Hospital Practices and Policies for Neonatal Abstinence Syndrome: United States, 2022.

Background and objectives: Historically, care for newborns with neonatal abstinence syndrome (NAS) focused on pharmacotherapy provided in a neonatal intensive care setting. The understanding of optimal care models is evolving and focuses on nonpharmacologic practices (eg, skin-to-skin/kangaroo care) in settings that minimize overstimulation. We describe the prevalence of nonpharmacologic practices and policies specific to the support of newborns with NAS among US hospitals.

Methods: Data from the 2022 Maternity Practices in Infant Nutrition and Care (mPINC) survey were used to determine the prevalence of evidence-based practices and policies related to the management of infants with NAS in US hospitals that provide maternity care. Likert scale response options describing implementation of these practices included few (0%-19%), some (20%-49%), many (50%-79%), or most (≥80%) infants.

Results: Three-quarters of hospitals (74.8%) had policies regarding the provision of nonpharmacologic practices for newborns with NAS. About half of hospitals reported that most (≥80%) newborns with NAS experienced skin-to-skin/kangaroo care (52.1%) and rooming-in (50.7%), whereas 34.3% of hospitals reported that most (≥80%) newborns with NAS were breastfed or provided expressed breast milk. Smaller hospitals and hospitals with lower levels of neonatal care more often reported rooming-in for most (≥80%) newborns with NAS.

Conclusions: Although 3 in 4 hospitals have policies in place regarding nonpharmacologic care practices, only about half are implementing the practices for most newborns with NAS. Identifying barriers to implementation of nonpharmacologic practices could help efforts to increase these practices when caring for newborns with NAS.