W4W can provide no-cost services that may include the following for women in all stages in their lives:

  • Connections to SUD treatment
  • One-on-one recovery supports
  • Resources for daily needs such as housing, transportation, food, medical appointments, etc.
  • Assistance with birth control or planning for pregnancy
  • Help with accessing prenatal care
  • Information to help make decisions about pregnancy, parenting, and self-health

All support through W4W is free and confidential.

To speak directly to a CHW/RC to learn more about these services and supports, contact AskPETRA by:

CALL: (603)259-1729 -M-F 8-4:30pm

TEXT: (603)259-4820 -M-F 8-4:30pm

EMAIL: #ob#NfxCRGEN#at#APUPAU.bet#ob#

WARM4Women (W4W) was developed to reduce the rate and impact of Neonatal Abstinence Syndrome (NAS) through prevention, education, treatment, and recovery supports for women of child-bearing age who may or may not be pregnant or already have children and have a history of or are at risk for Substance Use Disorder (SUD).

W4W has trained Community Health Worker/Recovery Coaches (CHW/RC) who provide free, non-judgmental, one-on-one supports to women before, during, and after pregnancy. W4W’s Community Health Worker/Recovery Coaches (CHW/RC) are trusted members of the North Country community and serve as a personal guides and mentors for people with Substance Use Disorder (SUD) who are seeking recovery or are at risk of relapse. Supports can include providing connections to treatment, housing, transportation, healthcare, and other essential daily needs and are free and confidential.

You matter. And we care. Reach out to learn how W4W can support you.


What is Neonatal Abstinence Syndrome (NAS)?

During Pregnancy, almost every substance in the mother’s blood can pass to the baby. Neonatal Abstinence Syndrome (NAS) is most often caused when a pregnant woman takes drugs called opioids.  It also can be caused by other substances such as antidepressants, barbiturates or benzodiazepines (sleeping pills), marijuana, alcohol, nicotine and even some herbal remedies. NAS happens when newborns are no longer exposed to the drug after birth, which can cause withdrawal symptoms.

If you are a person in need of supports or services because of a Substance Use Disorder and you do not fit the criteria for the W4W program, you may still be eligible for the Wellness And Recovery Model (WARM) that provides many of the same services. Contact AskPETRA for more information.


When you are pregnant, the way you take care of yourself is the way you take care of your baby. Everyone’s pregnancy is different. There are things you can do to have the healthiest pregnancy possible. This includes connecting with prenatal care (medical care for you and your baby), as well as maintaining a healthy diet, rest, and exercise.  

Read more about what you can do to prevent NAS in your baby.

Signs of NAS can be different for every baby and usually depends on the type of substance the baby was exposed to before birth. Most symptoms can happen within 3 days of birth, but some could happen immediately or even a few weeks after birth.

Read more about the signs and issues of NAS.

Neonatal Abstinence Syndrome (NAS) is a group of symptoms that a baby experiences when withdrawing from opioids and other substances s/he may have been exposed to before birth. It is not an addiction. Most babies with NAS get treatment in the hospital right after birth and get better in a few days or weeks, but there can be long-term effects.

Read more about treating NAS.

A baby who has NAS will need some special follow-up care to manage any longer-term concerns that may come up. The most important part of the baby’s recovery is to take him/her to all scheduled follow-up appointments and well-baby checkups, even if they are doing well. Your baby’s healthcare provider checks your baby at these visits for problems such as developmental delays, nutrition and growth issues, and problems with hearing and vision.

Read more about developmental delays and what to do if you believe your child has complications due to NAS.


