Supporting mother-infant dyads impacted by prenatal substance exposure

Abstract

Improving health and well-being of mothers, infants, and children represents a national public health priority, with emphasis placed on understanding how environmental and social determinants (access to quality health care, education, employment, economic opportunities, social support, and resource availability) influence maternal health behaviors and infant-child well-being. Substance use during pregnancy is a predominant maternal-infant health risk; many affected mother-infant dyads also face co-occurring psychosocial adversities, often necessitating social services-based interventions. Best practices to support infants exposed to substances across the medical, mental health, substance use, and social service sectors have historically been affected by heterogeneity of dyad needs, varied stakeholder perspectives, and limited cross-sector resource availability. Recent legislative changes designating a universal, family-centered, non-punitive, and supportive social services-based approach toward affected mother-infant dyads, known as Plans of Safe Care, offer a potential solution to comprehensively address diverse needs. In this narrative review, we discuss current public health-based efforts and novel implementation of federally-funded family support programs, including Plans of Safe Care and Family First legislation, to address the multiple health and psychosocial adversities facing prenatally substance exposed mother-infant dyads. Opportunities for future research, including analysis of the impact of Plans of Safe Care and other policy interventions on dyad health and safety outcomes is explored.