# The Clinical Challenges and Costs of Caring for Infants with Neonatal Opioid Withdrawal Syndrome (NOWS) in the Post-Nursery Period

> **NIH NIH K23** · YALE UNIVERSITY · 2024 · $167,551

## Abstract

PROJECT SUMMARY
The increased use of both prescription and illicit opioids among women of child-bearing age over the past two
decades has resulted in a five-fold increase in neonatal opioid withdrawal syndrome (NOWS). The requisite
monitoring and management of infants with NOWS prolong postnatal hospitalization, resulting nationally in
hospital costs that currently exceed $560 million annually. Multiple approaches have been investigated to reduce
the substantial care and cost burden of treating infants with NOWS postnatally, including through dyadic
approaches such as the Eat, Sleep, Console protocol. Far less attention has been paid to understanding the
clinical needs and subsequent trajectory of care for infants with NOWS during the remainder of their infancy—
including their risk of hospital readmission and the associated costs. A clearer understanding of these issues is
integral to developing protocols to assist mothers with opioid use disorder (OUD) in caring for their infants during
a time when the health care needs of both the mother and the child are great. Mothers with OUD are at high risk
of relapse and of overdose during the first postpartum year. In turn, the risk of abuse or neglect is highest for all
children in the first year of life. Thus, the objective of this career development proposal is to understand the
challenges of caring for infants with NOWS in the year following discharge from the birth hospitalization. The first
study aims to quantify the risks and costs of hospital readmissions during the first year of life for infants with
NOWS. The second study will focus on the challenges of keeping infants with NOWS healthy and safe in the
year following discharge from the birth hospitalization, a vulnerable time for both mother and child.
 Long-term, my goal is to use these findings to inform the development of an evidence-based model of care
within the home-visiting framework that addresses the unique needs of families affected by NOWS following
discharge from the birth hospitalization. In applying for this award, I am seeking to develop the skills I need to
successfully transition into the field of NOWS research. As an epidemiologist with a background in pediatric
nursing, I have spent the past 12 years investigating the impact of the opioid crisis on adults (and to a lesser
extent, children and adolescents) through secondary analyses of large datasets. I need further training related
to 1) the clinical care of infants with NOWS and skillfully working with mothers with OUD, 2) economic
evaluations, 3) qualitative research methods, and 4) implementation science. I have assembled a mentorship
team led by experts in parental substance use and child abuse that addresses each area of training and
leverages the resources available at Yale. The training and research outlined in this proposal promise to have a
high impact on my career, as they will provide me with the skills and knowledge that I need to meet my long-
term career goal o...

## Key facts

- **NIH application ID:** 10817095
- **Project number:** 5K23HD109508-02
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Julie Rozelle Gaither
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $167,551
- **Award type:** 5
- **Project period:** 2023-04-01 → 2027-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10817095

## Citation

> US National Institutes of Health, RePORTER application 10817095, The Clinical Challenges and Costs of Caring for Infants with Neonatal Opioid Withdrawal Syndrome (NOWS) in the Post-Nursery Period (5K23HD109508-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10817095. Licensed CC0.

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