Neonatal abstinence syndrome (NAS)

CHAPTER 22 Neonatal abstinence syndrome (NAS)



Mark Davies, David Cartwright


[From: Guidelines for the management of babies of substance-using women. Norton B, Kuhnert L et al. Brisbane: Grantley Stable Neonatal Unit; 2001.]



Admission guidelines



Indications for admission to the special care nursery (SCN)


Babies of mothers who have a history of using:


• opiates (heroin, methadone)

• amphetamines (speed, Ritalin) — the evidence for NAS in infants of mothers using amphetamines alone is weak

• benzodiazepines (Serepax, diazepam)

• cocaine (crack).


Admission to the special care nursery (SCN)



1. Babies at risk for NAS are monitored using the Finnegan Neonatal Abstinence Score. The minimum stay is 72 hours.

Some units allow this monitoring on the postnatal ward.


2. Baby is then transferred to postnatal ward (until at least 5 days of age) to be with mother.


Pharmacological treatment


Commence pharmacological treatment once the Finnegan scores average >8 for three consecutive scores or average >12 for two consecutive scores. Pharmacological treatment should always be done in the special care nursery.




Morphine


Morphine is used for opiate withdrawal, e.g. methadone, heroin, pethidine.


• Dose:
— start at 0.5 mg/kg/day orally, given every 6 hours (0.125 mg/kg/dose).
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Jul 18, 2016 | Posted by in PEDIATRICS | Comments Off on Neonatal abstinence syndrome (NAS)

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