NAS/NOWS, Neonatal — Non-Pharmacologic Interventions — Clinical Pathway: Inpatient Care

Neonatal Abstinence Syndrome (NAS) /Neonatal Opioid Withdrawal Syndrome (NOWS), Clinical Pathway, Inpatient

Maximize Non-Pharmacologic Interventions

Parental Engagement
  • Presence with infant, hold/rock infant as much as possible
  • Skin to skin time with either parent
  • Staff to hold infant “on demand” whenever crying or fussy
Feeding
  • Feed on demand
  • Encourage breastfeeding
  • Provide space for pumping, breastfeeding
  • Provide pacifier
Positioning, touch
  • Position change
  • Infant rockers with motion
  • Wrap /swaddle infant with soft blanket
  • Patting infant
  • Massage
  • Range of motion exercises (ROM)
Environmental
  • Provide quiet care space
  • White noise machine
  • Soft music
Avoid Unnecessary Stimulation
  • Tactile
    • Use gentle, firm touch, stroking or massage to hands/feet
  • Auditory
    • Avoid toys with lights and sounds; no nearby extraneous auditory stimulation
    • Expose infants to rhythmic sounds, slow and steady (ex. white noise machine)
  • Movement
    • Slow, fluent movements when picking up and placing down
    • Range of motion exercises while changing diapers
  • Visual
    • Use indirect lighting or low watt bulbs
    • Shield eyes when turning on light or position facing away from light
  • Taste and smell
    • Feed in a calm environment
    • Avoid noxious smells and tastes from products
    • Provide scent blanket from mother when she is not there