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. Author manuscript; available in PMC: 2024 Oct 6.
Published in final edited form as: Subst Use Misuse. 2024 Feb 25;59(8):1150–1156. doi: 10.1080/10826084.2024.2321253

Babywearing Reduces Urges to Use Substances in the Postpartum Period among Mothers with OUDs

Lela Rankin 1, Lisa M Grisham 2, Natasha Mendoza 3, Alicia Allen 4
PMCID: PMC11456258  NIHMSID: NIHMS2023708  PMID: 38404001

Abstract

Objectives:

While pregnancy presents a strong motivation to seek and comply with Opioid Use Disorder (OUD) treatment, the risk for relapse during the postpartum period is high. The purpose of the present study was to examine the impact of babywearing while admitted to the NICU on urges to use substances within 9 months of childbirth.

Methods:

Mothers with a history of OUD (N=47, Mage=28.91, SD=5.14; 48.9% White, 19.1% Latinx) and their newborns were randomly assigned to the intervention (babywearing) or control (infant rocker) condition while admitted to a NICU. Interviews occurred every 3-months. Participants reported their strong desire or urge to use substances since the last interview. Approximately 68.1% had urges within 9 months. At 3 months, participants were categorized as: never babywore (0 hours, N=18), some babywearing (1–44 hours, N=13), consistent babywearing (45+ hours, i.e., minimum of 3.5 hours per week, N=16).

Results:

Condition X2(2,N=47)=12.55, p<.001, Phi=.52 and babywearing category, X2(2,N=47)=6.75, p=.034, Phi=.38 significantly predicted urges to use. Mothers in the intervention condition were more likely to report no urges to use: 56.5% had no urges (43.5% had urges) compared to 8.3% of control mothers (91.7% had urges). Mothers who consistently babywore had significantly fewer urges to use (43.8% had urges) compared to mothers who never babywore (83.3% had urges).

Conclusions for Practice:

There is a critical window to capitalize on mothers’ desire to abstain from substance use. Babywearing, and specifically babywearing at least 30 minutes a day, reduced urges to use substances post-partum, a factor associated with relapse.

Opioid epidemic and perinatal use

Based on the most recent available national data, currently 4.6 out of every 1,000 births in the US are those with maternal opioid-related diagnoses (MOD), representing an increase by 131% over the past decade (Hirai, Ko, Owens, Stocks, & Patrick, 2017). The increase in MOD has persisted for decades and has likely been amplified during the COVID-19 pandemic (White et al., 2022). Pregnancy presents a strong motivation to seek and comply with Medication for Opioid Use Disorder (MOUD) treatment, with approximately two out of three MOD pregnancies seeking MOUD (Schiff et al., 2018). However, compared to the third trimester, the risk of fatal and non-fatal overdose in the postpartum period doubles within the first six months of childbirth and then increases by nearly four-fold in the 6–12 months after childbirth (Schiff et al., 2018). Indeed, drug overdose is one of the leading causes of maternal mortality (Schiff et al., 2018). While MOUD is protective against postpartum overdose and relapse, currently there are no other evidenced-based approaches to reduce this risk during this unique time period.

The fourth trimester (i.e., the time from childbirth to 12 weeks postpartum) is a critical time period for both mothers and infants. Not only is the risk for MOUD relapse extremely high, but there is also an increased risk of numerous MOUD relapse risk factors including, but not limited to: postpartum depression, postpartum anxiety, intimate partner violence, postpartum pain management, caregiving-related stress, interactions with the judicial system, threats of loss of child custody, and other stressors (e.g., poverty, stigma, Nawaz, 2022). Interestingly, the fourth trimester is also a time when the mother typically experiences substantial neurobiological reward in response to infant cues (Ball & Klingaman, 2007). However, substance misuse alters the natural neurobiological reward response, which dampens the infant-stimulated reward response. Consequently, the infant-mother bond may be hampered. Interventions that strengthen mother-infant bonding during the highly sensitive fourth trimester may ultimately reduce the risk of MOUD relapse.

