Supporting Mothers in Caring for their Infants with Neonatal Abstinence Syndrome: Better Outcomes and Lower Costs

Citation:

Fran Hodgins, Jessica Lang, Griffin Jones, Mary Houghton, and Munish Gupta. 2/10/2020. “Supporting Mothers in Caring for their Infants with Neonatal Abstinence Syndrome: Better Outcomes and Lower Costs.” 2020 AcademyHealth Health Datapalooza and National Health Policy Conference. Publisher's Version

Abstract:

In light of the dramatic growth in the incidence of neonatal abstinence syndrome (NAS) in Massachusetts, the Health Policy Commission launched the Mother and Infant-Focused NAS Interventions to pilot and accelerate the adoption of evidence-based interventions and emerging best practices to treat mothers and infants impacted by opioid use disorder (OUD).

Caring for infants with NAS can be complex and costly. Historically, infants with NAS have required pharmacotherapy treatment in the neonatal intensive care unit (NICU). While sometimes necessary, these practices can increase length of stay, increase costs, and contribute to overtreatment. Furthermore, locating infants in the NICU can interfere with mother-infant bonding, and may contribute to the stigma that mothers with OUD face in health care settings. Emerging evidence suggests a family-centered treatment approach may be preferable and more cost-effective. The NAS Interventions were designed to improve care for both mothers and infants affected by OUD, reflecting the belief that mother and infant needs and interests are inseparable.

A key component of the NAS Interventions was the engagement of mothers in providing treatment for their infants. Hospitals implemented a range of evidence-based practices to treat NAS, including promotion of many non-pharmacological treatments, such as breastfeeding and skin-to-skin contact, that emphasize the role that the mother plays in caring for her infant. Recognizing that supporting mothers is key to both their recovery and ability to care for their infants, hospitals increased perinatal supports for mothers and conducted staff training to reduce stigma. In six hospitals over 24 months, these practices were associated with shorter infant length-of-stay, less frequent placement in the NICU, and reduced need for pharmacologic treatment.

These findings suggest that non-pharmacological care which incorporates the mother as an active caregiver has potential for improved outcomes and could result in cost savings.

Last updated on 06/15/2022