Preventing NAS

If you are pregnant and you are using substances, consider the following:

  • See a healthcare provider to start prenatal care (the care of the unborn baby) and let them know you are using substances. Do not stop taking the drug or substance without talking to your healthcare provider first. If you suddenly stop taking substances it can cause severe problems for you and your baby, including death. Talk to your healthcare provider about treatment to help you stop using substances in a way that is safer for you and your baby.
  • If your substance of choice is opioids, ask your healthcare provider about Medication Assisted Treatment (also called MAT). MAT medications include methadone and buprenorphine. NAS in your baby may be easier to treat if you are on MAT during pregnancy.
  • If you go to a healthcare provider who prescribes medicine to treat a health condition, make sure that provider knows you are pregnant. You may need to stop taking certain medicines or change to medicines that are safer for your baby. Ask all your healthcare providers if the medicine you take—even prescribed medications— can cause NAS in your baby. Even if you use the prescription medications exactly as your provider tells you, there is a risk that it may cause NAS in your baby.
  • The pressures and decisions when becoming pregnant can sometimes feel like too much. A Warm4Women Community Health Worker/Recovery Coach (CHW/RC) can help guide and support you. Find out how you can connect with a CHW/RC for one-on-one supports.

What is Prenatal Care?

Prenatal care is the healthcare you and your unborn baby get while you are pregnant. Prenatal care has a schedule of regular checkups and prenatal testing to be sure you and your baby are healthy during the entire pregnancy.

Why is Prenatal Care Important?

Prenatal care can help keep you and your baby healthy. Babies of mothers who do not get prenatal care are three times more likely to have a low birth weight and five times more likely to die than those born to mothers who do get care. Healthcare providers can spot health problems for either the mother or the baby early when they see mothers regularly. Prenatal care is especially important if the mother has or is at risk of Substance Use Disorder (SUD). Your provider can help you make a care plan that addresses the challenges you may face, helping you and your unborn baby to be as healthy as possible.

What is a wellness checkup?

A wellness checkup is a regularly scheduled visit with your child’s doctor to make sure s/he is continuing to grow healthy. Your child will need wellness checkups at ages: 2 weeks, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months, 2 years, 2 1/2 years, 3 years, 4 years, and 5 years.

What happens at a wellness checkup?

  • Your baby/ child gets scheduled immunizations (vaccinations) to prevent illness. You can also ask your pediatrician about nutrition and safety in the home and at daycare or school.
  • Your provider will track your baby’s growth and development to compare how much your baby has grown in the time since your last visit. You can discuss your baby’s social and learning behaviors.
  • You can raise concerns. Make a list of topics you want to talk about with your child’s doctor such as development, behavior, sleep, and eating. Bring your questions or concerns with you to talk with the doctor at the start of the visit.
  • Regular visits with your baby’s provider helps to create strong, trustworthy relationships among the doctor, parent and child. Working together will help raise a healthy, strong baby.

Signs and Issues of NAS

Babies born with health conditions from NAS may need to be treated in the Newborn Intensive Care Unit (NICU). There is not a lot of information about the long-term effects of NAS on a baby. Scientists are still researching to see what babies born with NAS may be like as children and young adults.

Signs of NAS can include:

  • Body shakes, twitches or seizures
  • Tight muscle tone (stiff arms and legs that have trouble moving)
  • Fussiness or excessive crying
  • High-pitched crying
  • Poor feeding or slow weight gain
  • Breathing problems, including very fast breathing
  • Fever, sweathing, or blotchy skin
  • Trouble sleeping
  • Diarrhea or throwing up
  • Stuffy nose or sneezing

If your baby shows any of these symptoms and may have been exposed to substances before birth, contact his/her doctor immediately.

Complications from NAS can include:

  • Low birth weight (being born weighing less than 5 pounds, 8 ounces)
  • Jaundice- this is caused when your baby’s liver isn’t fully developed or working. Your baby’s eyes and skin will look yellow.
  • Seizures
  • Sudden Infant Death Syndrome (SIDS)- this is the unexplained death of a baby who is younger than 12 months old.
  • Developmental delays- when your child doesn’t have the skills that they should at a certain age (such as sitting, walking, or talking)
  • Motor problems- when your baby has problems using their muscles or moving
  • Speech and language delays
  • Sleeping problems
  • Ear infections
  • Vision problems

Treating NAS

Healthcare providers will watch your newborn for about a week after birth. Treatment for NAS will depend on your baby’s symptoms. In severe cases, doctors may give your baby medications in gradually decreasing doses to gently wean him/her off of drugs. IV fluids may be necessary to prevent dehydration, and high-calorie baby formula can help overcome feeding issues. Babies with NAS sometimes get treated in the neonatal intensive care unit (NICU).