Treatment for Mothers and for Infants

The standard treatment for opioid use in pregnant and postpartum women is Medication for Opioid Use Disorder (MOUD). MOUD typically includes medication such as methadone, buprenorphine, or buprenorphine with naloxone, to prevent withdrawal symptoms and cravings (Tobon et al., 2019). MOUD is most effective when combined with behavioral interventions, such as counseling or participation in group therapy (Sutter et al., 2019). Doses of medication for OUD often have to be increased during late pregnancy due to the increased circulating blood volume to support the fetus. This results in a decreased circulating concentration of the medication and an increased risk for maternal withdrawal symptoms (Shiu & Ensom, 2012).

Opioid use during pregnancy can result in Neonatal Abstinence Syndrome (NAS) in newborns, a condition that occurs when infants experience withdrawal symptoms after no longer receiving the opioid as they did in utero (Kocherlakota, 2014). Symptoms usually present within the first five days of birth and can affect the gastrointestinal system (diarrhea, frequent emesis, feeding discoordination), the central nervous system (tremors, irritability, difficulty sleeping, increased muscle tone), and the autonomic nervous system (repetitive sneezing and yawning, sweating, tachypnea). Although nonpharmacologic interventions are the primary recommendation by the American Academy of Pediatrics, many of the infants with moderate to severe withdrawal receive pharmacologic treatment to manage the symptoms. This results in increased rates of inpatient hospital stays (averaging 3–4 weeks), prolonged exposure to postnatal opioids, and exorbitant costs to the healthcare system (Patrick et al., 2015).

Public Health Approach to NAS and Perinatal Substance Use

Pharmacologic treatment of NAS usually includes an opioid replacement, such as morphine or methadone, and in some cases and institutions, an adjunct medication is used to manage severe symptoms or decrease the amount of opioid necessary (Bader et al., 2021). More recent approaches to treating infants with NAS are working to incorporate the mother and family utilizing a rooming-in model (Grossman et al., 2017). This, combined with a simplified assessment tool known as Eat, Sleep, Console, has made remarkable improvements in length of stay, reductions in postnatal opioid treatment, and decreased costs to the healthcare system (Hwang et al., 2020). Beyond these remarkable metrics, are the often immeasurable benefits to the mother. Being part of the treatment of their child suffering from withdrawal is healing for the mother and gives a sense of purpose (McGlothen-Bell et al., 2021), however, its direct impact on recovery from OUD has been largely unexplored.

The Family Centered Neonatal Abstinence Syndrome (FC-NAS) care program utilizes an evidence-based bundled approach to managing an infant with NAS (Grisham et al., 2019). The bundle consists of 1) maximizing nonpharmacologic interventions, 2) having the mother/caregiver room in with the infant, 3) using Eat, Sleep, Console as the assessment tool to evaluate the infant’s ability to function while experiencing withdrawal symptoms, and 4) changing from scheduled morphine to as needed dosing for moderate to severe withdrawal symptoms. The goal is to keep the mother and infant together throughout the hospitalization. Once the mother is discharged, the infant is transferred to the NICU and the family stays with the infant in a private room, which includes a bed for the parents, cable television, and a bathroom. Families are also provided with a meal tray three times a day to facilitate their presence and avoid situations where families must leave the infant to get meals.

Babywearing

Babywearing is the practice of hands-free infant carrying through the use of soft fabric, developing in response to bipedalism, from the evolution of mammals walking on four legs to humans walking on two legs (Berecz et al., 2020). Also referred to as infant carrying, babywearing has been practiced for hundreds of years and was recognized as a necessity in cultures where women had to work as part of the family’s survival. It was also thought to be used in children and adults with disabilities that immobilized them. Geographically, it is believed that infant carrying began in Africa and spread to Europe, Asia, and eventually America (Berecz et al., 2020).

