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87: Neonatal Abstinence (Withdrawal) Syndrome
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Published:May 2023
Jennifer Murzycki, MD, PhD, "Neonatal Abstinence (Withdrawal) Syndrome", Caring for the Hospitalized Child: A Handbook of Inpatient Pediatrics, American Academy of Pediatrics Section on Hospital Medicine, Jeffrey C. Gershel, MD, FAAP, Daniel A. Rauch, MD, FAAP, SFHM
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Neonatal abstinence syndrome (NAS) is a withdrawal syndrome experienced by newborns after in utero exposure to any substance that can cause physiologic dependence. Neonatal opioid withdrawal syndrome (NOWS) specifically refers to the symptoms experienced as a result of exposure to opioids, including heroin, codeine, oxycodone, methadone, and buprenorphine. NOWS is most common, but a number of substances can cause NAS (antidepressants, barbiturates, nicotine, gabapentin), and polypharmacy is unfortunately common.
Assess whether the newborn has had gastrointestinal (feeding difficulties, vomiting, diarrhea), central nervous system (tremors, seizures, increased muscle tone, hyperactive Moro reflex), or autonomic (fever, nasal congestion, sweating, yawning, sneezing) signs...
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