Which nursing action should be included in the plan of care for a newborn experiencing symptoms of drug withdrawal?

• A. Swaddle the infant snugly and hold tightly
• B. Play soft music and talk to soothe the infant
• C. Administer chloral hydrate for sedation
• D. Feed every 4 to 6 hours to allow extra rest

Answer: (A)

Calming containment and close physical contact are foundational for a newborn experiencing withdrawal. Swaddling the infant snugly and holding the baby tightly provides a womb-like feel, reduces the startle reflex, and gives proprioceptive input that helps regulate the nervous system. This soothing, close contact supports more stable breathing, temperature control, and sleep, which in turn can decrease the infant’s irritability and energy expenditure.

In NAS, nonpharmacologic soothing is prioritized because it directly addresses the dysregulated autonomic state and high arousal these babies often exhibit. Keeping environmental stimuli low—quiet, dim lights, minimal handling, and clustered care—further helps the infant settle. While gentle comforting methods like soft talking or music can be soothing, they don’t replace the primary benefit of containment and close contact.

Pharmacologic sedation is not appropriate as a routine plan of care for drug withdrawal in a newborn, as it can mask symptoms and carry risks; treatment is guided by the severity of withdrawal and typically managed with medications only when indicated by clinical assessment. Feeding should be guided by the infant’s hunger cues and coordination of suck–swallow–breathe, with smaller, more frequent feeds as needed rather than rigidly spaced intervals.