Recently, research has identified a variety of behavioral and biological benefits of babywearing (see Grisham et al., 2023, for a scoping review). Behaviorally, caregivers have demonstrated increased responsiveness to the infant’s cues, thought to be the result of continual contact and close proximity (Anisfeld et al., 1990; Little et al., 2021). This increased responsiveness has led to decreased crying, increased breastfeeding related behaviors (Little et al., 2021), and the perception that the infant was calmer, slept more, and was more comfortable as a result of babywearing (Williams et al., 2021).

More research is emerging that indicates benefits of babywearing for caregivers. Riem et al. (2021) conducted research with new fathers, those who babywore in the first three weeks of life showed increased amygdala reactivity to infant crying, the brain region thought to be associated with increased accuracy of infant communication cues. Research conducted by Schoppmann et al. (2021) found associations between reduced maternal repetitive thinking and positive maternal mental health when babywearing. These promising findings suggest that babywearing may improve health outcomes for parents, as well as infants, in the postpartum period.

The use of infant carriers in the hospital is an emergent practice. Consideration for infection prevention and patient falls requires extra attention in the inpatient setting. Given these considerations, however, babywearing can be an effective tool for comforting infants experiencing withdrawal while admitted in the neonatal intensive care unit (NICU) (Williams et al., 2021). Among infants with NAS, babywearing has been effective at decreasing the heart rate of both infants and caregivers after a 25-minute babywearing intervention (Williams et al., 2020), indicating a dyadic calming effect. However, its impact on mothers with OUD is under-researched.

The Present Study

The purpose of the present study is to examine babywearing as a behavioral intervention for mothers with OUDs and their urges to use substances postpartum. Specifically, 1) does the intervention condition (babywearing) compared to the control condition (infant rocker) impact urges to use substances within 9 months of childbirth, and 2) does the total number of hours spent babywearing in the fourth trimester impact subsequent urges to use?

Methods

Participants

The research was conducted in accordance with prevailing ethical principles and was reviewed by an Institutional Review Board. Mothers with a history of OUD and their newborns were invited to participate in the FC-NAS during their stay in a NICU in the Southwest U.S. if they had received prenatal care and were in compliance with their MOUD. Mothers who were non-compliant yet had a family member that would be able to assume care of the infant at the time of discharge (e.g., infant’s father, grandparent), were eligible to participate in FC-NAS (birth mothers and guardians completed separate assessments at each wave). Mothers enrolled in FC-NAS were invited to participate in the Newborn Attachment and Wellness study, which included using a baby item (randomly assigned) throughout the fourth trimester and an agreement to be interviewed about their experiences with infant bonding over the next 18-months. Mothers were randomly given either a baby carrier (the intervention condition, N=23) or an infant rocker (the control condition, N=24) within the first two weeks of life. Infants invited to participate were deemed medically stable by the nurse, neonatal therapist, or provider caring for the infant. Mothers in the intervention condition were asked to babywear daily for one hour starting in the hospital, control mothers were not given specific instructions on how often to use the infant rocker. Caregivers could select either a Baby K’tan or an Ergobaby carrier (see Figure 1). For infants weighing less than the minimum weight requirement of the carrier, a provider’s order was placed in the chart. A layer of clothing or cloth was always placed between the infant and the wearer (i.e., cloth-to-cloth contact). Infants were observed closely by the parent and medical staff during the babywearing, and there were no adverse events.

Figure 1.

Figure 1.

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Two NICU nurses from the Newborn Attachment and Wellness study babywearing infants in a Baby K’tan (left) and an Ergobaby carrier (right).

