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What Is Neonatal Abstinence Syndrome (NAS) or Neonatal Opioid Withdrawal Syndrome (NOWS)?

What Is Neonatal Abstinence Syndrome (NAS) or Neonatal Opioid Withdrawal Syndrome (NOWS)?

What Is Neonatal Abstinence Syndrome (NAS) or Neonatal Opioid Withdrawal Syndrome (NOWS)?

If you're pregnant, your addiction specialist or obstetrician may mention neonatal abstinence syndrome (NAS) or neonatal opioid withdrawal syndrome (NOWS). Both of these terms refer to the effects your baby could experience after delivery related to opioid exposure during pregnancy. It's important to understand what signs and symptoms to look for and what to do about them.


NAS and NOWS describe a cluster of symptoms that infants may develop within their first 24 to 48 hours of life if their mothers were using opioids before delivery. They may happen even if the mother uses opioids prescribed by a doctor, including for the treatment for opioid use disorder (OSD).

Medication for opioid use disorder (MOUD) may include drugs such as buprenorphine and methadone. While these are effective for treatment, they do pose some risks.

Not every mother who uses opioids during pregnancy will have a baby who has symptoms of NAS/NOWS. And not every baby with signs of NAS/NOWS will need enhanced care.

For some babies, comfort care measures, including skin-to-skin contact and breastfeeding, can go a long way in managing symptoms and may reduce the need for more involved treatment. The treatment plan is something you and your care team will need to evaluate and decide together. If you notice symptoms, talk with your care team about what to do next.

In more severe cases, babies may need additional monitoring and require medication to help ease symptoms, including small doses of morphine. It's crucial to work with a doctor to give any necessary prescriptions safely.

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This article has been medically reviewed by
Erin Hillers
Erin Hillers
Erin Hillers
Nurse Practitioner

Erin is a Nurse Practitioner with 8 years of experience in midwifery and women's health. She has spent the past 5 years specializing in the treatment of opioid and alcohol use disorders.

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