Medical Treatment Options

The treatment for Neonatal Abstinence Syndrome (NAS) is to assist the infant through detox as painless as possible. First, knowing what type of drug the mother is on is very important. On average, if the mother is on a narcotic with a short half life, like Hydrocodone, the infant could be discharged at age 3 days if no withdrawal symptoms occur. If the mother is on a narcotic with a long half life, such as Methadone, the infant needs to be observed until age 5 to 7 days and then can be discharged if no withdrawal symptoms occur (Hamdan, 2016). Then appropriate follow up care is needed. 
After an infant is diagnosed with NAS the infant is sent to the NICU, which is better equipped to treat such a diagnosis. Nonpharmacologic interventions include assessing the infant closely with sleeping habits, feeding patterns, weight gain and any signs of withdrawal. Minimizing stimuli in the room is very important along with swaddling, non-nutritive sucking with a pacifier and frequent small feedings of hypercaloric formula (Hamdan, 2016).

(Kocherlakota, 2014)

Pharmacologic therapy should only be used for supportive therapy because it can prolong hospitalization and expose infants to more agents that are not necessary. Approximately 30-91% of infants who are diagnosed with NAS receive pharmacological treatment. This treatment allows the infants to feed, sleep, gain weight and interact with caregivers. The most common treatment is  oral morphine solution, followed by methadone and even clonidine (Hamdan, 2016).

 (Kocherlakota, 2014)

The chart above explains the types of medication used to assist the infant through detox. As the infant grows older and symptoms decrease, weaning of the pharmacological intervention is started. The goal is to get the infant off all medications. Side effects that are the most concerning are sedation and longer treatment. Types of medications were stopped if the infant was not responding well to them, mainly not getting comfortable with the type of medication. Luckily medication is given on a schedule of on average every four hour. This allows medical staff to step in if any worsening side effects occur, but the main objective is to keep the infant comfortable (Kocherlakota, 2014).

References

Hamdan, A. (2016). Neonatal Abstinence Syndrome Treatment & Management. Retrieved February 23, 2016, from http://emedicine.medscape.com/article/978763-treatment 

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