Participants in the Newborn Attachment and Wellness study (N=47) were approximately 28.91 years old (SD=5.14) and represent the diversity of the region (48.9% White, 19.1% Hispanic, 6.4% Black, 6.4% Indigenous). Forty-five participants self-reported a history of opioid use, including prescription use (90.7%, e.g., fentanyl, oxycodone [OxyContin, Percocet], hydrocodone [Vicodin], methadone, buprenorphine) and street opioids (74.4%, e.g., heroin, opium). Though two mothers denied a history of opioid use, the mother and/or the infant had a positive toxicology screen that indicated opioid exposure during pregnancy and were therefore included in the study. Other life-time substances used included cannabis (88.4%), cocaine (58.1%), methamphetamines (53.5%), sedatives/sleeping pills (37.2%); hallucinogens (34.9%), prescription stimulants (33.3%), other substances (23.1%, e.g., molly), and inhalants (11.9%). There were no statistically significant differences between the intervention group and the control group on demographic characteristics, however, fathers in the intervention group were more likely to be involved in the infants’ life, X2 (2, N=43) = 11.44, p=.003, Phi=.52 (see Table 1).

Table 1.

Demographic characteristics by condition

Intervention Group (N = 23) Control Group (N = 24)
N Frequency (%) M SD N Frequency (%) M SD
Age 21 28.71 5.41 22 29.09 4.98
Race/Ethnicity
 White/non-Hispanic 12 57.1 11 50.0
 Latinx/Hispanic 5 23.8 4 18.2
 Native American 3 14.3 0 0.0
 African-American 0 0 3 13.6
 Multiple/other 1 4.8 3 13.6
Education
 Less than high school 10 47.6 6 27.3
 Graduated high school/ 3 14.3 8 36.00
 Some college 8 37.1 8 36.3
Working currently 6 30.0 5 22.7
Pregnancy
 Vaginal Delivery 12 66.7 16 72.7
 Planned 4 19.0 2 9.1
 First child 6 28.6 3 13.6
 Infant sex (female) 14 66.7 12 54.5
Breastfeeding in hospital 14 66.7 13 59.1
Relationship to father*
 Not involved 0 0 8 36.4
 Involved, living separately 2 9.5 4 18.2
 Living together 19 90.5 10 45.5
Physical IPV in past year 1 5.0 3 15.8
Lifetime substance use
 Cannabis 18 85.7 20 90.9
 Cocaine 15 71.4 10 45.5
 Prescription stimulants 7 35.0 7 31.8
 Methamphetamine 11 52.4 12 54.5
 Inhalants 4 19.0 1 4.8
 Sedatives/sleeping pills 6 28.6 10 45.5
 Hallucinogens 9 42.9 6 27.3
 Street opioids 15 71.4 17 77.3
 Prescription opioids 19 90.5 20 90.9
 Other substances 3 27.3 3 20.0
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Note. Statistically significant at p<.05

Analyses for the present study include four waves of this longitudinal study: birth, 3-, 6-, and 9-months post-delivery. Due to the COVID-19 pandemic, interviews after March 2020 occurred by zoom (40%), and they were approximately the same length of time as in-person interviews (approximately 60–90 minutes). At each wave, participants completed a measure on their strong urge to use various substances (e.g., “In the past 3 months, how often have you had a strong desire or urge to use [substance]?”). Response options included “Never”, “Once or Twice”, “Monthly”, “Weekly”, and “Daily or Almost Daily.” We aggregated all affirmative responses across substances (excluding cannabis) and created a dummy score of any urges to use substances by 9 months: no urges (0) or any urges (1). Approximately 68.1% of the sample had at least one urge within 9-months.

Mothers in the intervention condition were texted weekly to self-report how often they babywore in the past seven days. Given that mothers in the control condition could have babywore by chance, we asked all mothers at their 3-month interview (wave 2) how often they babywore in the past 3 months (13 weeks). We did not have weekly data for hours of babywearing for mothers in the control condition, so we created a proxy of total hours based on their estimated use over the past 3 months. For example, mothers who babywore for approximately 1 hour a week would receive a “total babywearing hours” score of 13 hours at wave 2. Across conditions, total babywearing hours within the newborn period ranged from 0 to 168, and was statistically higher among intervention mothers (M=61.41 hours, SD=41.60 vs M=4.19 hours, SD=10.93), t(45)=−6.51, p<.000. Total babywearing hours by 3 months was recoded into 3 meaningful groups: never babywore (0 hours, N=18, 94.4% control mothers), some babywearing (1–44 hours, N=13, 53.4% control mothers), consistent babywearing (45+ hours, i.e., minimum of 3.5 hours per week, N=16, 100% intervention mothers). We interviewed mothers at each wave, regardless of if they had custody of their infant. Six mothers did not have custody at some point over the four waves of study (50% from the intervention condition). The number of hours the infant was worn by the foster/adoptive parent or father was not used for the purposes of the present study.

