Infants exposed to drugs no longer need to be reported to CPS under new Washington policy in effort to reduce addiction stigma

In an effort to reduce the stigma against parents suffering from addiction, Washington introduced a new policy this week that no longer requires hospitals to report all drug-exposed infants to Child Protective Services, the Seattle Times reported.

Nancy Gutierrez, a Department of Child, Youth and Families spokesperson, noted that if hospital staff feel the newborn is in “imminent risk of serious harm” due to substance abuse, they are still required to report their concerns to CPS.

She noted that the medical team’s decision to report should be based on the child’s safety and not the drug detected.

“If there are no safety concerns, state policy now allows substance-exposed infants to receive voluntary wrap-around services without being reported to Child Protective Services. All hospitals should update policies to align with state policy and train staff no later than Jan. 1, 2025, to comply with federal requirements,” the state’s Department of Health announced this week.

The new policy aims to improve infant care by adopting the “Eat, Sleep, Console” plan, according to Tiffani Buck, a nurse practitioner with Washington’s Department of Health.

Buck told the Seattle Times that hospitals have historically used the Finnegan Neonatal Abstinence Scoring Tool to determine whether an infant is experiencing withdrawal symptoms. The method, developed in the 1970s, examines the baby’s behavior, including crying, sleeping, tremors, sneezing, and feeding.

If withdrawal symptoms are believed to be present based on the assessment, medical professionals move the babies to the neonatal intensive care unit, where they would likely receive medication.

“Parents are sometimes included in the care there, and sometimes they’re not,” Buck said. “It depends on the facility.”

She explained that the method often listed normal behavior as potential symptoms.

“It’s normal for infants to cry,” Buck stated. “I think it’s common for [symptoms] to be exacerbated with withdrawal, but they’re not indicative of withdrawal.”

A National Institutes of Health report found that newborns treated with the Eat, Sleep, Console system were often discharged nearly a week earlier than those treated through the Finnegan method.

However, the study also noted that the Eat, Sleep, Console method has “not been rigorously tested in a large population,” which “has raised some concerns about potentially underrating infants or discharging them prematurely.”

The new system involves keeping infants in dark, quiet rooms where their parents are taught how to swaddle and feed them.

“What do we really need babies to be able to do? We need babies to be able to eat, we need babies to be able to sleep, and we need babies to be consolable,” Buck stated. “Let’s look at those three things, instead of subjective symptoms, to assess how the baby’s doing and whether or not interventions are needed for withdrawal.”

The DOH announced that “NICU admissions should no longer be the first line of treatment for infants exhibiting withdrawal symptoms.”

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