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Introduction: Breastfeeding offers the substance exposed mother and child potential short and long-term health benefits, with breast milk shown to alleviate the severity of Neonatal Abstinence Syndrome. Substance dependent women, however, have limited success establishing breastfeeding with physical, psychological and institutional factors cited as barriers. This study aimed to develop and test the feasibility of an evidence informed and theory based intervention to support continued breastfeeding for this group. Methods: The research was a two-phase feasibility study. Phase 1 informed intervention development using a mixed methodology approach which included (a) a comprehensive systematic literature review of breastfeeding support for women from disadvantaged groups (b) expert advisory group recommendations and (c) ‘think aloud’ verbal protocols with opioid dependent women. Phase 2 underpinned the evidence with the theoretical constructs of behaviour change, prior to testing the acceptability and implementation fidelity of the intervention in a feasibility study with an embedded small-scale randomised controlled trial. Results: Phase 1 identified the barriers to breastfeeding continuation as low maternal self-efficacy; neonatal feeding difficulties associated with withdrawal and unsupportive healthcare practices. Evidence and theory synthesis resulted in an integrated breastfeeding support model founded on practical, informational, psychological, person-centred and environmental components. Phase 2 demonstrated that the intervention was feasible to implement and acceptable to participants. The randomised controlled trial reported higher rates of continued breastfeeding and a greater level of maternal confidence in breastfeeding ability in the intervention group compared to the control group. Breastfed infants were less likely to require pharmacological management and had corresponding shorter durations of hospitalisation than formula fed infants. Conclusion: The research provided an original contribution to the development of a complex healthcare intervention which is meaningful to both existing research and clinical practice. The findings highlighted the potential of the intervention to support breastfeeding for the substance exposed mother and baby, which has wide ranging implications for the improved health and social equalities of this group.

The diploma thesis deals with neonatal abstinence syndrome which occur to newborns whose mothers were on addictive illegal drugs in the time of pregnancy. The most frequently taken drugs are canabinoids, stimulancias, opiods and opiates, halucinogens, and drugs taken during substitutional therapy. Neonatal abstinence syndrome is a multisystem disorder that frequently affects central nervous system, gastrointestinal system, respiratory system and autonomic system. To diagnose neonatal abstinence system is the most important careful monitoring of baby in the first days of its life. There are different scoring systems which have been developed for assessing the severity of neonatal abstinence syndrome, we use the Finnegan scoring system. Treatment of neonatal abstinence syndrome is mainly supportive and pharmacological therapy. There are also social serious consequences of this problems; mothers are usually not able to take care of babies and children live in children's homes. The aims of this study were to find out special needs of newborns born to mothers using addictive illegal drugs during pregnancy, to find care interventions which help newborns with neonatal abstinence syndrome in their first days of life and to discover interventions helping mothers stop using addictive illegal drugs. The theoretical part of this study is based on research of already presented scientific studies. The practical part of the study problems of neonates of mothers using addictive illegal drugs in first days after delivery. We have used Virginia Henderson's need theory to evaluate neonate's need. We have chosen only the most important elementary components out of 14 components in Virginia Henderson's need theory. I was also trying to find out if nurses know how to help neonates with neonatal abstinence syndrome and what nursing interventions have positive influence to neonates. Another goal was to know how nurses communicate with mothers and if they have positive influence on mothers. The method of communication with mother using addictive illegal drugs was semistructured interview. I wanted to know what kind of addictive drugs mothers were using during pregnancy and if mothers tried to solve their problem in pregnancy, before delivery. Results are sorted into categories and subcategories and showed in diagrams and tables. Neonates of mothers using addictive illegal drugs during pregnancy have problems in all investigated needs such as breathe, eat and drink adequately, sleep and rest, thermoneutral zone and social need. I also found out that some nursing intervences have positive influence on neonates with neonatal abstinence syndrome. Very important intervenes were individual contact with each neonate and quick reaction to every change in behavior. It is also necessary to respect their sleep and rest time, take nursing and medical care together in blocks, use non-pharmacological treatment of pain, feed them individually according to their needs and also try different techniques of feeding, put babies into the right position and eventually nestle, rock or touch them. In last part of the study we discuss mothers who use addictive illegal drugs. We found out that nurses did not speak with them very actively, did not offer them to breast-feed in special conditions, did not tell them about possibility to be with neonate together in the hospital until a discharge. On the other hand, mothers were not interested in the breast-feeding or staying with babies. The goal of the study was to create brochure with information of negative consequences of taking addictive drugs on babies. This brochure is convenient for education of mother and students as well.

