Which of the following is typical signs and symptoms of Neonatal Abstinence Syndrome (NAS)?

• A. Difficulty to Console, Hypotonic, Respiratory Distress
• B. High Pitched Cry, Tremors, Vomiting and Watery Stools
• C. Hypoactive Moro Reflex, Sleep Deprivation, Disorganization
• D. Lethargy and Poor Feeding

Answer: (B)

Neonatal Abstinence Syndrome occurs when a newborn withdraws after in-utero exposure to opioids or other substances, leading to neurobehavioral excitability plus autonomic and gastrointestinal symptoms. A high-pitched cry reflects CNS withdrawal and irritability, tremors show CNS hyperexcitability, and vomiting with watery stools indicate GI involvement. This combination—neuro irritability with GI distress—is the most characteristic cluster of NAS signs, making it the best match. Lethargy or hypoactive reflexes are less typical, and while some infants may have other signs, the described triad best represents NAS.