Diagnosis

When diagnosing Neonatal Abstinence Syndrome (NAS) it is always important to consult with the infant's doctor because signs and symptoms of NAS can look like other medical problems. It is important to know what drugs the mother is on, and when the last use was for each substance. A maternal drug test would be beneficial to see exactly what is in the mother's system and at what strength. To make a true diagnosis in the infant, toxicological confirmation is necessary, as this confirms what narcotics are in the infants system (Trevino, 2016).


A scoring system is used to measure how severe the infants symptoms are, which allows a systematic, objective, periodic and thorough evaluation of the newborn of the progression of NAS (Jansson,  Velez, & Harrow, 2009). There are a few different scoring sheets that can be used, a common model is the  Modified Finnegan Neonatal Abstinence Score Sheet. This model allows the medical staff to assess 31 items to quantify the severity of NAS, this is repeated every four hours. Other scoring systems that are used in the medical setting include  The Lipsitz Neonatal Drug-Withdrawal Scoring System, The Neonatal Withdrawal Inventory, and The Neonatal Narcotic Withdrawal Index, the later two being simplified versions of the Finnegan scoring tool (Jansson, Velez, & Harrow, 2009).


The scoring sheets work well with treating the infants because with the score, it lets the medical staff know when medications need to be used to cut down the severity of symptoms. But keep in mind, no scoring system is perfect, these measuring tools are subject to observer variability and simplified versions of longer measuring tools have had little success. 

This syndrome progresses in the infant, and expresses itself through detox symptoms, which include tremors, high pitch crying, and not being able to get comfortable. The nursing staff keeps the infant comfortable through the symptoms by weaning the infant off the narcotic and healthy enough to go home (Kocherlakota, 2014).

References

Jansson, L. M., Velez, M., & Harrow, C. (2009). The Opioid Exposed Newborn: Assessment and Pharmacologic Management. Journal of Opioid Management, 5(1), 47–55.

Kocherlakota, P. (2014). Neonatal Abstinence Syndrome. Pediatrics, 134(2).

Trevino, H. (2016). University of Rochester Medical Center. Retrieved February 11, 2016, from https://www.urmc.rochester.edu/Encyclopedia/Content.aspx?ContentTypeID=90