Neonatal abstinence syndrome (NAS) refers to the withdrawal infants exposed to opioids in utero may experience following birth. In recent years, the number of infants born who present with NAS has grown exponentially. This increase in the number of infants with NAS has led to a new population within the caseloads of speech-language pathologists (SLPs) who work in neonatal intensive care units (NICUs). SLPs’ knowledge base and skill set of assessment and treatment of swallowing and feeding disorders in infancy play a vital role in the treatment of infants with NAS in the NICU. A dearth of research exists regarding the specific nature of the feeding problems and skills of infants with NAS and whether SLP intervention for infants with NAS needs to differ from that of other infant NICU populations. Identifying how SLPs can best serve infants with NAS in the NICU is essential to their immediate well-being as well as the development of these infants. The purpose of this survey-based research study was to examine NICU SLPs’ perceptions of infants with NAS, and more specifically, how NAS affects the infants’ feeding skills, structural, and oral-motor characteristics. A questionnaire was developed based on an in-depth literature review to collect information on NAS, caseloads, treatment environment, and respondent demographics. The survey consisted of three sections: NAS (further divided into Assessment, Treatment, and Education), Environmental Description, and Respondent Demographics. The secure web-based questionnaire was distributed through SurveyMonkey™, an online survey platform. Survey research was conducted, and hospital-based speech-language pathologists within the USA acted as respondents. The findings will contribute to establishing a preliminary base of information on this topic. The results are expected to further inform the field as well as current practices in evidenced-based practice care for infants with NAS.

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Introduction and background Opioid use disorder (OUD) is an epidemic in the U.S. OUD affects both the mother’s and infant’s health. Substance-exposed infants suffer from decreased health outcomes relative to non-exposed infants. Purpose The aim is to identify infant health outcomes when pregnant women are prescribed medication-assisted treatment (MAT) for OUD. Among pregnant women with OUD in the U.S., is medication-assisted therapy as compared to no therapy associated with decreased negative infant health outcomes? Literature review Five studies on OUD and infant outcomes in the U.S. were reviewed. CINAHL and PubMed were searched using terms opioid use disorder, pregnancy, and neonatal abstinence syndrome (NAS). The search was limited to the last five years and full text only. Of the 815 results, five articles were selected that focused on infant outcomes and prevention of NAS. Articles were excluded if the focus was solely on the maternal outcomes, cost, or unoriginal research. One meta-analysis was included that compared two types of MAT for pregnant women with OUD. Findings MAT is correlated with a shorter hospital stay and less severe NAS symptoms in infants. Conclusion and implications Rates of NAS and OUD have increased significantly in the US. Some of the increase may be attributed to the transition to ICD-10 codes. MAT for pregnant women with OUD is associated with better health outcomes for infants. Patient-centered care could help decrease negative health outcomes for both infants and women with OUD. Future study should focus on degrees of opioid exposure and related outcomes.

of the thesis: Background: The theme of the drugs problem users - mothers are becoming more and more topical. The specificity of women's groups on the drug scene is given to the problems associated with pregnancy and motherhood , different biological factors compared to men. Expert advice for women and addressing issues that are associated with the feminine role is a must for professionals . The phenomenon of mothers - user is necessarily linked to the issue of child care and subsequent abstinence . Our professional and lay society has regarding pregnancy , treatment, abstinence and motivation of mothers who are drug addicts many prejudices and stereotypical behavior. So the question arises , how the fact of pregnancy users - mothers affects their drug use and subsequent motivation for abstinence and retention in treatment . The aim of this work is to determine whether the child is the motivation for abstinence and the role of drug use in pregnancy women. Methods: Data were obtained using a semi-structured interview , the respondents were clients aftercare program . For data analysis using elements of grounded theory. Results: Based on the statements of the respondents , it was found that even when the child is passive motivation for abstinence , responder treatment of 80 % successfully completed....