Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-12-2018

Graduate Advisor

Susan Dean-Baar

Committee

Elizabeth Merritt

Pamela Lesser

Abstract

The incidence of opioid use disorder (OUD) has grown to epidemic proportions. Infants exposed to opioids inutero are likely to experience withdrawal symptoms during the hours and days immediately following birth, known as Neonatal Abstinence Syndrome (NAS). Research indicates maximizing non-pharmacologic, supportive management decreases Neonatal Intensive Care Unit (NICU) admissions, the length of stay, and the severity of NAS. The purpose of this project is to evaluate the effects of an antepartum consult designed to prepare mothers with OUD to participate in this nonpharmacologic care. The Women and Infants Substance Help (WISH) Center delivers prenatal care for women with OUD. Women receiving care at WISH were given an antenatal consult to inform them of the proposed plan of care for their infant after delivery. Outcomes were compared to mothers from WISH who did not receive the consult, to assess the consistency of mothers rooming-in and breastfeeding to treat NAS in the first 5-7 days, as measured by whether the mother roomed-in with her baby, the percentage of babies who received their mother’s milk, and the length of hospital stay for the baby. While there was a small improvement in these measures among the mothers who received the consult, it did not reach statistical significance. A secondary analysis supported existing studies which associated rooming-in and breastfeeding with shorter lengths of stay for infants. The overall success of this model of care warrants continuation. Further investigation is needed to identify and refine the factors which contribute to this success.

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