The Hushabye Opioid Pregnancy Preparation and Empowerment Program (HOPPE) An Innovative Approach to Neonatal Abstinence Syndrome

ABSTRACT Background: Neonatal abstinence syndrome (NAS) continues at excessive levels in the United States, affecting thousands of newborns yearly who require extended hospitalizations for their withdrawal symptoms. Hushabye Nursery is a free-standing care facility for infants with NAS and their caregivers with substance use disorder, which optimizes care through nonpharmacologic approaches and parent engagement. Purpose: To provide preliminary observational data on the Hushabye model of care. Methods: A retrospective observational cohort study between November 2020 and October 2025, evaluating the effect of a specialized care delivery model in a free-standing treatment facility. Outcomes assessed included length of stay (LOS), pharmacological treatment, prenatal engagement, and discharge disposition. Results: The average LOS of infants (n = 1105) at Hushabye was 8.3 days (SD = 5.1). Over half of the infants (n = 569, 51%) never received pharmacologic treatment for withdrawal symptoms. Antenatal enrollment at Hushabye was associated with significantly shorter LOS (mean [SD], 7.8 [5.2] days vs. 9.0 [4.9] days; P < .001) and lower rates of morphine treatment (35% vs. 63%; P < .001). Infants who did not receive morphine were most likely to be discharged home without child welfare involvement (45%), and infants requiring morphine had higher rates of foster care placement (22% vs. 11%) and kinship placement (25% vs. 11%) ( P < .001). Implications for Practice: Infants with NAS may be effectively treated in a free-standing facility using the Hushabye model, achieving outcomes similar to or better than current models of care while reducing the burden and costs associated with a prolonged hospital stay.