The Impact of COVID-19 on Parenting Infants with Neonatal Abstinence Syndrome

Background and Purpose:

As of May, 2020, there are over 76,000 deaths and 1.2 million individuals infected in the U.S. as a result of the coronavirus disease (COVID-19). The impact of COVID-19 is projected to be long-lasting and widespread. The impact on parents with a substance use disorder (SUD) is unknown, however, these parents disproportionately experience increased levels of stress and social stigma; subsequently, they have less resources to buffer the impact of COVID-19 on parenting.

Methods

The Newborn Attachment and Wellness study is an ongoing longitudinal study of infants with Neonatal Abstinence Syndrome (NAS) and their legal caregivers (interviewed at birth, 3-, 6-, 9-, 12-, and 18-months old). This study qualitatively assessed the early perceived impact of COVID-19 on parenting infants with NAS. In the immediate weeks following at-home restrictions, participants were interviewed via Zoom: “How has COVID-19 impacted you?” “How has COVID-19 impacted your parenting?” Responses were transcribed verbatim and an open thematic content analysis was conducted using NVivo (N=8 parents, 50% White, 25% Hispanic, Mage = 28.1; N=6 foster parents, 100% White, Mage = 51.0).

Results:

Participants parenting was impacted by COVID-19 in four primary areas: Protection from physical risk and stress (e.g., “I don't go out, other than medications doctors and groceries, but you know that that still puts us at risk. And so how am I going to protect him while we're doing that.”), Anxiety related to access to supplies and medical care (e.g., “I can't take them to a doctor. Like, you don't want to take them out. So then I'm like sending pictures of him”), Community connection and disruption (e.g., “We're really grateful because we've had people that have, like, ‘Hey, I found wipes’ and then they bought it for us.”), and Time (“We're doing online type schooling and packets for the elementary kids so that also impacts my baby because the kids are home so [the baby is] getting more attention from the siblings...and I'm spread out a little more. So it's changed where he used to get a lot of one-on-one attention [from me] when they were at school”). Some parents were unsure or unable to articulate impacts of COVID-19.

Conclusion and Implications:

Our findings reflect the immediate interruptions to daily living routines that parents have faced nationwide. Parents have had to quickly adapt in concrete ways (e.g., searching for toilet paper, establishing employment/housing/food security), which has manifested in feelings of protection, anxiety, increased reliance on – or detachment from – community, and shifts in time spent with children. The additional stressors associated with COVID-19 are particularly concerning for parents with SUD given the heightened risk for relapse as well as child maltreatment in the postpartum period. We recommend that parents establish new routines with their children, which will foster internalized beliefs that their parents will be there in times of stress. Parents that are able to respond to their infants’ needs, particularly in times of stress, will support the long-term development of trust and security.