NAS stands for Neonatal Abstinence Syndrome, and it’s a group of conditions caused when a baby withdraws from drugs he was exposed to in the womb.  I’ve written about how caring for these babies is very different than how you’d care for your own.  They suffer from unique symptoms such as tremors, seizures, sweating, fevers, breathing difficulties, wakefulness, and irritability.  Today I wanted to compile a list of those must-have’s that can get you through the first weeks and months.  As always, I want to throw out the disclaimer that I definitely wouldn’t call myself an expert as we’ve only had two NAS babies, so many of these tips come from those of you who’ve been around longer and were willing to throw in your two cents.  Thank you for sharing your wisdom!

 

Bottles

NAS babies often have difficulty feeding.  They can have trouble latching on to a bottle and have an uncoordinated suck and swallow pattern.  Sometimes they won’t breathe when they swallow and will need to stop frequently to breathe between gulps.  This can lead to a lot of gas buildup and long feeding sessions with frequent pauses.  In response, doctors recommend more frequent, smaller feedings.

 

Unfortunately, the bottles that people usually recommend are the ones with a thousand little parts.  If you ask foster parents which bottle to use for NAS babies, Dr. Brown’s bottles are always at the top of the list.  They claim to be the only bottle with an internal vent system that helps reduce colic, spit-up, and gas.  We’ve found that although they’re an absolute pain to clean, they do live up to their reputation with the natural or slow flow being ideal for newborns.

Click on any image to take you to the product listing on Amazon.

 

My personal favorite is the Tommee Tippee bottle.  They came out with an advanced anti-colic bottle that looks strikingly similar to the Dr. Brown’s design.  But the reason I like these better is Tommee Tippee are a wider bottle so it’s easier cleaning, and I’ve never had leaking issues like I do with Dr. Brown bottles.  They also have a  nifty little heat sensor that turns pink if the water is too hot for baby to drink.

Swaddling

Swaddling is a NAS essential.  Many newborns respond well to swaddling, but NAS babies need minimal external stimuli and swaddling not only provides comfort but also helps prevent auto-stimulation.  When our NAS newborns are sleeping, they’re swaddled.  I don’t know how we’d get through a night without it to be honest.  It’s a staple.

 

Many people like using Muslin swaddle blankets you fold yourself to make as tight or loose as you’d like.  We have a few of those that I use occasionally, but I’ve never been able to bring myself to use them overnight for fear of a squirmy baby wiggling around and moving the fabric up over his nose and mouth.  Maybe I’m just paranoid, but luckily there’s a safe and really convenient solution.  The SwaddleMe sleepsack.

 

We’ve tried several styles and brands of these, but my favorite is the original SwaddleMe.  One reason for that is it has a thin, breathable fabric making it ideal for a drug-exposed newborn who sweats and becomes too hot in heavier fabrics.  I also like that it’s tapered at the bottom so the baby’s legs are also snug, not just his arms.  If you look at HALO’s sleepsack, you’ll notice it’s a lot bulkier and gets wider at the bottom so baby can only be tightly swaddled on top.  Added bonus: SwaddleMe has cuter designs, like this gender-neutral safari 3-pack!

Humidifier

Like I mentioned before, NAS babies can quickly develop respiratory issues, and they often struggle with autonomic dysfunction.  They’re more likely to become congested and develop a cough.  One of the first things our pediatrician recommended was a humidifier along with using saline spray and a bulb syringe to clear baby’s passages.  As far as what brand to get, Geniani is the highest rated humidifier on Amazon and comes at a decent price.  It has a good output, will last an entire day, and apparently makes the perfect gift according to one of the pictures on its listing.  Nothing says Happy Valentine’s Day like a Geniani humidifier!

Pacifier

Babies experiencing withdrawals often have excessive rooting or sucking behavior.  If they don’t have a pacifier, they can develop blisters on their hands and knuckles from sucking constantly on them.  A good pacifier eliminates that problem and also helps the newborn self-soothe.  I would consider the pacifier to be another absolute must-have item.

