Supporting Mothers So They Can Support Their Infants: NICU Visitation in the Context of Substance Use Disorder and Neonatal Abstinence Syndrome.

Abstract

The increasing prevalence of maternal substance use, particularly opioids, has led to a significant rise in neonatal abstinence syndrome (NAS) and neonatal opioid withdrawal syndrome (NOWS). This rise presents unique challenges for NICUs across the United States. This article examines the critical importance of maternal engagement in the care of infants affected by NAS/NOWS and identifies the barriers that mothers with substance use disorder encounter, including stigma, fear of legal consequences, and logistical obstacles. Evidence shows that maternal involvement in nonpharmacologic interventions-such as skin-to-skin contact, breastfeeding, and comforting techniques-can mitigate NAS symptoms, reduce the need for pharmacologic treatments, shorten NICU stays, and improve long-term outcomes for both the mother and the infant. The article highlights the value of adopting trauma-informed, family-centered care approaches to encourage maternal participation, reduce stigma, and create a supportive NICU environment. Additionally, it underscores the importance of educating NICU staff about addiction, recovery, and trauma-sensitive communication to improve care and reduce bias. By fostering maternal involvement and providing comprehensive support, NICU teams can significantly improve health outcomes and strengthen the maternal-infant bond for this vulnerable population.