Which statement best describes management of neonatal abstinence syndrome (NAS)?

• A. Surgical intervention is the primary management.
• B. No treatment is ever required.
• C. Supportive care and pharmacotherapy (e.g., morphine, methadone) as needed.
• D. Immediate immunotherapy.

Answer: (C)

Management centers on easing withdrawal symptoms while supporting the infant’s growth and comfort. Start with thorough supportive care: careful monitoring, a calm and low-stimulus environment, gentle handling, swaddling, rooming-in with the mother when possible, and small, frequent feeds with good hydration and weight gain. Breastfeeding can be encouraged if the mother is on stable opioid maintenance and the infant is not at risk. If withdrawal signs are significant or not adequately controlled with supportive care alone, pharmacotherapy is used to relieve symptoms, most commonly opioids such as morphine or methadone, with dosing guided by a standardized scoring tool and then tapered as the infant improves. The aim is to balance relief from withdrawal with a safe, gradual withdrawal of drugs, avoiding unnecessary interventions. Immunotherapy or surgical interventions are not part of NAS treatment.