Strategy
Expand Services for Neonatal Opioid Withdrawal Syndrome
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Neonatal Opioid Withdrawal Syndrome (NOWS), sometimes referred to more broadly as Neonatal Abstinence Syndrome, is a condition that occurs in newborns who were exposed to opioids while in the womb. It can be caused by maternal use of heroin, fentanyl, and prescription pain killers, as well as methadone. Symptoms of NOWS can include irritability, diarrhea, and tremors among infants experiencing withdrawal. Identifying and treating these symptoms is critical to an infant’s health and development.
Caring for an infant with NOWS requires a multi-faceted approach that alongside medical care should include comprehensive medical treatment, parental and family involvement and education, psychological and emotional support services for parents, social services, and care coordination. The use of evidence-based strategies in each of these domains has been shown to decrease hospital stay lengths, decreasing the burden of the condition on both infants and families. Prevention and treatment strategies are critical, from preconception education, prenatal care, postpartum care, and newborn/infant care, to help prevent and treat NOWS.
Evidence-Based Strategies
Promote Rooming-In and Non-Pharmacological Interventions
Rooming-in practices, where newborns with NOWS stay in the same room as their mothers, prioritizes non-pharmacological interventions to soothe infants and reduces the need for medications. Rooming-in supports maternal-infant bonding and breastfeeding, which can reduce the severity of NOWS and improve infant outcomes. Non-pharmacological interventions, such as swaddling, skin-to-skin contact, and quiet environments, can also help soothe infants and minimize the need for medications.
- Educate hospital staff on the benefits of rooming-in and non-pharmacological interventions.
- Develop standardized protocols for NOWS care that prioritize these approaches.
- Create a supportive environment for mothers and infants, including comfortable rooms and access to lactation consultants.
Standardize NOWS Assessment and Treatment Protocols
Inconsistent assessment and treatment practices can lead to variability in care and potentially unnecessary medication use. Implementing standardized tools and protocols for assessing and treating NOWS across hospitals and healthcare settings helps ensure consistent, evidence-based care at the appropriate level of care based on infants’ individual needs.
- Adopt a validated NOWS assessment tool, such as Eat, Sleep, Console.
- Develop clear guidelines for pharmacological and non-pharmacological interventions.
- Provide training to healthcare professionals on the standardized protocols.
Expand Access to Early Intervention Services
Infants with NOWS may experience developmental delays and challenges. Connecting infants with NOWS and their families to early intervention services, such as developmental therapies, home visiting programs, and mental health support can help address these issues and improve long-term outcomes.
- Establish referral pathways between hospitals and early intervention programs.
- Provide education to families about the benefits of early intervention.
- Ensure adequate funding and resources for early intervention services
Enhance Care Coordination and Follow-Up
Families affected by NOWS often have complex needs that require coordinated care from multiple providers. Improving coordination of care between hospitals, healthcare providers, and social service agencies can help ensure that families receive the necessary support and services.
- Designate a care coordinator to oversee the transition from hospital to home.
- Establish clear communication channels between providers.
- Develop a comprehensive discharge plan that addresses the family’s needs.
- Provide ongoing follow-up care to monitor infant development and maternal well-being.
The Commonwealth’s Examples
A regional partnership between Henrico, New Kent, Charles City County proposed a housing facility for pregnant and parenting women experiencing substance use disorder. The facility is to serve as a sober living location and provide support for children to remain in their mother’s custody.
- Youth
- OAA Funded
