Inpatient Pathway for the Evaluation/Treatment of Infants with Neonatal Abstinence Syndrome
Screening Infants for Neonatal Abstinence
Assess all pregnant women for substance use
Send urine toxicology on mothers with:
- No prenatal care or scant PNC (< 5 visits)
- History of drug use/abuse (licit/illicit) within past year
- History of positive toxicology screens during PNC, previous pregnancy
- Past history of narcotic use
- It is good practice to inform the mother that she and/or the infant will be tested.
- Informed consent (written or verbal) is NOT required by PA/NJ law when drug testing is for MEDICAL purposes.
- Testing for criminal issues requires consent.
- Request for release of information to legal authorities for criminal issues should be referred to Hospital counsel.
Indications for Infants Toxicology Screening
- Positive maternal drug abuse by history or urine toxicology
- Send urine and/or meconium for drug screen
- Consider umbilical cord drug screen if meconium is not available
- Admit to the appropriate care setting.
- Full-term infants will be admitted to the Well Baby Nursery for observation and care.
- Start at 2 hours of life
- Assess infants at least every 4 hours
- Score 30-60 minutes after feeding