Results

We used two Chi-Square tests of independence to determine if 1) there was a statistically significant difference between the control group and the intervention group, and 2) whether there was a statistically significant difference by babywearing usage (never, some, consistent), on urges to use substances within 9 months of childbirth.

There was a statistically significant difference in urges to use within 9 months by condition, X2 (2, N = 47) = 12.55, p<.001, Phi = .52 and babywearing category, X2 (2, N = 47) = 6.75, p = .034, Phi = .38. Mothers in the intervention condition were less likely to have urges to use: 56.5% had no urges (43.5% had urges) compared to 8.3% of mothers in the control group (91.7% had urges; see Figure 2). Mothers who consistently babywore were less likely to have urges to use: 56.3% had no urges (43.8% had urges) compared to 16.7% of mothers who never babywore (83.3% had urges). There was no significant group difference with some babywearing mothers to no babywearing mothers or to consistent babywearing mothers (see Figure 3).

Figure 2.

Figure 2.

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Condition (intervention vs control) by urges to use substances within 9 months of delivery.

Figure 3.

Figure 3.

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Babywearing category (never babywore, some babywearing, consistent babywearing) by urges to use substances within 9 months of delivery.

A Logistic Regression analysis was used to assess if these findings held while controlling for statistically significant differences between the intervention and control group at wave one (living with biological father, X2 (2) = 11.44, p = .003) as well all wave 1 covariates that were significant bivariate predictors of urges to use substance within 9 months of childbirth (mothers age, r = −.42, p = .003). In this final model, living with biological father was no longer significant (as a categorical variable or as dummy coded as any father involvement or living with father). Thus, this covariate was dropped and the final model included age and condition (X2 (2) = 11.69, p = .003), Nagelkerke R2 = .37. Condition (B = −2.04, SE = 1.00, Wald = 4.16, p = .042, OR = .13) and age (B = −.25, SE = .11, Wald = 5.39, p = .020, OR = .78) significantly predicted the odds of having urges to use substances within the first 9 months of childbirth. That is, the intervention condition and age served as a protective effect against urges to use, such that mothers in the intervention condition had an 87 percent reduced risk, and each year that mothers were older resulted in a 22 percent reduced risk.

Discussion

Many parents, care providers, service providers, health professionals, and community members believe that babywearing has at least some benefit to mothers and babies. However, until recently, the study designs needed to test these hypotheses have been lacking in the literature. The results of the present study indicate that babywearing improves maternal health outcomes, at least for mothers with Opioid Use Disorders. We found that babywearing, and more specifically babywearing for at least 30 minutes a day, reduced urges to use substances in the postpartum period, a factor strongly associated with relapse (Kakko et al., 2019; Tiffany & Wray, 2012). The findings of the present study coincide with previous literature to support babywearing as an inhibitor of postpartum urges for substances. Babywearing is prospectively associated with a greater likelihood of a secure mother-infant attachment (Anisfeld et al., 1990; Williams & Turner, 2020), breastfeeding (Piscane et al., 2012), and increased mother’s responsiveness to infants’ cues (Williams, 2020), which are all known protective factors against postpartum relapse (Rankin, Mendoza, Grisham, 2022).

