Explain neonatal abstinence to parents after OAT pregnancy — CASC communication station

Open. Name role/time; ask what they heard and what frightens them most (removal, “damage,” blame). [1]

Explain NAS simply. “Because the baby was used to methadone through the placenta, after birth some babies become irritable, shake, cry, feed poorly, or have loose stools for a while. This is withdrawal, sometimes called NAS or NOWS. It is common after treatment medicines as well as street opioids. It does not mean methadone was a mistake or that the baby is ‘an addict’ in the adult sense.” [1][2]

Care plan. “We keep mother and baby together when safe. Low light, holding, skin-to-skin, feeding support often settle babies. We watch carefully for a few days because methadone effects can show later than street heroin. If the baby still cannot feed, sleep, or be comforted, we may use a medicine (often morphine under a hospital protocol) and then slowly reduce it.” Mention function-focused care principles without drowning in trial names unless asked; Young ESC evidence supports this philosophy. [2][4]

Mother’s methadone. “Stopping methadone now would risk you becoming unwell and returning to street opioids, which is more dangerous. Guidelines support continuing treatment in pregnancy and after birth.” [3]

Breastfeeding. If asked: “If you stay stable on methadone and are not using street drugs, breastfeeding is often encouraged and can help the baby — we individualise with the team.” [1][2]

Child protection. “Social work looks at safety and supports. Being on methadone and having a baby with treatable withdrawal is not automatically a reason to remove a child, but they will talk about supports, home safety, and any other risks. I will work with you openly — I will not use threats.” Avoid promising “they will never take the baby.” [1][3]

Close. Summarise; written info; introduce neonatal and social-work contacts; teach-back (“can you tell me what NAS means in your own words?”). [1]