NASCEND

Technology-enhanced training & certification for healthcare systems to improve outcomes for OEI.

06/02/2026

Adverse childhood experiences (ACEs) have been tied to many child and adult health problems. Toxic stress associated with ACEs can actually change brain structure in areas that are crucial for functioning and succeeding in every day life. Do you know which 3 areas are affected? 🤔 Drop your guess in the comments.

06/01/2026

Fact! Due to increased maternal blood volume and plasma, commonly used medications like insulin, Prozac, and MAT prescriptions require an increase in dosage.

05/28/2026

Development of withdrawal is multi-factorial. Here are 5 things that influence how withdrawal develops in opioid-exposed infants:
💊 Type of drug
💉Polysubstance exposure
⏰Timing between last maternal drug ingestion and infant delivery
🤰Prematurity
🧬Genetics

05/26/2026

Opioid exposure in pregnancy rarely comes alone. Many mothers also smoke, and ni****ne withdrawal in newborns is real, it starts early, and it can look a lot like opioid withdrawal.
For care teams, this creates both a challenge and an opportunity. Early stimulant withdrawal symptoms can actually lead to earlier recognition and treatment of withdrawal overall. But if the full substance history is not known, those same symptoms can be mistaken for opioid withdrawal and treated with opioids the infant does not need.
The goal is always to minimize exposure. Knowing every substance the infant was exposed to is what makes that possible.

05/23/2026

Myth! If mom received her methadone dose 2 hours before delivery, baby may not show any signs of withdrawal for 48 to 72 hours postpartum. That is methadone's long half-life at work.
An asymptomatic newborn is not necessarily a safe newborn. Knowing when baby was last exposed is just as critical as knowing the type of drug.

05/18/2026

Last week we shared that withdrawal timelines in opioid-exposed newborns are not one-size-fits-all. This week, here is the breakdown.
He**in and other short-acting opioids move fast, with symptoms often appearing within hours. Buprenorphine has a longer half-life, so onset is slower, usually 1 to 3 days. Methadone is uniquely complex. It stores in fetal fat tissue during pregnancy and releases gradually after birth, which means some infants may not show withdrawal symptoms until up to 28 days later.
That last one catches a lot of care teams off guard. An infant who looks fine at discharge may still be heading toward peak symptoms at home.
Knowing the exposure is not just good practice. It is what makes the rest of the care plan possible.

05/12/2026

Did you know? Withdrawal in opioid-exposed newborns doesn't follow a single timeline — and that distinction can make a real difference in care.
The onset, peak, and duration of NAS/NOWS symptoms vary depending on what the infant was exposed to and for how long. Some timelines are much shorter. Others are far longer than many care teams expect — with symptoms that can continue well beyond the newborn period. An infant who looks stable in the first day or two may not have reached their peak yet. Without knowing what to watch for and when, critical windows can be missed.
Knowing mom's full substance history isn't just background — it's a clinical roadmap for your whole care team.
👉 Watch for our next post where we break down the timelines side by side, by substance.

05/04/2026

When we talk about opioid-exposed newborns, the conversation often starts and ends with withdrawal. But the clinical picture is bigger than that.

Infants with in utero drug exposure are also at elevated risk for:

🍼 Low birth weight — 24% of substance-exposed infants are born small for gestational age, as exposure interferes with placental function and fetal growth.

🍼 Premature birth — 17% are born preterm, compounding existing vulnerabilities before withdrawal even begins.

🍼 Poor feeding — 17% experience significant feeding difficulties, driven by CNS dysregulation and disorganized feeding reflexes in the early neonatal period.

Each of these can extend NICU stays, increase the need for medication, and contribute to higher morbidity and mortality.

Caring for this population well means understanding the full picture. Reach out to us to learn more.

05/02/2026

Myth!
A common misconception in perinatal care: if an opioid was prescribed, it won't affect the baby.

The reality is that any opioid exposure in utero — prescribed or illicit — carries the same risk of neonatal dependency and withdrawal.

For mothers in MAT, the benefits often outweigh those risks. Reduced overdose risk, better prenatal engagement, and stabilization for mother and baby are all meaningful outcomes. But providers still have a responsibility to have that honest, informed conversation so families and care teams are prepared.

04/23/2026

What an incredible experience at the NANT Conference! 🎉 125 attendees, meaningful conversations, and a room full of healthcare professionals who are deeply committed to improving outcomes for their most vulnerable patients.
The engagement from neonatal therapists throughout the event was such a highlight — a great reminder of what is possible when passionate, cross-disciplinary providers come together. Thank you to everyone who attended and leaned into these important conversations.

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