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    Neonatal Abstinence Syndrome

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    Eben Ezar Dela Cruz
    Neonatal Abstinence Syndrome (NAS) is scored in newborns to assess withdrawal from substances the mother used during pregnancy. Scoring is done every 3-4 hours before feeding to document signs like sleeping difficulties, tremors, and poor feeding. Total scores indicate the severity level: mild is <5, moderate is 5-8, severe is 8-12, and very severe is >12. Higher scores mean the infant is not ready to be weaned from treatment for withdrawal.

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    Neonatal Abstinence Syndrome

    Uploaded by

    Eben Ezar Dela Cruz
    106 views1 page
    Neonatal Abstinence Syndrome (NAS) is scored in newborns to assess withdrawal from substances the mother used during pregnancy. Scoring is done every 3-4 hours before feeding to document signs like sleeping difficulties, tremors, and poor feeding. Total scores indicate the severity level: mild is <5, moderate is 5-8, severe is 8-12, and very severe is >12. Higher scores mean the infant is not ready to be weaned from treatment for withdrawal.

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    NAS

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    Neonatal Abstinence Syndrome (NAS) is scored in newborns to assess withdrawal from substances the mother used during pregnancy. Scoring is done every 3-4 hours before feeding to document signs like sleeping difficulties, tremors, and poor feeding. Total scores indicate the severity level: mild is <5, moderate is 5-8, severe is 8-12, and very severe is >12. Higher scores mean the infant is not ready to be weaned from treatment for withdrawal.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    106 views1 page

    Neonatal Abstinence Syndrome

    Uploaded by

    Eben Ezar Dela Cruz
    Neonatal Abstinence Syndrome (NAS) is scored in newborns to assess withdrawal from substances the mother used during pregnancy. Scoring is done every 3-4 hours before feeding to document signs like sleeping difficulties, tremors, and poor feeding. Total scores indicate the severity level: mild is <5, moderate is 5-8, severe is 8-12, and very severe is >12. Higher scores mean the infant is not ready to be weaned from treatment for withdrawal.

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    Neonatal Abstinence Syndrome (NAS)- Scoring Explanation (done @Newborn 2hrs age)

    -is a result of the sudden discontinuation of fetal exposure to substances that were used or abused by the mother during
    pregnancy.

    Assessment & Documentation


    -The infant is scored at 2 hours of age and every 3-4 hours prior to a feeding
    -The NAS score will be recorded for the 3-4 hour period immediately before the scoring activity
    Signs and symptoms are documented on the NAS form and totaled for a score

    Total Score
    *<5 -MILD- ready to wean down on their methadone
    *5-8- MODERATE -a breakthrough dose of morphine may not be appropriate; the infant may not be ready to wean
    down on their methadone further.
    *8-12- SEVERE- not ready
    *>12- VERY SEVERE- not ready
    Criteria Score
    Sleeping  3hrs or more continuous 0
     2-3hrs after feeding 1
     1-2hrs after feeding 2
     1hr after feeding 3
    Moro Reflex  Hyperactive Moro: arms stay up 3-4 sec with or without tremors 1
    Cup infant’s head in your hand and
    raise his/her head about 2-3 inches  Markedly Hyperactive Moro: arms stay up > 4 sec with or without tremors 2
    above the mattress, then drop your
    hand while holding the infant.
    Tremors  Mild tremors: hands or feet only, last up to 3 seconds 1
    Involuntary movements that are
    rhythmical  Moderate-severe tremors: arms or legs, last more than 3 seconds 2
    Increased Muscle Tone  Difficult to straighten arms but is possible; head lag is present 1
    While the infant is lying supine,
    extend and release the infant’s arms  No head lag noted or arms or legs won’t straighten 2
    and legs to observe for recoil. Infant
    supine, grasp arms by wrists and
    gently lift infant, looking for head lag
    Excoriation  Skin red but intact or is healing and no longer broken 1
    Red or broken skin from
     Skin breakdown present 2
    excessive rubbing
    Sweating  Wetness felt on the infant’s forehead, upper lip 1
    Nasal Stuffiness  Any nasal noise when breathing 1
    Sneezing  Infant sneezes 4 or more times in the scoring interval of 3-4 hours 1
    Tachypnea  Respiratory rate > 60/min 2
    Nasal Flaring  Outward spreading of the nostrils during breathing 1
    Poor Feeding -Infant demonstrates excessive sucking prior to a feeding yet sucks 2
    -infrequently while feeding and takes a small amount of formula/breast milk.
    -Demonstrates an uncoordinated sucking reflex (difficulty sucking and swallowing)
    -Infant continuously gulps while eating and stops frequently to breathe.
    -Inability to close mouth around bottle/breast
    -Feeding takes more than 20 minutes
    Regurgitation/Vomiting  Frequent regurgitation (vomits whole feeding or vomits 2 or more times during 2
    feed) not associated with burping
    Loose Stools  Infant has a stool that is at least half liquid 2
    Current weight <90% of  Weight is < 90% of birth weight 2
    Birth Weight
    Excessive Irritability  Consoling calms infant in 5 minutes or less 1
     Consoling calms infant in 6-15 minutes 2
     Consoling takes more than 15 minutes or no amount of consoling calms 3
    infant

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