Despite the host of negative factors there is little evidence that the prenatal exposure results in cognitive deficits for the affected newborns. An update, F. F. Rubaltelli and B. Granti, editors. Thus, it is preferable to have a larger, more mature newborn who is addicted to the methadone than a small and potentially compromised newborn less severely addicted to heroin. Thus, it would be preferable to feed less often using large feedings. However, the newborn undergoing withdrawal has a less effective suck and large feedings are not possible.
Nutrition can be a significant problem and the solution is to opt for frequent small feedings.
An increased caloric formula is usually not necessary if the nursing care is adequate. In addition, hypercaloric formula may exacerbate the diarrhea seen as part of the clinical picture of withdrawal. Signs and symptoms of NAS are non-specific and can mimic sepsis or other neurologic or gastrointestinal problems. Compounding the problem is the treatment consisting of some form of narcotic which can mask pain, discomfort, and other signs of neurologic or gastrointestinal disease. If the NAS score is 2 or less there is not likely to be much need for additional treatment and if the patient is being overdosed, discontinuing treatment is essential.