Rooming-in care for infants of opioid-dependent mothers: Implementation and evaluation at a tertiary care hospital

• Published in: Canadian family physician 2015-12, Vol.61 (12), p.e555-e561
• Main Authors: Newman, Adam, Davies, Gregory A, Dow, Kimberly, Holmes, Belinda, Macdonald, Jessica, McKnight, Sarah, Newton, Lynn
• Format: Article
• Language: English
• Subjects: Adult; Analgesics, Opioid - therapeutic use; Babies; Drug therapy; Female; Humans; Infant; Infant, Newborn; Intensive care; Intergenerational relationships; Length of Stay - statistics & numerical data; Morbidity; Mortality; Mother-Child Relations; Mothers; Mothers - psychology; Neonatal Abstinence Syndrome - drug therapy; Neonatal Abstinence Syndrome - psychology; Neonatal Abstinence Syndrome - rehabilitation; Object Attachment; Ontario; Opioid-Related Disorders - drug therapy; Opioid-Related Disorders - psychology; Opioid-Related Disorders - rehabilitation; Pregnancy; Pregnancy Complications - drug therapy; Pregnancy Complications - psychology; Pregnancy Complications - rehabilitation; Prenatal Exposure Delayed Effects - drug therapy; Prenatal Exposure Delayed Effects - psychology; Prenatal Exposure Delayed Effects - rehabilitation; Program Description; Rooming-in Care; Tertiary Care Centers; Treatment Outcome
• ISSN: 0008-350X; 1715-5258

Infants born to opioid-dependent women are admitted to intensive care units for management of neonatal abstinence syndrome (NAS), serious morbidity, and prevention of mortality; however, the disadvantages of this approach include infants experiencing more severe NAS and exhibiting a greater need for pharmacotherapy owing to the interference with mother-infant bonding. To implement a rooming-in program to support close uninterrupted contact between opioid-dependent women and their infants in order to decrease the severity of NAS scores, lessen the need for pharmacotherapy, and shorten hospital stays. Opioid-dependent pregnant women were assessed antenatally by a multidisciplinary team and provided with education and support. Psychosocial issues were addressed in collaboration with a community program developed to support addicted mothers. The mother-infant dyad was admitted postpartum to a private room and attended by nurses trained in Finnegan scoring. Infants remained with their mothers unless persistently elevated scores made transfer to neonatal intensive care units necessary for initiation of pharmacotherapy. With the rooming-in program, the proportion of infants requiring pharmacotherapy decreased from 83.3% to 14.3% (P < .001) and the average length of stay decreased from 25 days to 8 days (P < .001). The rooming-in experience was rated favourably by participating mothers.