Neonatal Abstinence Syndrome (NAS)

Reportable by Providers

About this Reportable Condition

Infectious agent:  N/A

Description of illness: Neonatal abstinence syndrome (NAS) is a withdrawal syndrome exhibited by infants shortly after birth.  The syndrome most commonly occurs after in-utero exposure to opioids like heroin, methadone, or hydrocodone; however, in-utero exposure to other substances has also been reported.

Information about this Reportable Condition for Healthcare Providers

Clinical Summary

  • Neonatal abstinence syndrome (NAS) is a withdrawal syndrome in newborns that occurs shortly after birth, most commonly after in-utero opioid exposure (and can also occur with exposure to other substances).
  • Clinical presentation varies, and management depends on the type of prenatal exposure, infant health status, and gestational age/clinical course. Care typically emphasizes nonpharmacologic supportive measures (e.g., calming environment, feeding support) and, when indicated, medication-based treatment under newborn care protocols.
  • Neonatal Opioid Withdrawal Syndrome (NOWS) is a subset of NAS specific to opioid withdrawal in the first 28 days of life, and families of infants treated for NAS should receive a Plan of Safe Care from the healthcare team.
  • In Tennessee, NAS is a reportable condition, and cases diagnosed among Tennessee resident births should be reported at the time of diagnosis via the NAS reporting process/portal.

Healthcare Provider Reporting

Healthcare reporting requirements apply to all providers located within Tennessee, as well as providers whose patients reside in Tennessee.

Providers must report cases of all diseases and conditions listed through one of these methods:

• Mail or fax a completed PH-1600 form to your local health department or fax to the state health office at (615) 741-3857

• Send automatically via electronic case reporting (eCR). See this TDH webpage for more information on eCR, register at the Trader Partner Registration website, or contact MU.Health@tn.gov for assistance.

• Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting. 

• Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link. 

Information about this Reportable Condition for the Public

What Is It

Neonatal abstinence syndrome (NAS) is a group of health problems that can happen when a newborn goes through withdrawal after being exposed to certain substances during pregnancy, most commonly opioids.

Signs and Symptoms

Symptoms can look different from baby to baby and may require medical evaluation soon after birth. Treatment is based on the baby’s symptoms and overall health.

What It Causes

NAS most often occurs after in-utero exposure to opioids (including prescription or non-prescription opioids), but exposure to other substances has also been reported. 

Diagnosis and Treatment

Healthcare teams evaluate newborns for withdrawal and provide care based on the baby’s needs. Many babies improve with supportive care; some need medications. Families of infants treated for NAS should receive a Plan of Safe Care from the healthcare team.

Support and Follow-Up

Ongoing support for the infant and family is important after discharge, including follow-up care and services described in the Plan of Safe Care.

This Page Last Updated: March 25, 2026 at 9:25 PM