Neonatal Abstinence Syndrome

Priority 7: Non-Pharmacological Intervention

NAS Non Pharma InterventionsFrom hospital admission to the weeks or months following discharge of mother and baby, interventions should be guided by non-judgmental, empathic care. Whenever possible, the use of non-pharmacological interventions should be considered and encouraged. Non-pharmacological interventions may reduce prolonged hospitalization and separation of the mother–infant dyad.

While these practices can potentially disrupt breastfeeding or disturb mother-infant bonding, there are tested models that may keep the mother-infant dyad together, reduce admissions to the NICU and reduce the need for pharmacotherapy. To minimize the common symptoms of restlessness, tremors, agitation and gastrointestinal disturbances that often occur in infants with NAS, nonpharmacological treatment should be universally incorporated into standards of care. Quality improvement initiatives demonstrate the benefits of non-pharmacologic care, including reducing extended inpatient stays and separation of mother and baby.


  • Develop a universal approach to nonpharmacologic management of substance-exposed infants as a standard of care.
  • Optimize nonpharmacologic management by designing inpatient and outpatient environments that foster care for NAS infants.
  • Promote methods to decrease infant agitation and promote healthy sleep.
  • Promote swaddle, skin-to-skin contact, decreased stimulation, rooming-in, breastfeeding, education for primary caregivers and support systems.
  • Provide guidance that encourages calming techniques for infant, caregiver, environment.
  • Encourage continuity in caregiving to develop trust and rapport.

For more information on NJHA’s activities to improve maternal and child health,