THE Resource For Parents/Caregivers Caring for Infants Impacted By Prenatal Drug Exposure

Welcome to dr. kiti’s nAS Care resource toolkit

Parents and Caregivers:

This ToolKit is for you!! It is an excellent web-based resource for parents & caregivers of infants born with prenatal substance exposure. This kit will provide you with valuable tools for caregiving.  It was developed specifically for infants who were born prenatally exposed to opioids, however, it is also very useful to parents and caregivers of infants who are exposed to other substances (e.g. alcohol or other drugs).  In fact, this kit is not only useful to parents of high risk infants, but to any parents. 

Providers:

Physicians, Nurses, Psychologists, OT, PT, Sp/L, Daycare, Early HeadStart providers—ANYONE taking care of infants impacted by prenatal substance exposure. This Resource is for you!!  The strategies in the ToolKit may assist you in caring for these infants AND the families you serve will thank you for referring them to this resource!

Why this ToolKit:

The NAS CARE Resource ToolKit is an amazing resource for parents & caregivers of infants impacted by NAS (Neonatal Abstinence Syndrome) or other prenatal substance exposure! This resource describes the NAS signs & how to intervene to help these babies. Importantly, this Toolkit offers strategies to help caregivers help their babies Calm, Sleep, Eat, Eliminate, Stop Crying, Regulate, and much more.

What is NAS/NNE:

Neonatal Abstinence Syndrome (NAS) are withdrawal signs experienced by infants who were exposed to Opioids in Utero. These signs (e.g. tremors, inconsolable crying etc) impact a baby’s functioning and can make it difficult to care for the baby.

NNE, or Neonatal Neurotoxic Effects, are also signs of withdrawal, very much the same as NAS, that are experienced by infants exposed to other substances in Utero (like alcohol, methamphetamines etc). 

These signs impact the baby’s functioning and can make it difficult to care for the baby.  Impact of signs on neurodevelopment and behavior can be long lasting. However, if we can help the baby to be comforted and regulated as much as possible during this time, we can help the baby now AND may even prevent long lasting problems.

(Full definitions of NAS and NNE can be found on the Provider page)

Why this ToolKit is Unique:

• Free & Web-based

• Focus is on the parent/caregiver and how to take care of the baby

• Transdisciplinary approach (professionals from many disciplines working together) – gives parents/caregivers several strategies for each sign or behavior of concern so the parent can find the best strategy for their baby

• Parent contributions to make strategies practical and useable

• Focus is on infants impacted by NAS & NNE but strategies may be useful to any parent/caregiver

Clinical Expert Basis:

• Transdisciplinary team with experts from various disciplines

• Developmental Approach within the context of Supportive Caregiving Environment

• Caregiving strategies from transdisciplinary input—“not one size fits all”

• Recognition of signs & when to seek help

Application: From Hospital to Home to Daycare to Early Intervention:

The NAS CARE Resource ToolKit offers strategies for anyone caring for an infant impacted by NAS or NNE.  It is focused on parents & caregivers.  It can also be utilized effectively in a variety of settings such as:

·      Ob/Gyn – education for pregnant women

·      Newborn Nursery and NICU – for nurses and parents

·      Community nursing – to share resource or review videos together as part of parenting education

·      Pediatricians – there is a provider section that provides a great deal of history and information on NAS/NNE featuring Dr Loretta Finnegan. 

We encourage providers to share this resource with parents/caregivers and use the ToolKit to further support their recommendations.  

What is Inside the ToolKit:

• Provider Page – History of NAS, Signs, White Paper of NAS CARE, Other Resources

• Parent/Caregiver Page– Description of what is in the ToolKit and how it can be best utilized. How to access other resources.

• NAS CARE Resource ToolKit:

  • Signs – withdrawal signs and strategies from the transdisciplinary team on how to help the baby

  • TIPs (TimeIn Parenting Strategies)

  • Therapeutic Music

  • Other Resources

Implications:

With attuned caregiving a baby’s trajectory can change course; preventing potential delays or difficulties AND teaching them strategies that can help them through the course of their life. 

This ToolKit can be a lifesaver for parents/caregivers –  it has been compared to ‘ask an expert’ or ‘phone a friend’ at your fingertips!

Expertise:

The NAS Care Resource ToolKit was developed by Dr Kiti Freier Randall. She has had over 30 years of experience working with infants born with prenatal substance exposure. In addition to her expertise, the ToolKit includes content and insight from expert colleague providers in other disciplines including medicine, nursing, OT, and speech/language. Importantly, the input of parents/caregivers of high risk prenatally drug exposed infants who experienced NAS/NNE is also included.

Attention: This toolkit does not replace the infant’s care by their medical provider

© 2025 Dr. Kiti Freier Randall