Breastfeeding: An Evidence-Based Intervention for Neonatal Abstinence Syndrome
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Opioid drug use during pregnancy is a national and local emergent concern. The state of Ohio has experienced a dramatic increase in neonates born with neonatal abstinence syndrome (NAS). NAS occurs after the neonate is born and no longer receives a supply of opioids from the mother. NAS occurs in approximately 55 to 94 percent of neonates exposed to opioids in utero and if left untreated can become life threatening. Nationally, an estimated $1.5 billion is spent annually for NAS treatment equating to $53,400 per infant hospitalized. Non-pharmacological supportive care measures such as breastfeeding can aid in managing NAS symptoms. The purpose of the evidence based practice improvement project (EBPIP) was to provide continuing education (CE) for maternal newborn care staff in Erie County Ohio on the national standards of care and recommended practice guidelines that encourage and support opioid dependent postpartum women in medication assisted treatment (MAT) programs to breastfeed their neonates. The goal of the project is to foster maternal decision making to breastfeed as a means to decrease the occurrence of NAS symptoms, decrease the need for pharmacological interventions, and decrease the length of stay (LOS) in an acute care hospital setting for affected neonates. The Model for Evidence-Based Practice Change was used to guide project implementation. The CE program titled Breastfeeding’s Role in Neonatal Abstinence Syndrome was presented to maternal newborn care staff (N= 133) of Erie County Ohio. The program provided education on NAS and the national standards and guidelines for breastfeeding and maternal substance use. A comparison of the pre and post questionnaire demonstrated gains in staff knowledge and comfort level regarding the implementation of breastfeeding guidelines for opioid dependent women in MAT. The use of standardized evidence-based guidelines ensures nonpharmacological treatments (such as breastfeeding) are supported for the neonate born to opioid dependent mothers who are participating in an MAT program.