(1078) Prenatal Consults: Identifying At-risk Families and Expectation Setting Prior to Prolonged Hospitalization for Concern for Neonatal Abstinence Syndrome

The focus of treatment for infants with Neonatal Abstinence Syndrome (NAS) has shifted from pharmacological intervention towards a holistic approach, maximizing family involvement and comfort measures. Our hospital is a large academic center delivering ~4,500 infants per year, and cares annually for 70-80 infants with concerns for NAS. An interdisciplinary taskforce was created in April 2019 to redesign our NAS care model. We aimed to prepare mothers prenatally for the infant’s expected hospital stay of at least 5 days, and the rigors of non-pharmacologic care by implementing a prenatal NAS consult service. Consults began in September 2020. To conduct these consults a collaborative calendar was created with outpatient obstetrics/gynecology services at our hospital. Consults were conducted on pregnant patients 34 weeks gestation via telephone by a diverse group of healthcare professionals. The goal was to foster a therapeutic relationship, emphasize the importance of the parent/infant bond in the infant’s recovery, discuss breastfeeding when applicable, explain Finnegan scoring, and set expectations for the post-partum period. The time allowed for chart review, detailed history and assessment, care coordination, and an opportunity to address parental questions. We have completed all referred consults (6) to date. Post-partum follow up interviews are being done to elicit parent feedback. Parents report positive response to consults. Our goal is to expand our consult service to provide information to every prenatal patient with an infant at risk for NAS, and to share our experiences to promote consultation for mothers outside of the Penn Medicine system.