Which of the following is a GI symptom seen with neonatal abstinence syndrome?

• A. High-pitched crying
• B. Hypertonia
• C. Tachypnea
• D. Poor feeding, vomiting, and diarrhea

Answer: (D)

Neonatal abstinence syndrome involves withdrawal symptoms that affect multiple body systems, including the gastrointestinal (GI) tract. GI signs arise from withdrawal-related disruption of gut motility and feeding coordination. Poor feeding with vomiting and diarrhea is a classic GI cluster seen in NAS, reflecting how withdrawal impacts the infant’s ability to feed and process milk. The other signs—high-pitched crying (a neurobehavioral cue), hypertonia (increased muscle tone), and tachypnea (rapid breathing)—are CNS or respiratory symptoms, not GI. Thus, the option describing poor feeding, vomiting, and diarrhea best represents the GI manifestations of NAS.