Welcome to the NAS CARE RESOURCE ToolKit

**DR. KITI FREIER RANDALL**
PEDIATRIC NEURODEVELOPMENTAL PSYCHOLOGIST

Dear parent/caregiver,

We are very excited to share this information with you. As a reminder, this does not take away or replace the care of your infant’s physician. However, our team has expertise in working with thousands of infants with prenatal drug exposure, and we know first hand that providing an attuned caregiving environment makes a huge difference in the current daily function of an infant (and the family) AND in their long-term trajectory.

We were designed for relationships. The tens of thousands of articles written on resiliency show that the one consistent aspect that promotes resiliency is RELATIONSHIP. AND this is why knowing what your baby is trying to communicate and responding with understanding (attuned caregiving) makes such a huge difference in how the infant will develop and behave over time.

Also, remember that typically there are many reasons for any behavior and this is why it is helpful to have several different professionals represented here to give you their perspective. Each sign may be related to one OR more different reasons and/or any one or more of the suggested interventions may be helpful. It is also important to know that your baby may have the same behavior or sign at different times, for different reasons. The signs can vary according to the types of substances the baby was exposed to, the baby’s medical condition (prematurity, etc), the baby’s age, etc. So it is important to keep looking at all the suggestions to identify what may be happening for your baby and what interventions might work at that time.

NOTE—there is some overlap in some of the different professional’s recommendations, but we kept that overlap as we felt it important to provide the full information from each discipline.

We sincerely hope that this information may help you help your baby.

WHERE TO FIND THE SIGNS YOUR BABY MIGHT BE EXPERIENCING

CENTRAL NERVOUS SYSTEM

Irritability
Startles
Stiff Muscles
Floppy Muscles
Reflexes
Tremors
Seizures
Hyperactivity
High Pitch Cry
Sleep Disturbances
Excessive or frantic sucking

GASTROINTESTINAL SYSTEM

Suck/Swallow Difficulties
Spitting up/Vomiting
Feeding Problems
Loose Stools
Constipation
Weight Loss/Poor Intake

RESPIRATORY SYSTEM

Excessive Mucous/Drooling
Congestion
Fast Breathing

AUTONOMIC SYSTEM

Sneezing
Yawning
Sweating
Increased Temperature

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