Caring for Infants and Families Affected by Neonatal Abstinence Syndrome
The goal of this article is intended to aid nurses in providing improved care for infants and families affected by neonatal abstinence syndrome (NAS).
Opioid Use Disorder in the United States is a public health emergency not only for adults, but also for newborns. Infants exposed to opioids in utero and who exhibit withdrawal signs after birth are diagnosed with neonatal abstinence syndrome (NAS). According to Winkelman and colleagues, NAS incidence has quadrupled within the last decade; as of 2014, the incidence was approximately 14.4 cases per 1,000 births. More recent reports indicate that the incidence continues to rise, suggesting rates as high as 20 cases per 1,000 live births.
Throughout the United States, at least one newborn is affected by NAS every 15 minutes. The standard of care for newborns with NAS includes an environment that supports physiologic stability by offering comforting interventions such as holding, swaddling, and decreasing excessive stimulation. Infants who don’t respond to this care may require pharmacologic treatment, most commonly with morphine or methadone. Pharmacologic intervention is associated with significantly longer lengths of stay, increased hospital stay costs, and the potential for mother and baby separation.
Key Learning Outcomes
- Identify manifestations of neonatal abstinence syndrome (NAS).
- Describe the treatment of NAS.
- Discuss how nurses can address challenges of NAS.
Elizabeth Schierholz, PhD, NNP-BC
Elizabeth Schierholz is a neonatal nurse practitioner at Children’s Hospital of Colorado in Aurora, and a research fellow in data science to patient values at the University of Colorado School of Medicine in Aurora.
Rachel French, BSN, RN
Rachel French is a predoctoral research fellow at the University of Pennsylvania School of Nursing in Philadelphia.
Anne-Marie Boucher, BSN, RN, NNP
Anne-Marie Boucher is a neonatal nurse practitioner at C.S. Mott Children’s Hospital in Ann Arbor, Michigan.