Prenatal Breastfeeding Education: Impact on Infants With Neonatal Abstinence Syndrome

Neonatal abstinence syndrome (NAS) is a growing problem in the United States, affecting 32,000 infants annually. Although breastfeeding would benefit infants with NAS, rates among these mothers are low.

The purpose of this quality improvement project was to increase breastfeeding rates and decrease hospital length of stay (LOS) for infants with NAS through prenatal breastfeeding initiatives.

A pre-/postquality improvement design was used to assess the relationship between breastfeeding initiatives on breastfeeding rates and LOS in infants with NAS. A 3-class curriculum was offered to pregnant women at risk for delivering an infant with NAS. Chart review was completed for all infants evaluated for NAS in a hospital at baseline (n = 56), after Baby Friendly Status (BFS) (n = 75), and after BFS plus breastfeeding education (n = 69).

Although not statistically significant, the BFS plus breastfeeding education cohort had the largest percentage of exclusively breastfed infants during hospitalization (24.6%) and at discharge (31.9%). There was a statistically significant decrease in LOS (P < .001) between cohorts.

The small sample made it not possible to infer direct impact of the intervention. However, results suggest that prenatal education may contribute to an increase in the numbers of infants with NAS who receive human milk and a decrease in hospital LOS.

Refinement of best practices around breastfeeding education and support for mothers at risk of delivering an infant with NAS is recommended so that breastfeeding may have the greatest impact for this subgroup of women and their infants.