Neonatal Abstinence Syndrome

Priority 8: Discharge Planning & Referral

NAS Discharge PlanningAfter delivery, the risk of relapse for women with substance use disorder is heightened. Support services, continuation of pharmacotherapy and planning for future pregnancies are critical. Safe, sustainable plans of care that provide for the appropriate discharge, referral and linkage to care that are responsive to an infant’s needs are essential to promoting healthy behaviors and optimal clinical outcomes. Discharge plans should include home visitation and early intervention services and support a plan of safe care for mother and infant, addressing maternal comorbid conditions. 

ACTIONS

  • Create a foundation of collaborative relationships with primary caregivers, physicians, social workers, community services and other stakeholders.
  • Initiate discharge planning for mothers with OUD and infants at risk for NAS upon admission.
  • Consider modifying the infant discharge checklist developed by SAMHSA to align with your hospital’s criteria for infant discharge.
  • Prior to discharge ensure exposed (or at risk) infants have been properly monitored for development of NAS.
  • Provide the primary caregiver with a written list of community resources (e.g., postpartum depression, peer-to-peer counseling, home visitation, safe housing).
  • Ensure primary and secondary caregivers can demonstrate how to create a safe sleep environment, soothe agitation and use other nonpharmacologic management techniques with infants.
  • Provide contraception counseling and provide immediate, easy access to contraceptive choices.
  • Ensure pediatric follow-up within 72 hours of hospital discharge.

For more information on NJHA’s activities to improve maternal and child health,
email: Contactus@njha.com