Neonatal Abstinence Syndrome — RACP Paediatrics MCQ

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ModerateNeonatologyNeonatal Abstinence SyndromeRACP Paediatrics

A term neonate born to a mother with untreated opioid use disorder presents at 48 hours with irritability, high-pitched cry, hypertonicity, tremor, sneezing, and poor feeding. What is the diagnosis?

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Correct answer: C — Neonatal abstinence syndrome (NAS)

NAS presents 24-72 hours after birth (longer for methadone exposure). Symptoms include CNS irritability, GI dysfunction, autonomic instability, and poor feeding. Scored using the modified Finnegan score. Management includes supportive care (swaddling, quiet environment, frequent small feeds) and pharmacological treatment (morphine or phenobarbitone) if severe.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Neonatal Abstinence Syndrome