Neonatal withdrawal or neonatal abstinence syndrome (NAS) is a withdrawal syndrome of infant

Infant

A newborn or baby is the very young offspring of a human or other mammal. A newborn is an infant who is within hours, days, or up to a few weeks from birth. In medical contexts, newborn or neonate refers to an infant in the first 28 days after birth...

s, caused by administration of drugs. Tolerance, dependence and withdrawal may occur as a result of repeated administration of drugs, or even after short-term high dose use for example during mechanical ventilation

Mechanical ventilation

In medicine, mechanical ventilation is a method to mechanically assist or replace spontaneous breathing. This may involve a machine called a ventilator or the breathing may be assisted by a physician, respiratory therapist or other suitable person compressing a bag or set of bellows...

 in intensive care units. There are two types of NAS: prenatal and postnatal. Prenatal NAS is caused by substance abuse

Substance abuse

A substance-related disorder is an umbrella term used to describe several different conditions associated with several different substances .A substance related disorder is a condition in which an individual uses or abuses a...

 by the pregnant mother, while postnatal NAS is caused by discontinuation of drugs directly to the infant.

The drugs involved may be for example opioids, selective serotonin reuptake inhibitors (SSRIs), alcohol and benzodiazepines. When pharmacological treatment of opiate withdrawal in neonates is deemed necessary, opiates are the treatment of choice, which are slowly tapered down to wean the neonate off opiates. Phenobarbitol is sometimes used as an alternative but is less effective in suppressing seizures; however, phenobarbitol is superior to diazepam

Diazepam

Diazepam , first marketed as Valium by Hoffmann-La Roche is a benzodiazepine drug. Diazepam is also marketed in Australia as Antenex. It is commonly used for treating anxiety, insomnia, seizures including status epilepticus, muscle spasms , restless legs syndrome, alcohol withdrawal,...

 for neonatal opiate withdrawal symptoms. In the case of sedative-hypnotic

Sedative

A sedative or tranquilizer is a substance that induces sedation by reducing irritability or excitement....

 neonatal withdrawal, phenobarbitol is the treatment of choice.

Neonatal abstinence syndrome does not happen in prenatal cocaine exposure

Prenatal cocaine exposure

Prenatal cocaine exposure occurs when a pregnant woman uses cocaine and thereby exposes her fetus to the drug. Crack baby was a term coined to describe children who were exposed to crack as fetuses; the concept of the crack baby emerged in the US during the 1980s and 90s in the midst of a great...

 (with babies exposed to cocaine

Cocaine

Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. The name comes from "coca" in addition to the alkaloid suffix -ine, forming cocaine. It is a stimulant of the central nervous system, an appetite suppressant, and a topical anesthetic...

 in utero); at least, such symptoms are difficult to separate in the context of other factors such as prematurity or prenatal exposure to other drugs.