1. Neonatal Abstinence Syndrome Following the birth the baby, he/she may require prolonged treatment and spend several weeks or possibly months in hospital, in the special care baby unit. Whilst there the innocent baby will need specific care, when he begins to withdraw. Swaddling the baby quite firmly could be necessary as this has shown to be effective also nursing your baby in a quiet environment (Golianu et.al.2007).The H.C.S.W./ NN who will care for the baby forms a part of the team who will help delegate the care needed for the NAS baby (WAG 2010) and often initiates the obvious need for prescribed medicine, which will be given orally before a feed.This medicine would normally be morphine or if the baby has been exposed to multiple street drugs, a further prescribe drug called phenobarbitone may be necessary as a continued part of the baby’s DRUG regime. The close observation process would be a delegated task for the Health Care Support Worker / Nursery Nurse to have the opportunity to work within their role (WAG 2011) and before treatment would begin the baby would need to show recordable signs of obvious pain and discomfort Oral et al.(2006). For this a scoring system known LIPSITZ SCORE CHART (Lipsitz 1975) would be used.Then with consecutive high scores the doctor along with the nursing team caring for the baby would then commence medication. Which continues until baby’s symptoms are under control. Only then can his medication gradually be reduced. Discharge from hospital would not be allowed until the baby is no longer showing signs of withdrawal. Which has proven to take many weeks or months. IS SUFFERRED BY INFANTS WITHDRAWING FROM SUBSTANCES ON WHICH THEY HAVE BECOME PHYSICALLY DEPENDANT AFTER INTRAUTERINE EXPOSURE (V T Serane et. al 2008) Common substances Which can cause NAS are; HEROIN COCAINE METHADONE (both illicit & prescribed ) CANNABIS Some prescriptive drugs (sleeping tablets, strong pain killers. During pregnancy the foetus receives all the necessary nutrients along with the mothers toxins found naturally in her system through the umbilical cord. In a normal healthy pregnancy this process works very well and the baby is born with NO ADDICTION. Unfortunately when a mother is herself addicted to illicit or prescriptive drugs, the unborn baby has already suffered these harmful toxins and inevitable damage to the fragile foetus has occurred. So on arrival into this world THE BABY already faces his new life DEPENDENT ON DRUGS. LOOK TO THE FUTURE- As your child grows-up using COCAINE during pregnancy will, seriously contribute to behavioural problems and could have a detrimental effect on their language and cognitive skills in early childhood through to adolescence.While continued opiate use (heroin & methadone) has the risk of potentially impairing the brain and behavioural development.( Lester et al.2010). NAS is a relatively new, but very serious growing problem. It affects every social stratum gender and race with pregnant women being of no exception,it is also now found to be growing in the more affluent areas. Throughout neonatal units, within the NHS modernisation agenda (WAG 2005), the role of the Health Care Support Worker/Nursery Nurse is often to care for these babies and their mothers from admission with continued support for a improved future in health care (Kessler et al.2010). As a nursery nurse I acknowledge that it is my responsibility to work within my capability and am regularly updated through education training study days, as outlined by WAG ( 2011) Ethical issues are always present within the healthcare setting and the health professional is faced with the dilemma when the pregnant woman has chosen to behave in a way that carries potential harm to the developing foetus, but would still have to commit an obligation of care for both her and her unborn baby in such a way that would benefit them both once the baby is born. (Lambert et.al 2010). All health professional should always remain non- judgemental throughout (NMC 2008) and eliminating discrimination with reduction of inequalities of care (DOH, 2010). Offering written information where possible on the specific effect of illicit drug taking on their un-born baby. Whilst continuing to reinforce verbal education before and during her pregnancy. By continuing to support the mother and helping her to understand from early pregnancy the detrimental effects of NAS can dramatically reduce the time spent for the baby withdrawing (Hamdan 2009).Continued support would prove to a positive and bright future as outlined in the WAG Designed for Life (2005). W- wakefulness I- intense suffering T- tremors H- hot flushes D- drug treatment R- rigidity, from cramps A- aimless crying W- weight loss A- anxiousness L- loose bowels REFERENCES DOH(2010).Department of Health. The Coalition’s Vision for the NHS. Golianu B;Krane E;Seybold J;Almgren C and Anand K J(2007).Non-pharmacological techniques for pain management in neonates. Seminars in Perinatology 31(5) p318-22 Hamden,AH.(2009)Neonatal abstinence syndrome: Differential diagnoses &work-up.eMedicine from Web MD. Retrieved Febuary18,2010,from http://www.emedicine.com/ped/topic2760.htm(GI).http://www.emedicine.com/ped/topic2760.htm(GI) Kessler I; Heron P(2010).NHSmodernization and the role of HCA’s. British Journal of Healthcare Assistants July,vol04 No7 p318 – 320. Lambert B; Schneider M; Cambell D(2010).Ethical issues and addiction. Journal of Addictive Diseases (J ADDICT DIS),Apr-Jun;29(2):164-74. Lester B M Lagesse L L (2010).Children of addicted women Journal of Addictive Diseases( J ADDICT DIS ),Apr- Jun;29(2):259-76. Lipsitz PJ. (1975) A proposed narcotic withdrawal score for use with new born infants. A pragmatic evaluation of its efficiacy,Clin Pediatr;14:592-4. NMC(2008).Advice. Conscientious objection, online. Available at http://www.nmc-uk.org/Nurses-and- Midwives/Advice-by-tpic/A/Advice/Conscientious-objection/.Accessed on 10 th May 2011.http://www.nmc-uk.org/Nurses-and- Midwives/Advice-by-tpic/A/Advice/Conscientious-objection/ Oral, R,& Strang, T.(2006).Neonatal illicit drug screening practices in Iowa: The impact of utilization of a structured screening protocol.Journal of Perinatology,26(11),660-666. Tiroumourougane V. and Ommen K. (2008)Neonatal Abstinence Syndrome.Indian Journal of Pediatrics, vol75- Sep.p911. Welsh Assembly Government (2005) Designed for Life: Creating World Class Health and Social Care for Wales in the 21 st Century. Welsh Assembly Government (2010) All Wales guidelines for Delegation. WAG. Welsh Assembly Government(2011) Code of Conduct for Healthcare Support Workers in Wales. WAG 09008012 PEIS030