Neonatal abstinence syndrome is a set of withdrawal symptoms some babies have after birth when they were exposed before birth to certain substances or medicines, most often opioids. Signs can include tremors, irritability, poor feeding, and trouble sleeping. NICU teams use a scoring system to guide care that focuses first on comfort (swaddling, quiet, skin-to-skin, feeding support) and sometimes medicine, with symptoms easing over days to weeks.
Introduction: why this question matters for your family
Families often arrive at this question during or soon after the NICU stay, when a new term, test, or piece of the medical picture raises questions. This article is written for families of a newborn being treated for withdrawal (nas) and explains what the question really means, what to expect, and the next steps other families have found most useful.
What this really points to
Behind the question are patterns that a NICU and neonatology team, with social work support can recognize quickly. The specific thing parents typically describe is tremors, irritability, poor feeding, and disrupted sleep in the days after birth. One observation rarely answers the question on its own; a clear picture comes together from what parents notice, the history, and a focused evaluation [1].
The most useful next step is usually an evaluation by a NICU and neonatology team, with social work support, often with a standardized withdrawal scoring assessment that guides treatment [3].
Why early action makes a real difference
Acting early matters because this is most manageable when it is caught and treated promptly. Timely evaluation and treatment by the care team help your baby stay stable while the underlying issue is addressed [3].
If any developmental concerns come up later, Early Intervention (Part C) offers free evaluations for eligible children under 3 [5].
We work with NICU families across 38 states, offering clear answers and support.
What usually lies behind it
The most relevant contributing factor here is withdrawal after prenatal exposure to opioids or certain other substances or medicines. This is the underlying mechanism behind what parents notice: tremors, irritability, poor feeding, and disrupted sleep in the days after birth [2].
The specific cause depends on the condition and your baby’s history. Your care team can explain what is driving it in your baby’s case and how they are treating and monitoring it.
How a real evaluation works
A typical evaluation here combines a careful history, a focused examination, and the tests that fit the concern. Where useful, the team adds a standardized withdrawal scoring assessment that guides treatment [4].
Any treatment or follow-up your baby needs is arranged by the care team, and the right next step depends on the specific condition. Many of these are managed with monitoring and support rather than long-term therapy.
Mistakes families often make
The most common mistakes we see: waiting too long on a quiet ‘let us wait and see,’ comparing one child to another, skipping NICU follow-up visits, and not requesting the full medical record.
Trusting your own observation is one of the strongest tools you have [3].
Step-by-step: what parents can do next
If the patterns described above match what you are seeing, here is a practical sequence other families of a newborn being treated for withdrawal (nas) have found useful.
- Gather and keep the key records and results (NICU discharge summary, imaging, and any lab values), and note any new concerns about your baby’s breathing, feeding, muscle tone, or development.
- At your next visit, describe your concern in concrete terms and share any notes you have. Ask whether a referral to a NICU and neonatology team, with social work support is appropriate now.
- Keep every NICU follow-up and pediatric appointment, and raise any new breathing, feeding, or development concern promptly.
- Request the records that matter: the NICU or newborn discharge summary, the test and imaging results relevant to this condition, and the labor and delivery notes.
- Follow the care team’s plan, and keep up with the monitoring and follow-up they recommend.
- For major decisions, get a second opinion at a children’s hospital with subspecialty depth in your child’s area of concern. Bring all reports.
- If a birth event may have played a role, schedule a free, no-pressure case review with CP Family Help.
- Pennsylvania – Pennsylvania Early Intervention
- New Jersey – New Jersey Early Intervention System
- Washington DC – DC Strong Start Early Intervention
- Texas – Texas Early Childhood Intervention (ECI)
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- Alabama – Alabama Early Intervention System
- California – California Early Start
- Arizona – Arizona Early Intervention Program
- Arkansas – Arkansas First Connections
- Colorado – Early Intervention Colorado
- Connecticut – Connecticut Birth to Three System
- Florida – Florida Early Steps
- Georgia – Georgia Babies Cant Wait
- Illinois – Illinois Early Intervention
- Indiana – Indiana First Steps
- Iowa – Iowa Early ACCESS
- Kansas – Kansas tiny-k Early Intervention
- Kentucky – Kentucky First Steps
- Louisiana – Louisiana EarlySteps
- Maryland – Maryland Infants and Toddlers Program
- Massachusetts – Massachusetts Early Intervention
- Michigan – Michigan Early On
- Minnesota – Minnesota Help Me Grow
- Mississippi – Mississippi First Steps
- Missouri – Missouri First Steps
- Nebraska – Nebraska Early Development Network
- Nevada – Nevada Early Intervention Services
- New Mexico – New Mexico Family Infant Toddler Program
- New York – New York Early Intervention Program
- North Carolina – NC Infant-Toddler Program
- Ohio – Ohio Early Intervention
- Oklahoma – Oklahoma SoonerStart
- Oregon – Oregon Early Intervention/ECSE
- South Carolina – South Carolina BabyNet
- Tennessee – Tennessee Early Intervention System
- Utah – Utah Baby Watch Early Intervention
- Virginia – Virginia Infant & Toddler Connection
- Washington – WA Early Support for Infants and Toddlers
- West Virginia – WV Birth to Three
- Wisconsin – Wisconsin Birth to 3 Program
When to get help quickly
Withdrawal is managed in the hospital, but if a baby at home has a seizure, cannot be consoled for long stretches, feeds very poorly, becomes very sleepy or hard to wake, or has breathing changes, seek emergency care right away (call 911 or go to the ER).
What to bring to every follow-up visit
Bring three things: a short list of what has changed since last time, one or two phone videos, and a single specific question.
How CP Family Help supports families
CP Family Help works with families across 38 U.S. states whose children were diagnosed with cerebral palsy, HIE, or other birth injuries. Every initial consultation is free and confidential.
A free case review can clarify whether the standard of care was met.
Important exceptions and case-specific factors
Every child’s situation is different. Factors that can change the picture include your child’s gestational age, NICU history, imaging results, family history, your state’s Early Intervention eligibility rules, and statute of limitations.
- Experience: CP Family Help works exclusively with cerebral palsy, HIE, and birth-injury cases across 38 U.S. states.
- Expertise to verify: Information like this should be cross-checked with CDC, NIH/NINDS, AAP, and ACOG.
- Professional guidance: Confirm medical decisions with your pediatrician and, where appropriate, a NICU and neonatology team, with social work support.
- Case-specific: Your child’s gestational age, NICU history, MRI findings, and state-specific rules all shape application.
High-confidence information
- About 1 in 10 U.S. newborns receives care in a NICU (March of Dimes).
- NICU teams follow a clear treatment and monitoring plan tailored to each baby’s condition.
- Most newborn and NICU conditions are managed with close monitoring and follow-up.
- If developmental concerns arise later, Early Intervention (Part C) offers free evaluations for eligible children under 3.
Case-specific information
- Whether tremors, irritability, poor feeding, and disrupted sleep in the days after birth reflects a lasting difference or an expected, temporary pattern depends on the individual child and is best judged by the care team.
- Early Intervention eligibility rules vary slightly by state.
- Statutes of limitations for birth-injury claims vary by state and child’s age.
- Therapy access, Medicaid waivers, and insurance coverage vary by plan and state.
Related reading for parents
- Cerebral palsy: parent guide
- HIE explained for parents
- Birth injury overview
- Early signs of cerebral palsy
- Cerebral palsy and milestones
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