Washington State has introduced a new policy aimed at reducing the stigma surrounding parents struggling with addiction. Under this policy, hospitals are no longer required to report all drug-exposed infants to Child Protective Services (CPS), as reported by the Seattle Times.
Nancy Gutierrez, a spokesperson for the Department of Children, Youth, and Families, clarified that if hospital staff believe that a newborn is in immediate danger due to substance abuse, they are still obligated to report their concerns to CPS. The decision to report should be based on the child’s safety rather than the presence of drugs.
The state’s Department of Health announced that substance-exposed infants can now receive voluntary wrap-around services without being reported to CPS, as long as there are no safety concerns. Hospitals are expected to update their policies to align with the state’s new policy and train their staff accordingly by January 1, 2025, to comply with federal requirements.
The primary objective of the new policy is to enhance infant care by adopting the “Eat, Sleep, Console” approach, according to Tiffani Buck, a nurse practitioner with Washington’s Department of Health. Buck explained that hospitals have traditionally used the Finnegan Neonatal Abstinence Scoring Tool to assess whether an infant is experiencing withdrawal symptoms. This method, developed in the 1970s, evaluates the baby’s behavior, including crying, sleeping, tremors, sneezing, and feeding.
If withdrawal symptoms are suspected based on the assessment, the infants are usually transferred to the neonatal intensive care unit, where they might receive medication. Buck mentioned that parental involvement in the care of these infants varies depending on the facility.
She pointed out that the Finnegan method often identifies normal behaviors as potential withdrawal symptoms. Buck stated, “It’s normal for infants to cry. I think it’s common for [symptoms] to be exacerbated with withdrawal, but they’re not indicative of withdrawal.”
A report from the National Institutes of Health revealed that infants treated with the Eat, Sleep, Console system were often discharged nearly a week earlier compared to those treated using the Finnegan method. However, the study also raised concerns about potentially underestimating infants or discharging them prematurely, as the Eat, Sleep, Console method has not been extensively tested in a large population.
The new system involves keeping infants in dark, quiet rooms where parents are taught how to swaddle and feed them. Buck emphasized the importance of focusing on three key aspects—eating, sleeping, and being consolable—to assess the well-being of the baby and determine if interventions for withdrawal are necessary.
The Department of Health announced that neonatal intensive care unit (NICU) admissions should no longer be the initial course of treatment for infants exhibiting withdrawal symptoms.