Providers take many steps to treat babies with NAS. These can include:

  • Identifying the risk for delays in natural growth and development (developmental delays).
  • Controlling the baby’s environment: This can include dimming the lights, keeping the room quiet, assisting with sleeping patterns, introducing sensory input slowly, avoiding brisk or startling movements.
  • Educating caregivers about infant stress cues: Cues an infant is under stress can include looking away from the observer, arching the neck and back, making frantic and excessive movements, and frequently hiccuping, sneezing, or yawning.
  • Helping caregivers recognize engagement clues: Cues an infant is ready to interact may include looking at caregivers, bringing hands to mouth, snuggling, etc. Use of a pacifier can help with calming, and blankets can be used to make infants feel “contained” to decrease excessive movements.
  • Providing therapeutic touch and movement experiences
  • Helping to improve food intake: Treatment can include recognizing infant sucking patterns, using pacifiers, and other ways to strengthen the baby’s ability to take a bottle or breastfeed successfully.
  • Family education: Physical therapists play a critical role in providing individualized caregiver education with an emphasis on helping parents understand their infant’s behavior cues.

Eat. Sleep. Console Method (ESC)

Babies with NAS can be managed with the Eat, Sleep, Console (ESC) method which can comfort a baby that may be fussy and hard to soothe. ESC involves parents providing skin-to-skin contact, swaddling, on demand feeding and other measures that help calm the baby. ESC has been proven to show shorter hospital stays and less need to use medical treatment to treat their NAS.

Plans of Safe Care (POSC)

Federal and state laws require a “Plan of Safe Care” (POSC) if a baby has been exposed to substances.

The POSC provides support to mothers, babies, caregivers, and families and is developed with the mother to plan ahead for when the mother and baby have left the hospital. The plan may address such supports Medication Assisted Treatment, trauma-informed parenting support, well child-care, recovery supports, mental health care, and women’s health care.

The POSC is given to the mother before leaving the hospital and will be shared with the baby’s provider. The mother is encouraged to share the POSC with the people in her life, including the professionals, providers, and family members that are supporting her. The POSC is not shared with the Department of Children, Youth, and Families (DCYF) unless a report of child abuse or neglect has been made.

If your child has NAS

If your baby has developmental delays, it means that they did not reach one or more “developmental milestones” meaning they are not doing the things that are expected at certain ages, such as rolling over, crawling, speaking or walking. Talk to your baby’s provider about accessing “early intervention” services. Many communities have these specific services that can help children from birth through 3 years of age to learn important skills. Services include therapy to help a child talk, walk, learn self-help skills, and interact with others. Getting services as early as possible can help improve your child’s development. With early intervention, most children with a developmental delay do overcome their challenges and perform at the same level as their peers.

Things you can do if your child has NAS

There are many things you can do to help your baby in the hospital or at home:

  • Spend as much time with your infant in the nursery as possible. Your baby will be comforted by your close contact.
  • Hold your baby close and use skin-to-skin contact often.
  • Some babies like to be patted or rocked, while others do not. Understand what your baby prefers.
  • Give a pacifier.
  • Keep a calm and quiet environment.
  • Use a blanket to wrap your baby but be careful not to overheat.
  • Give smaller, more frequent feedings.
  • Change your baby’s diaper often and clean his or her skin with warm water.
  • Learn the signs of withdrawal so you will know if your baby is getting worse.
  • Keep in close contact with your doctor.