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    Symptoms of NAS depend on various factors including the type of drug the mother used, how much of the drug she used, how long she used the drug, and how the mother’s body breaks down the drug. The optimal treatment for NAS has not been established.Primary treatment of neonatal symptoms related to prenatal substance exposure should be supportive because pharmacologic therapy can prolong hospitalization and exposes the infant to additional agents that are often not necessary.

    Two major types of NAS are recognized: NAS due to prenatal or maternal use of substances that result in withdrawal symptoms in the newborn and postnatal NAS secondary to discontinuation of medications such as fentanyl or morphine used for pain therapy in the newborn.

    However, pharmacotherapy for infants with more severe expression of NAS is necessary to allow them to feed, sleep, gain weight, and interact with caregivers.

    Opioids are currently considered the first-line therapy. Phenobarbital has been effective for the treatment of opioid withdrawal seizures and polydrug exposure. Neonatal withdrawal syndrome, generically termed neonatal abstinence syndrome (NAS), is a complex disorder.

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