NAS: What you should know

Roughly 800 infants were born in Tennessee last year with NAS, or Neonatal Abstinence Syndrome, according to Tennessee's Neonatal Abstinence Syndrome Surveillance Report. This condition refers to a series of symptoms related to infant withdrawal from substances used by the mother during pregnancy. The most acute symptoms can occur immediately after birth and include fever, blotchy skin, decreased sucking during feeds, respiratory difficulty, and increased muscle tone, among others. Children born with NAS may experience difficulties in feeding in the weeks directly after birth.

While NAS is most severe in the first two weeks after birth, long-term effects related to development can also occur during childhood. A study from the Tennessee Department of Health, with support from the Centers for Disease Control and Prevention (CDC) and March of Dimes, found that children born with NAS were more likely to have a developmental delay or a speech or language impairment in early childhood compared to children born without NAS. Children born with NAS may continue to experience feeding difficulties related to withdrawal even after the acute withdrawal phase has passed.

For children with substance exposure, long-term effects may show up on various tests in preschool and school environments. Children with opioid exposure perform significantly more poorly on cognitive and behavioral tests than their non-exposed peers, according to research analysis. For these children, attentional skills are reported to be more similar to children with attention deficit hyperactivity disorder (ADHD) than their peers. In the long term, scores for literacy and numeracy are also depressed in comparison to non-exposed peer groups.

Children with NAS may also benefit from occupational therapy as withdrawal-related symptoms and effects may interfere with children's engagement in occupational tasks of daily living. In the same way, physical therapists may be able to help children reach developmental milestones related to gross motor goals.

If you are concerned about your child's exposure and progress in feeding, language, or functional skill milestones, reach out to us today about a possible evaluation or screening.

References: icon icon

Occupational Therapy Management Strategies for Infants With Neonatal Abstinence Syndrome: Scoping Review - PubMed (

The Opioid Crisis on Our Caseloads: Babies born addicted to opioids can show immediate neurological and feeding problems. Studies also point to longer-term effects.: The ASHA Leader: Vol 23, No 11