Health Library

Neonatal Opioid Withdrawal Syndrome (NOWS)

What Are the Symptoms of Neonatal Opioid Withdrawal Syndrome (NOWS)?

It is hard to tell which babies might get neonatal opioid withdrawal syndrome. Some babies have NOWS when a mother takes only a small amount of drugs, while other babies may only have NOWS when a mother takes large amounts of drugs. Most babies born to mothers using drugs develop NOWS, and signs are most often seen within the first few days after birth. Some signs of NOWS are:

• High-pitched cry
• Tremors, jittering, shaking of arms, legs, face
• Frequent yawning
• Hard time sucking during feeding times
• Poor weight gain
• Fast breathing
• Frantic sucking of fists, fingers, thumbs
• Trouble falling asleep and staying asleep
• Fussy and hard to calm
• Sneezing, stuffy nose
• Tense arms, legs and body
• Vomiting, diarrhea
• Skin rashes – more so in the diaper area and face
• Warm to touch, sweating

How Is Neonatal Opioid Withdrawal Syndrome (NOWS) Treated?

Neonatal Opioid Withdrawal Syndrome Treatment

Nurses use a scoring sheet to help them watch for signs of NOWS. This score helps the team know if a baby has NOWS. If a baby has a high score for a while, medicine may help a baby be more comfortable. If a baby does get medicine, the medicine will be lowered over time depending on each baby's needs.

Below are things you can do to help comfort your baby during this time.

Parents can help their baby best by staying nearby and holding their baby. Many parents find their baby calms best when handled gently, slowly and when held close to their body. This is because you and your baby know each other best.

If you are worried or anxious, your baby can pick up your energy. If you find this to be true, try to take deep cleansing breaths and focus on calming yourself.

If you need help, please ask a family member or friend. If you do not have help close to you, call your baby’s doctor.

Can I Breastfeed My Baby?

We know that breastfeeding is best for your baby. If you are on any medicine or drugs, the baby will get small amounts through the breast milk. This is usually safe if the mother’s medicine is managed by her doctor, but check with your baby’s doctor to make sure it is safe for your baby. It is vital that the mother does not take any other medicine while breastfeeding unless your baby’s doctor says the medicines are safe.

When Can I Take My Baby Home?

You can take your baby home when:

• Your baby no longer needs medicine (if it was started).
• Your baby is eating well and gaining weight.
• Your baby can keep a stable heart rate, breathing rate and temperature.
• You have a community doctor to provide follow-up care for your baby.
• You know how to calm your baby.
• You received all needed teaching, including safe sleep practices.

Your baby may have some of these problems after leaving the hospital:

• Problems feeding
• Slow weight gain
• Poor sleeping patterns
• Sneezing, stuffy nose or trouble breathing

Your baby’s doctor or nurse can help teach you ways to care for your baby. Also, work with your baby’s doctor to find community resources.