Johns Hopkins All Children's Hospital

Neonatal Abstinence Syndrome Clinic

The Neonatal Abstinence Syndrome (NAS) Follow-Up Clinic at Johns Hopkins All Children’s Hospital treats babies born at 35 or more weeks of gestation who have been exposed to certain types of medicines or drugs in utero.

NAS is a condition that occurs when a mother becomes pregnant while using opioids or other addictive drugs. The infant may begin to experience symptoms of withdrawal once they are born and are no longer receiving the opioids or drugs, causing a variety of symptoms such as tremors, irritability, weight loss and in rare cases, seizures. Newborns may require pharmacological treatment, which may include small doses of a drug in the same family as what the mother took throughout pregnancy.

New Solutions To National Issue

More than 4,200 Florida newborns were born to mothers using opioids in 2016, a dramatic increase of more than 1,700 over 2015, according to the Florida Agency for Health Care Administration. On average, Johns Hopkins All Children’s treats 100 newborns with NAS every year. Newborns with NAS need to be held and comforted constantly to ease their symptoms. The optimal environment is a quiet, dark place, away from bright lights and loud noises. Johns Hopkins All Children’s adapted these principles by creating a quiet physical space in the NICU for these babies and training a team of nurses to provide non-pharmacological comforting measures around the clock.

Symptoms of Withdrawal

Withdrawal can occur in different ways, and every baby may show symptoms of withdrawal in a different way. It is not possible to predict which baby will have withdrawal, how long symptoms will last or the severity of his or her symptoms.

When does withdrawal start?

Withdrawal usually starts within two to three days after birth, but may not be obvious until five to seven days after birth. Babies stay in the hospital for a minimum of five to seven days so that they can be observed for signs of withdrawal.

Common symptoms of withdrawal:

  • A high-pitched cry that does not stop with soothing
  • Trouble sleeping
  • Tremors or jitteriness, awake or asleep
  • Tight muscles
  • Sweating
  • High temperature
  • Frequent yawning or sneezing
  • Fast breathing
  • Excessive sucking or poor feeding
  • Throwing up a lot
  • Diarrhea that can cause diaper rash

What to Expect

Your baby will be seen by a pediatrician or nurse practitioner, occupational therapist, neurodevelopmental psychologist and a feeding specialist trained to take care of babies and toddlers. These therapists can identify any difficulties your baby may have and assist with providing therapy.

A follow-up appointment will be made for you within two to four weeks of your baby’s hospital discharge. The medical team will provide developmental follow-up and education for you and your baby at four, eight and eighteen months of age.

At twelve months of age, your baby will be scheduled for an appointment with our pediatic neuropsychologist for a neurodevelopmental evaluation and will be seen annually until the age of five.

These appointments do not replace your pediatrician appointments, but offer specialized services for your baby for their diagnosis of NAS.

Questions? Give us a call

We know that you want the best possible care for your child. Our team is happy to assist you with your questions.

Our Location

The NAS clinics are located at our Outpatient Care Center on the hospital's main campus in St. Petersburg, and Outpatient Care, Sarasota.

 

Maternal, Fetal & Neonatal Institute at Johns Hopkins All Children's Hospital

Johns Hopkins All Children’s Hospital is designated a Regional Perinatal Intensive Care Center (RPICC) by Florida’s Children’s Medical Services (CMS), providing high-risk obstetrical care and neonatal intensive care to all patients regardless of financial needs.