 

There are so many brands and styles of pacifiers.  Sometimes you have to find the right fit through trial and error, but I definitely have my favorite.  A friend of mine recommended the Tommee Tippee Night Time Pacifier after using it with her NAS babies, and I’ve been hooked ever since.  Even at this very moment, I can tell you exactly where my Tommee Tippee pacifier is.  It has the perfect shape to fit their mouth, and all my babies have taken to it right away.  I’ve become a one pacifier kind of woman and can’t live without my Tommee Tippee once again.

 

A neat added bonus is the night time pacifier comes with a glow-in-the-dark handle so it’s easy to spot in the dark when baby inevitably spits it out.

Sensitive Skin Care

Babies going through withdrawals tend to have loose stools or diarrhea that contributes to diaper rash.  Drug-exposed babies’ top layer of skin is also 30% thinner than unaffected adults and their skin retains more moisture in their diaper area making break-outs a common occurrence.  The babies we’ve had can go from clear skin to a bad diaper rash in the span between diaper changes.

 

A 2016 article entitled “Improving Skin Integrity in Babies Diagnosed with Neonatal Abstinence Syndrome” recommended the following interventions: frequent diaper changes every 1-3 hours, using superabsorbent diapers, throwing out commercial wipes and using dry wipes moistened with sterile water instead, and applying a thick layer of diaper cream.  The article recommended Nystatin, Aquaphor, and Desitin for mild to moderate diaper rash and Marathon Liquid Skin Protectant for more severe cases (prescription needed).

While the article covered the major, well-known brands of diaper cream, many of you suggested a product that didn’t make the article’s list: Calmoseptine.  It’s a clear user favorite and came up in every discussion of best products to use on an ugly diaper rash.  It may be a bit tricky to find in stores, but it’s readily available on Amazon.

 

A lot of people swear by dry wipes alone in helping prevent diaper rash.  Medline has a brand of dry wipes that is additive and fragrance-free and the same wipes used in hospitals.  They are very gentle on your skin and are versatile for make up remover or cleaning.

Speaking of skin issues, many NAS babies benefit from special skin care items in addition to diaper creams.  I was talking to a caseworker once who mentioned nearly every drug-exposed child she’s worked with has had eczema.  When I reached out to foster parents for their recommendations, Aveeno Baby Eczema Therapy came up.  This cream is clinically proven to reduce itching and irritation caused by eczema.

Swings

Probably the number one item you’ll hear foster parents recommend for drug-exposed infants is a good baby swing.  Many people swear by the Mamaroo as the best investment they made to help their NAS baby.  I did end up getting one, and while it’s definitely the best baby swing I’ve ever seen (you can program different motions, it has adjustable speeds, and there are several white noise options), my little one doesn’t care for it.  If you’re on the fence about investing in a Mamaroo, the tried and true Rock ‘n Play might be a better option.  The incline seating and vibration are two things a NAS baby would benefit from.

Extras

Above were all the things I’d consider essentials.  The following products are extra things that you can manage without but may make life easier.

 

This first one isn’t a product I own, but I’ve been intrigued by it since I learned of its existence several months ago.  The Baby Shusher responds to your infants cries in the middle of the night by playing a low, rhythmic shushing sound.  It’s doctor-approved and claims to help your baby engage their natural calming reflex.  But if this seems a little strange to you, a more traditional white noise machine is something to look into.

The vibrating mattress pad is a cool idea to help soothe baby while sleeping.  You simply stick it under a crib mattress, and the vibrations will lull your little one to sleep.  I did buy one of these for $2 at Goodwill, but it didn’t work and I haven’t gotten around to replacing it… I should do that.

The baby carrier is a wonderful resource since NAS babies need a lot of skin-to-skin contact and can be inconsolable when not held.  I put this in extras because there are so many different kinds of carriers, and I haven’t found one that I prefer over just carrying the baby in my arms.  For newborns, I’d probably go with a sling.  I currently have an Ergo with a newborn insert, and I don’t love how baby fits in it.  Boba makes a sling that’s just as good as a Moby Wrap, in my opinion, and it’s cheaper!

 

If you’re a foster parent and have a product we need to put on our list, please shoot us a quick email at stillorphans@gmail.com.  You can also find us on Facebook!