Neonatal Abstinence Syndrome

In Utero Drug Exposure

This infant had severe, persistent jitteriness on exam. In this case the jitteriness was associated with irritability, low grade fever, and difficulty feeding. Neonatal abstinence syndrome resulting from the mother's prescription medication was the underlying etiology. Twelve hours after treatment was started for the infant, all these symptoms resolved.

video by Janelle Aby, MD

When a newborn is at known risk of neonatal abstinence syndrome, or when the baby's symptoms are suggestive of the diagnosis, a withdrawal scoring system is useful to objectively measure the infant's symptoms.

Because many issues occur in well infants or those who have a different underlying problem, the diagnosis is based on the overall constellation of symptoms and their persistence rather than on a single event or piece of information. Scores of 8 or greater for at least 2 consecutive intervals are concerning for withdrawal; treatment should be considered for those infants.