Educational Materials
Fundamentals
Harm Reduction
Bias/Stigma
Trauma-Informed Care
State Initiatives
Prenatal Care
Care Templates and Tools
Care Coordination
The transition to home following birth hospitalization for infants with prenatal substance exposure requires multidisciplinary coordination to ensure safe and appropriate follow-up. Developing a Plan of Safe Care (PoSC) ideally during pregnancy and then during the birth hospitalization aids in the transition and communication to outpatient care by addressing the health and substance use treatment needs of the infant and family.
Transitioning to Home with a Plan of Safe Care
- Discharge Template for Infants with Prenatal Substance Exposure
- Plans of Safe Care – Best Practice Guidance
- Plans of Safe Care – One-Pager
- Colorado Department of Human Services Plan of Safe Care
- Colorado Naloxone Project: Take-Home Naloxone Implementation Toolkit
- Plans of Safe Care in Substance-Exposed Infants: Components, Complexities, and Collaboration
Postnatal Outpatient Care
Child development following perinatal substance exposure is an important consideration for both families and providers. Identifying and addressing developmental and behavioral changes early can improve outcomes for children. These resources provide information on what to expect and how to support development for infants with perinatal substance exposure.
Information, Resources, and Support
Quick Overview
Resources
Legislative Background
Federal legislation and policies continue to evolve in providing guidance for healthcare systems, providers, and allied child health agencies. This encompasses many aspects of child welfare including consent for medical care, reporting criteria, and plans of safe care with the aim to promote child safety and family support. These resources include overviews, highlights, and specific reference links to policies and statutes related to perinatal and pediatric care.
Summaries and Statutes
Birth Hospitalization Care
Substance Use Screening and Toxicology Testing
Best practice includes universal screening for substance use during pregnancy and use of evidence-based criteria for biological toxicology testing of birthing individuals and their newborns. The resources provided here offer information on screening for substance use, links to validated screening tools, guidance for developing hospital-based toxicology testing policies, and resources for naloxone distribution.
Screening
Toxicology Testing
- Indications for Toxicology Testing in Colorado Birthing Facilities
- Toxicology Testing Guidelines Algorithm
- Advances, Nuances, and Future Directions in Neonatal Toxicology Testing
- CHoSEN QIC Toxicology Policy Recommendations
- 2020 Colorado Statute
- Toxicology Resource Guide
- Colorado Poison Center
- Colorado Naloxone Project
Breastfeeding and Substance Use
Safe feeding is an important part of planning for the birth hospitalization and care of the newborn. Pregnant and postpartum patients should be supported to identify their goals of feeding and how to safely feed their newborn. Many resources are listed in this section to facilitate discussions about safe feeding with birthing individuals when there is recent or current substance use, including cannabis use.
Recommendations and Resources
- Substance Use and Breastfeeding: CHoSEN Guidance
- CHoSEN Perinatal Cannabis Use & Breastfeeding Recommendations
- How to Talk with Pregnant/Birthing Parents About Cannabis Use
- Myths and Misconceptions About Cannabis Use During Pregnancy & Breastfeeding
- What to Know About Breastfeeding in the Setting of Cannabis Use for Outpatient Pediatrics
- High Stakes: Exploring the Impact of Cannabis Use in Pregnancy and Lactation
- Colorado Monitoring Health Concerns Related to Marijuana
Care of a Newborn Exposed to Opioids
Optimal care for newborns exposed to opioids during birth now emphasizes the Eat, Sleep, Console (ESC) approach, which has largely replaced the Finnegan scoring system. The below resources include provider- and family-facing information about ESC along with published literature that supports this approach.
Eat, Sleep, Console (ESC) Approach
- Eat, Sleep, Console Care Overview
- Eat, Sleep, Console (ESC) Care Tool
- Eat, Sleep, Console Approach: Effectiveness, Outcomes, and Future
- Hospital Checklist for ESC Implementation
- A Novel Approach to Assessing Infants with Neonatal Abstinence Syndrome
- Eat, Sleep, Console Approach or Usual Care for Neonatal Opioid Withdrawal
Community Supports
Peer and community support systems for individuals and families affected by substance use are integral to provide ongoing support, resources, and connection, especially during pregnancy and the postpartum period. These organizations in Colorado have been identified as valued, trauma-informed peer supports aligned with the goals of birthing individuals and parents affected by substance use.
