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Neonatal abstinence syndrome and mother’s own milk at discharge



To describe factors impacting receipt of mother’s own milk (MOM) at discharge among California infants diagnosed with neonatal abstinence syndrome (NAS).

Study Design

Cohort study of the California Perinatal Quality Care Collaborative’s Maternal Substance Exposure Database for infants with NAS and gestational age ≥ 34 weeks from 2019 to 2020.


245 infants with NAS were identified. Variables with an increased likelihood of being discharged on MOM included maternal medication assisted treatment (p = 0.001), use of maternal addiction services (p < 0.001), receiving donor human milk (p = 0.001), being treated in the well baby unit (p < 0.001), rooming-in (p < 0.001), and kangaroo care (p < 0.001). Among infants with NAS for whom MOM was recommended (n = 84), rooming-in was the only factor associated with being discharged on MOM (p = 0.002); receiving formula was the only inversely associated factor (p < 0.001).


Results suggest supporting the mother-infant dyad and using non-pharmacologic treatment methods, such as rooming-in, increase receipt of MOM at discharge.

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Fig. 1: Population Chart.
Fig. 2: This figure shows the correlation of different modalities of care for NAS.

Data availability

Data for this study are not publicly available due to data use agreements with participating hospitals. Elements of the data can be made accessible based on purpose with appropriate permissions based on request to the authors.


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The authors thank the MatEx participating California NICUs for their enthusiastic dedication in improving the care of substance exposed infants and submitting their data to support a community of learning. The authors also thank Fulani Davis and Janella Parucha at the CPQCC Data Center for their efforts in ensuring the accuracy and clarity of the data.

Author contributions

TTN conceptualized and designed the study, and drafted the initial manuscript; CTN coordinated the study, drafted the initial manuscript, and critically reviewed the manuscript; MKQ developed statistical models for the study, conducted data analyses, and critically reviewed the manuscript; JW, LC, and RC contributed to the study design and critically reviewed the manuscript; AH and PA-J contributed to the study design and critically reviewed the manuscript; HCL contributed to study design, supervised the study team, and critically reviewed the manuscript; and all authors approved the final manuscript as submitted.

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Correspondence to Theresa T. Nguyen.

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The authors declare no competing interests.

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Nguyen, T.T., Toney-Noland, C., Wong, J. et al. Neonatal abstinence syndrome and mother’s own milk at discharge. J Perinatol 42, 1044–1050 (2022).

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