Nursing Diagnoses for Neonatal Abstinence Syndrome

This final blog post will describe some of the problems (physiological, emotional, and social) that nurses look for when they are caring for mothers who are involved in substance use and infants who are diagnosed with NAS. 

Nursing Diagnoses
1. Ineffective Childbearing Process R/T Substance Abuse AEB lack of prenatal visits, mother does not report appropriate pre and postpartum lifestyle because of substance abuse, has limited support systems

This nursing diagnosis describes the mothers impaired ability to safely manage her pregnancy. This relates to her failure to obtain prenatal care before birth, her lifestyle of drug use that cannot safely support an infant, and the possibility that she is not well supported by friends, family or significant others. 

2. Risk for disturbed Maternal/Fetal Dyad R/T substance abuse AEB challenging feedings, mother unable to adequately care for her infant, involvement of social services
This nursing diagnosis describes the possible problems between the mother and infant that may occur after birth. Their relationship may be disrupted by the symptoms of NAS the infant will experience which can be very traumatic for both the baby and the mother. It also involves the mothers inability to provide the care the infant needs. Finally, the required involvement of social services may lead to removal of the infant from the mother's care. This can be traumatic for both the infant and the mother. Watch the video below to see an expectant mother's experience with NAS and her desire to get help for her next infant.

3. Ineffective breastfeeding R/T withdrawal symptoms, neonatal abstinence syndrome (NAS) AEB increased infant crying, infant crying at breast, failure to latch, infant irritability
This nursing diagnosis addresses the potential problems infants affected by NAS may have in breastfeeding. Often, the symptoms of NAS involve excessive crying, irritability and inability to self-calm which infants should normally be able to do in order to begin breastfeeding. Mothers of infants with NAS often have many challenges breastfeeding. Healthcare professionals must be available to help the mother and assist her with breastfeeding.

4. Disorganized infant behavior R/T prenatal substance abuse AEB tremors, jitteriness, hyperactivity, fever, sweating, nasal flaring, respiratory distress, poor feeding, myoclonic jerking, seizures, GI disturbances
This diagnosis describes the challenges the infant may have in adjusting to new life with the onset of traumatic withdrawal syndromes. The symptoms listed above could develop into dangerous conditions such as serious breathing complications, inability to self-regulate temperature, malnutrition, brain damage and extreme fatigue. For more information about symptoms of NAS click here for a link to an earlier blog post.

The challenges faced by the drug-addicted mother and her infant suffering from NAS are extensive and have emotional, physiological and social implications as explained above. Expectant mothers who are addicted to substances must seek support from their local birthing center, primary care provider, addiction support facilities, and other community resources to ensure safe pregnancy and delivery, and to ensure their newborn starts life with the highest quality care and attention.

Support Groups for Neonatal Abstinence Syndrome

This blog post contains some support groups and community resources for individuals or families affected by Neonatal Abstinence Syndrome (NAS). Click the titles of each organization/group to access their website!

For anyone with an infant affected by NAS:

Pediatric Interim Care Center

This organization located in Washington State provides short-term care for infants affected by NAS who require intermediate medical attention but are not ready to go home without medical supervision yet. Although these infants are no longer in need of intensive care in a NICU environment, they can still have dangerous symptoms that parents may not be equipped to handle. For parents, adjusting to caring for an infant is hard enough with out a NAS condition, so this program allows them to receive further support with this difficult change in their lives.

For parents of infants with NAS seeking treatment for substance abuse:
Methadone treatment centers

Women who abuse substances and have recently found out they are pregnant are not advised to "quit cold-turkey" because this is medically dangerous not only for the mother but also for the fetus. Withdrawal symptoms cannot be treated in unborn babies. An alternative for soon-to-be mothers seeking treatment is a methadone treatment program that weans the participant off of their opioid of choice with methadone which is a drug that is easier to eventually stop using. This site has links to methadone treatment centers by state. Don't wait, start now in finding treatment for yourself and your future child!

Drug/Alcohol rehabilitation centers

This website is a search engine for finding certified treatment centers for drug or alcohol abuse. Parents of children already diagnosed with NAS who want to change their lifestyle can search here for treatment programs. This step is extremely important in finding support going forward in your life and the life of your child. 

For adoptive parents of infants with NAS:
Adoptive parent support groups
New parents who have adopted a NAS-affected infant may find it challenging to accept their child's condition, or the situations that lead to it. Adoptive parent groups are incredible resources for adoptive parents to come together and share their experiences. Social events, encouragement, advice and support are often available in groups like these. Search with this website's engine to find a local adoptive parent group that fits your needs!