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May 2018Vol. 19, No. 4Progress Report on the Substance-Exposed Infant Initiative

Opioid addiction has increased significantly over the past several years among individuals of all ages and backgrounds. As this rate has increased, rates of use also increased among pregnant women, which has led to states reporting significant increases in neonatal abstinence syndrome and infants experiencing opioid withdrawal symptoms. The Substance Abuse and Mental Health Services Administration and the Children's Bureau released a report that details the efforts of a special initiative begun by the National Center on Substance Abuse and Child Welfare (NCSACW)—the Substance-Exposed Infant (SEI) Initiative. This initiative built on NCSACW's technical assistance experience and worked to help six states respond to the increasing numbers of infants with prenatal exposure to opioids and the support these affected infants, families, and caregivers need during the critical period during infancy. They did this by focusing on increasing collaboration among child welfare professionals, mental health and substance use disorder treatment providers, public health and medical communities, home visiting and early intervention systems, and other stakeholders.

This report highlights five states that were included in the initiative: Connecticut, Kentucky, Minnesota, New Jersey, and Virginia. These states received an additional 6 months of technical assistance to continue their work after the initial SEI period. The report focuses on the lessons learned, challenges and barriers, and state strategies. It also highlights progress made toward improving the safety, health, permanency, and well-being of infants affected by prenatal substance exposure and the recovery of pregnant and parenting women and their families. Findings include the following:

  • Pregnant women with substance use disorders (SUDs) may avoid prenatal care or SUD treatment for fear of prosecution or custody loss.
  • Hospital protocols can be inconsistent within and across states, which limits access to services for treating infants.
  • Challenges related to collecting, sharing, and reporting data were new to many groups.
  • Strategies created by states to improve outcomes included developing statewide hospital protocols to promote consistent identification of infants in need of services and using consistent and nonstigmatizing language when referring to pregnant and parenting women with SUDs and their children.

This report, Substance Exposed Infants: A Report on Progress in Practice and Policy Development in States Participating in A Program of In-Depth Technical Assistance, is available at (426 KB).