Though this study is one of the few babywearing studies with an empirical design and among the first to focus on mothers with OUDs, there were several limitations that temper the impact of the findings. Most notably, the sample size is small, had an unequal distribution of specific covariates across the intervention, and most participants had at least one wave of missing data. It is difficult to retain mothers with OUDs in a longitudinal study, particularly when they no longer have custody of their infant. Missing data due to removal introduces bias as it is possibly related to urges in drug use. Also, when we have missing data, we do not know whether mothers have relapsed in between interviews or have continued in their recovery from OUD, but it is plausible that the mothers remaining in the sample are more likely to have fewer urges to use substances. Further, we are reliant on participants’ self-reported urges to use substances. Future research is needed that includes a larger sample size and urine toxicology report for drug use. Accurate reporting is influenced by the rapport between the participant and the interviewer, as well as several biases such as social desirability bias, recall bias, unblinded interview bias, among others. As well, while urges are informative, we do not know if participants have relapsed or not. Additionally, we had more contact with mothers in the intervention condition, as a consequence of requiring weekly reporting of babywearing usage. This may have resulted in increased perception of support, as well as differences in the accuracy of the time spent babywearing. Future research designs would benefit from having weekly contact with the control group, and having both groups report usage of a few babywearing items (including baby carriers and infant rockers). Although mothers in both groups were required to have another supportive adult involved in infant caretaking, the intervention group was over-represented by infant father involvement which could have impacted the results. Additionally, the impact of altering our interviews to a virtual format is unknown. This may have resulted in more comfort and honest reporting or it may have resulted in a diminished rapport and trust. Finally, participants were recruited from a specific group of mothers with a history of OUD and their newborns in a NICU in the Southwest U.S., which may introduce selection bias and limit the generalizability of the findings to a broader population.

Babywearing increased physical contact between mothers and infants, yet the mechanisms through which mothers reported fewer urges to use remain unknown. It may be that babywearing decreases parenting stress. Previous research with infants with NAS has found babywearing to be physiologically calming to both infants and their caregivers, during and immediately after babywearing (Williams, Gebler-Wolfe, Grisham, & Bader, 2020). Babywearing lowered the heart rates of both infants and caregivers, particularly if they were the parents (compared to a volunteer wearer). Perhaps the ability to calm and soothe their baby increased parental confidence, which enhanced feelings of bonding and increased connection to their baby. Alternatively, oxytocin, the hormone associated with social bonding in animals and humans, may increase during babywearing, as previous research has documented oxytocin increases associated with breastfeeding, birth, and skin-to-skin contact (Uvnäs-Moberg, Handlin, & Petersson, 2020). It is possible that enhanced oxytocin inhibits cravings (Moeini, Omidi, Sehat, & Banafshe, 2019), though research to date is mixed. Future research is needed to uncover the mechanisms through which babywearing benefits parents, particularly for mothers with OUDs. For example, it is possible that babywearing impacts infant and mother sleep patterns, and subsequently, quality of sleep impacts substance use urges.

Implications for Practice

Our findings indicate that babywearing may be a holistic approach for supporting mothers with OUD from relapse is both critical and worthy of our attention. Mothers were invited to participate in an intervention that was designed to help their infants cope with their symptoms associated with NAS, as well as to enhance mother-infant attachment, yet they directly benefited through lessening their urges for substances. The potential implications of these findings are substantial; mothers can be supported in their recovery during their prenatal care and while admitted to the hospital for delivery. Babywearing can be recommended by primary care providers as well as supported through hands-on instruction in the hospital. In addition to the interpersonal benefits, there are significant cost savings of using behavioral interventions in the hospital. We recommend utilizing babywearing when feasible for medically stable infants greater than or equal to 35 weeks gestation, in other NICU’s.

Our finding that babywearing is associated with reduced risk of relapse among mothers with OUD, occurred alongside substantial patient support from perinatal health and behavioral health care providers. Ongoing training and workforce development of those working with new parents is critical in the treatment of OUDs, considering the high risk for relapse in the postpartum period. Ultimately, knowledgeable health care providers play an integral role in education related to caring for infants with NAS (Combs, 2021) and as we found here, play an integral role in caring for those in care of infants with NAS.

