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College of Public Health

Florida Perinatal Quality Collaborative

Located at:

The Lawton and Rhea Chiles Center Revised logo

Neonatal Abstinence Syndrome


Neonatal Abstinence Syndrome (NAS) Initiative

Mother with Crying NewbornThe United States is battling an opioid epidemic, which has resulted in increasing illicit use and misuse of prescription opioids among pregnant women. Neonatal abstinence syndrome (NAS), in which infants exhibit postnatal withdrawal symptoms most commonly due to chronic in utero exposure to opioids, is one unfortunate sequelae of the opioid epidemic. It manifests as a combination of central nervous system irritability, autonomic nervous system hyperactivity, respiratory difficulties, and gastrointestinal dysfunction. The majority of pregnant women taking illicit drugs, using prescribed opioids, or receiving opioid replacement therapy will deliver an infant having withdrawal symptoms, and many of these infants will develop NAS and require pharmacologic management. NAS infants are more likely to have a diagnosis of prematurity, low birth weight, respiratory complications, seizures, and feeding difficulty. Beyond the neonatal period, they are at risk for behavioral problems, learning problems, visual disorders, and psychosocial difficulties (for example, risk for child abuse, foster placement).

Despite awareness of a rising NAS incidence, there is a scarcity of evidence-based management for NAS, lack of improvement in length of inpatient stay, and a rise in health care costs, which highlight the considerable variations in its management by pediatricians and neonatologists. The FPQC hopes to address variability in NAS management.  

  • NAS Initiative Resources

    New in the Tool Box: Provider Education video modules!

    Online Tool Box for NAS Hospitals

    The Tool Box contains:

    • NAS tool kit documents
    • Example hospital guidelines and helpful websites
    • Screening tools
    • Plan of Safe Care and Discharge materials
    • Patient education materials
    • FPQC NAS project presentation slides
    • Initiative data resoruces

    This resource is regularly updated throughout the project. 

  • Archived Webinars

    June 2, 2020 - NAS End of Initiative Celebration



    December 4, 2018 - NAS Data Collection: Definitions, Procedures, and Tools

    January 15, 2019 - Pharmacologic Management

    February 19, 2019 - Eat, Sleep, Console: The Colorado Experience

    March 19, 2019 - Connecting to the World Outside

    April 16, 2019 - Inter-Rater Reliability

    May 2019 - Non-Pharmacologic Management


  • Participating Hospitals

    • Manatee Memorial Hospital 
    • BayCare-Morton Plant Hospital 
    • St. Vincent's Medical Center (Riverside) 
    • Nemours Children's Hospital 
    • Tradition Medical Center 
    • Martin Medical Center 
    • Tampa General Hospital 
    • St. Joseph's Women's Hospital 
    • Winter Haven Women's Hospital 
    • Golisano Children's Hospital of Southwest Florida 
    • AdventHealth Waterman 
    • Winnie Palmer Hospital NICU 
    • AdventHealth Tampa 
    • Medical Center of Trinity 
    • Winnie Palmer Hospital Newborn Nursery 
    • University of Florida Health Jacksonville 
    • Lakeland Regional Health 
    • Sacred Heart Hospital Pensacola/Studer Family Children's Hospital 
    • Mease Countryside Hospital 
    • Sarasota Memorial Hospital 
    • Fort Walton Beach Medical Center 
    • Naples Community Hospital 
    • University of Florida Health - Gainesville 
    • Bayfront Health Spring Hill 
    • AdventHealth Memorial Medical Center 
    • Baptist Health South
    • Halifax Health Medical Center
    • Nicklaus Children’s Hospital 
    • Plantation General Hospital
    • Holtz Children's/Jackson Memorial Hospital
    • Holmes Regional Medical Center
    • Gulf Coast Regional Medical Center (Panama City)
    • AdventHealth for Children