Midwives' experiences of caring for infants with neonatal abstinence syndrome

Abstract

The study aimed to explore midwives' experiences of caring for infants with neonatal abstinence syndrome at the neonatal and paediatrics intensive care unit. The study’s objectives were to explore midwives' thoughts and feelings relating to infants affected by neonatal abstinence syndrome, gain insight into the care needs of these infants and into midwives’ experiences of providing such care, and to explore midwives' approach to supporting the infants’ parents. A qualitative approach was used. Face-to-face, semistructured interviews were conducted with a purposive sample of six midwives. A 100% response rate was achieved. The interviews where audio-recorded and transcribed verbatim. Thematic analysis, as described by Braun and Clarke (2006), was used to analyse the data generated. The findings of this study indicated that midwives had various reactions towards infants affected by neonatal abstinence syndrome. While these infants were perceived to be challenging to care for, providing this care was also perceived as satisfying. Midwives became emotionally attached to the infants and worried about their future prospects. In caring for these infants, midwives needed to adapt routine care, watch for signs of withdrawals and provide pharmaceutical support. Midwives’ views of, and approach to, the parents of NAS-affected infants differed according to the cause of the infant’s condition and the parents’ reaction to the diagnosis. Building a constructive relationship with these parents was not always easy and the midwives needed to liaise with other services to secure holistic care for these families. Thus, caring for infants affected by neonatal abstinence syndrome appears to be complex and multi-faceted, as well as both challenging and rewarding. Based on the results, a number of recommendations for further education, research, and practice are suggested, including the formation of a discharge liaison team associated with the NPICU to help support the transition home for these infants and their parents.