The continuous evolution of healthcare practices necessitates ongoing education and training for healthcare providers. Project ECHO (Extension for Community Healthcare Outcomes) emerges as a pivotal model in workforce development, offering a unique platform for disseminating best practices and emerging interventions to healthcare professionals. Project ECHO’s model is based on collaborative, interdisciplinary learning, where complex health conditions are addressed through case-based discussions and collective expertise sharing (Komaromy et al., 2016). This model is inherently inclusive, prioritizing interventions that are accessible, evidence-based, and capable of being integrated into diverse care settings. Babywearing, as an intervention for mothers with opioid use disorder (OUD), embodies these principles by promoting maternal-infant bonding, reducing infant distress, and supporting the overall well-being of the dyad—all critical aspects of holistic, patient-centered care. The alignment of babywearing with Project ECHO’s values is underscored by the intervention’s simplicity, effectiveness, and potential for widespread implementation. Babywearing is not just a practice but a tool for nurturing connections and supporting developmental outcomes, making it an exemplary candidate for dissemination through the ECHO model. It offers a practical, low-cost solution that can be readily taught and adopted by healthcare providers, thereby extending the reach of trauma-informed, family-centered care approaches to communities affected by OUD and neonatal abstinence syndrome (NAS).

In this light, our study’s exploration of babywearing as a novel intervention for mothers with OUD is not only innovative but deeply resonant with the ethos of Project ECHO. As a next step, leveraging the ECHO model, we can facilitate the integration of babywearing into standard care practices, thereby enhancing the capacity of healthcare systems to offer compassionate, effective support to families navigating the complexities of OUD and NAS. This initiative reflects a shared commitment to advancing healthcare education and practice, with the ultimate goal of improving outcomes for some of the most vulnerable members of our society.

Concluding Remarks

There is a critical window in which health care providers have the opportunity to capitalize on mothers’ desire to abstain from substance use. Maternal OUDs cause significant and potential long-term harm to self and to infants (postpartum depression and anxiety, increased risk of abuse/neglect, child welfare involvement, maternal mortality), and are likely to go untreated due to fear of child removal (Rankin et al., 2022). Policies that support enhanced infant-maternal contact in the postpartum period (e.g., babywearing at work when feasible, or alternative work duties that allow mothers to maintain contact with their infant in the newborn period) improves the health and wellness of mothers, which ultimately supports the health and wellness of their children. By targeting protective factors for relapse, such as enhancing mother-infant physical contact, we may be able to reduce risk for relapse among mothers with OUD.

Acknowledgments

This work is funded as a result of generous financial support from BHHS Legacy Foundation, which is an Arizona charitable organization whose philanthropic mission is to enhance the quality of life and health of those it serves. This work was also funded by a grant from the Ibis Foundation and the National Institute of Health’s Eunice Kennedy Shriver National Institute of Child Health & Human Development (PI: Alicia Allen, DP2-HD105541). Ergobaby, Baby K’tan, and ByKay provided the infant carriers used in this study. All aspects of the study received IRB approval and participants actively consented to the study. All authors contributed to the manuscript development.

Footnotes

Declarations:

The authors do not have any conflicts of interest/competing interests.

Contributor Information

Lela Rankin, School of Social Work Tucson, Arizona State University, 340 N Commerce Park Loop Suite 250, Tucson AZ 85745.

Lisa M. Grisham, Department of Pediatrics at Banner University Medical Center Tucson, 1625 N Campbell Ave, Tucson, Arizona 85719.

Natasha Mendoza, School of Social Work Phoenix, Arizona State University, 411 N. Central Ave. Phoenix, AZ 85013.

Alicia Allen, Department of Family and Community Medicine, College of Medicine - Tucson; Clinical Translational Sciences; Epidemiology & Biostatistics, Mel & Enid Zuckerman College of Public Health; University of Arizona, 3950 South Country Club Drive, Suite 330, Tucson, AZ, 85714.

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