Nursing Diagnosis

Interrupted breastfeeding r/t infant illness AEB infant diagnosis of Neonatal Abstinence Syndrome (Ackley, & Ladwig, 2014).
Breast feeding would be difficult with infants who are inconsolable, those infants who are going through withdrawal wont necessarily want to eat because of the pain. Education will be needed to assist the new mom on how to breast feed. It will assist in the baby's withdrawal because if the mother is still on narcotics some will come through the breast milk to assist in symptoms. It will be an important step forward to have appropriate breast feedings to assist the newborn bond with mom and build a trusting relationship.

Acute pain for infant r/t chemical injury agent AEB delivery from mother who is addicted to narcotics (Ackley, & Ladwig, 2014).
These infants will be suffering from pain from withdrawal. It is important to acknowledge what the infants are going through to assist in any way the medical staff can. Whether the intervention be medications, low stimuli environment or swaddling.

Maternal deficient knowledge r/t lack of interest in learning AEB addiction to narcotics while pregnant (Ackley, & Ladwig, 2014).
If the mother is addicted to narcotics it is highly probable that pre-natal health and education was neglected by the mother. Meaning education is needed to assist the mom in taking care of her infant and her own needs.

Maternal self neglect r/t substance abuse AEB continued use of substance that does harm (Ackley, & Ladwig, 2014).
Adding onto the diagnosis above, the mother might not know what to do for her infant or herself after delivery. Education is very important to set the infant and mom up for the best situation even if pregnancy was not planned. 

(Nurses NANDA, 2009)

 References

Ackley, B. J., & Ladwig, G. B. (2014). Nursing diagnosis handbook: An evidence-based guide to planning care. Maryland Heights, MO: Elsevier. 

Nurses NANDA. (2009). Nurses Nanda. Retrieved March 28, 2016, from http://www.nursesnanda.com/2015/09/newborn-priority-nursing-diagnosis-and.html 

Support Groups

(Support Group, 2016)

It is important for mothers who are addicted to narcotics to know there is support that they can turn to for assistance through pregnancy and post delivery. It will depend on the mother on what type of support will work well for her and her infant with Neonatal Abstinence Syndrome (NAS).

After finding out a woman is pregnant and is also addicted to narcotics, it is important to learn about what all can be passed to their new growing infant. This website is full of information of frequently asked questions of pregnant women. There is also a feature to email and chat with experts about questions related to narcotics transferring to the fetus and then newborn through both the umbilical cord and breast milk (MotherToBaby, 2014).

http://mothertobaby.org

For mothers who want to work toward being narcotic free, but it may be too dangerous to detox while pregnant, there is a possibility of looking to methadone clinics. This allows the mother to get on a methadone regimen that is monitored by the methadone clinic in her area. This gives the mother peace of mind to know she will not be going through withdrawal. Along with medication monitoring, there is counseling individualized for the mother to work on herself so she can be prepared for her soon coming infant (Methadone.US, 2016)

http://www.methadone.us/counseling-and-addiction-recovery/

For mothers who need more assistance after delivering their infant, there are facilities that take both the mother and infant and assist the mother through detox and learning to become a mom. An example is Good Shepherd Rehabilitation, this is an inpatient facility that works with mothers who need more hands on care with medication management with an infant with NAS. The criteria are that the mother is medically stable and the infant can maintain appropriate body temperature in an open crib (Good Shepherd Rehabilitation Network, 2016).

http://www.goodshepherdrehab.org/neonatal-abstinence-syndrome-program

After becoming sober, the mothers can go to groups for support in continuing on their journey of staying clean. Mothers can go to Narcotics Anonymous (NA). These meetings focus on the disease of addiction, not just a specific drug of choice. This way the attendees address their addiction, not just a particular drug that he or she took for a limited about of time (NA World Services, Inc, 2016).

https://www.na.org/

References

Good Shepherd Rehabilitation Network. (2016). Neonatal Abstinence Syndrome Program. Retrieved March 14, 2016, from http://www.goodshepherdrehab.org/neonatal-abstinence-syndrome-program

Methadone.US. (2016). Counseling and Recovery, Addiction Recovery, Methadone.US. Retrieved March 14, 2016 from http://www.methadone.us/counseling-and-addiction-recovery/

MotherToBaby (2014). Home. Retrieved March 14, 2016, from http://mothertobaby.org

NA World Services, Inc. (2016). NA. Retrieved March 14, 2016 from https://www.na.org/

Support Group. (2016). Retrieved March 14, 2016, from https://www.google.com/search?q=supportgroup

Apps to Recommend to Patients

While there are no apps that focus on Neonatal Abstinence Syndrome (NAS), there are some with links that can assist pregnant women who are trying to make it through their pregnancy.

 

For moms who need to stay on their narcotics, like those who are on Methadone treatment, an app that is a pill monitor would be very helpful. These types of apps educate their users on the type of medications and have reminders to take medications. It is a type of list that communicates to the user to make sure and finish everything throughout the day (Pill Monitor – Medication Reminders and Logs on the App Store, 2015).

https://itunes.apple.com/us/app/pill-monitor-medication-reminders/id477666512?mt=8

For those who stop taking their narcotics, there is an app called Relax Now. This app assists in reducing stress and anxiety by being a sort of pocket hypnotherapy. For moms who are trying to stay off the narcotic of choice or cut down on use, their anxiety will be high with possible insomnia. Stress relief will be important (Connolly, 2011).
https://itunes.apple.com/us/app/relax-now-hd/id415130280?mt=8 

To assist with the pregnancy, it will be important for the mothers to keep track of what she eats. There are several apps that assist in keeping track of proper nutrients the mother needs. An example is Health Plus. This will assist the mother in keeping up her nutrition, especially if she is still taking the narcotics, to get the proper nutrients to the fetus (ABCOM Information, 2011).
https://itunes.apple.com/us/app/health-plus/id426336271?mt=12

Finally, to assist with life after the birth of their infant, an app that will assist is Baby Connect. This app allows the parents to keep track of the infants habits, learn about important behaviors of their infant and can assist in calming down the infant. This will assist the new parents to care for the infant and stay organized, as much as they possibly can, for a smooth transition (Baby Connect, 2016)
https://www.baby-connect.com/

References

ABCOM Information. (2011). Health Plus on the Mac App Store. Retrieved March 07, 2016, from https://itunes.apple.com/us/app/health-plus/id426336271?mt=12 

Baby Connect: Baby tracker and log for Android, iPhone, iPad, Windows Phone and for the web. (2016). Retrieved March 07, 2016, from https://www.baby-connect.com/ 

Connolly, T. (2011). Relax Now HD on the App Store. Retrieved March 07, 2016, from https://itunes.apple.com/us/app/relax-now-hd/id415130280?mt=8 

Pill Monitor – Medication Reminders and Logs on the App Store. (2015). Retrieved March 07, 2016, from https://itunes.apple.com/us/app/pill-monitor-medication-reminders/id477666512?mt=8