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The Upper Peninsula Health Care Solutions Rooming-in program aims to improve health outcomes for families of infants born with NAS symptoms who were exposed to opioids. Rooming-in is defined as allowing the mother and infant to remain together 24 hours per day during the birth hospitalization. Similar to skin-to-skin care, rooming-in has multiple benefits in addition to facilitating breastfeeding. The Rooming-in Model strengthens the mother-infant bond and helps navigate and offer support in their medical care.

 Opioid-exposed newborns are typically cared for in neonatal intensive care units (NICUs), and standardized scoring systems, such as the modified Finnegan system, are used to quantify NAS symptoms and to adjust medications used in treatment. Paradoxically, studies have found that opioid-exposed newborns in NICUs experience more severe withdrawal, longer length of stay (LOS), and increased pharmacotherapy compared with newborns who room in. In rooming-in care, infant and mother remain together 24 hours a day unless separation is indicated for medical reasons or safety concerns. More maternal time at the infant bedside improves NAS outcomes but is harder to accomplish in a typical NICU. Neonatal intensive care units may be poor settings for newborns with NAS because of increased sensitivity to high clinical activity levels. In settings where separation from mothers is inherent in a NICU admission, it can interfere with bonding and may contribute to maternal perceptions of guilt and stigma.2

 

Thanks to the generous funding provided by the Blue Cross Blue Shield Foundation of Michigan and the Michigan Department of Health and Human Services (MDHHS) UPHCS has assisted Rooming-in implementation at MyMichigan Sault Medical Center in Sault Sainte Maire. We’re excited to share that we’ve received additional funding from MDHHS to bring this incredible program to OSF St. Francis Hospital in Escanaba.

 

Goals

      1. Decrease the number of babies transferred to the regional Neonatal Intensive Care Unit because of symptoms associated with perinatal exposure to opioids.
      2. Increase breastfeeding rates of babies exposed to perinatal opioids at initiation and 1-month postpartum by providing follow up with our lactation consultant.
      3. Increase prenatal education for mothers who screen positive opioid use, and their families on the topics of Neonatal Abstinence Syndrome (NAS) and hospital care of their baby.

Benefits of Sustainable Rooming-In:

  • Reduced Lengths of Stay
      • By implementing the rooming-in practice, the duration of hospital stays for infants can be significantly shortened.
  • Limited or No Pharmacological Treatment
        • Rooming-in allows for a decreased reliance on pharmacological interventions, minimizing the need for medications in the management of infants exposed to opioids or undergoing OUD treatment.
  • Enhanced Bonding and Thriving