby will always do better when the birthing person is there to help and to provide support.

02:30 We want to support rooming-in as a way to promote bonding.

02:34 We want to promote kangaroo care, which is that skin to skin contact.

02:38 We want to try non-pharmacologic care so soothing and providing comfort.

02:43 We want to support breastfeeding and using breast milk.

02:46 If it's not the birthing person's breast milk, using a donor system.

02:50 We also want to make sure that we're providing comfort by addressing the symptoms and they end the withdrawal symptoms specifically that the baby may be feeling.

02:59 This is one example of how we can provide compassionate care.