About MAiN

MAiN's mission is to provide treatment to infants with NAS. We offer complete and long-term support to help babies have a strong, healthy start in life.

The MAiN Journey

Prenatal Care

Mothers can self-enroll in MAiN, or their health care provider can make a referral. We will schedule a phone consultation to discuss mom’s potential care plan for pregnancy, birth, and beyond.

Mom / Baby Hospital Care

We let mothers using opioids stay in the same hospital room as their babies, and we provide supportive care for both mom and baby.

Home Care

A MAiN Nurse Navigator can provide supplies to support the baby’s health and safety, as well as organize home visits, breastfeeding support, and referrals to local community resources. MAiN will also help coordinate mom and baby healthcare visits and transportation when needed.

How It All Began

The History of MAiN

Over the last 18 years, a team led by Dr. Jennifer Hudson at Prisma Health Upstate created and tested the Managing Abstinence in Newborns (MAiN) program. MAiN gives early medicinal treatment to newborns who are healthy but at high risk for withdrawal, also known as neonatal abstinence syndrome (NAS).

What Drives Us

Our Core Beliefs

All women deserve a positive birth experience.

Mothers and newborns belong together, with rare exceptions.

Sudden opioid withdrawal can be painful and dangerous for babies. With proper care, we can prevent it.

Health care providers should advocate for the well-being of pregnant women using opioids.

All patients deserve a health care provider they can count on.

Dr. Jennifer Hudson

Meet the Physician Champion

Dr. Hudson has served as Chief Resident for the Pediatrics Residency Program at Greenville Memorial Hospital and has been a Prisma Health physician and researcher since 2000. She has received several awards during her time at Prisma, including the GHS Matthews Outstanding Faculty Teaching Award, Pediatrician of the Year, Outstanding Faculty Research Award, and Outstanding Scholar Award. Dr. Hudson’s special academic interests include breastfeeding, newborn medicine, environmental health, and residency curriculum design.

From Thinking to Action

Our Guiding Principles

1

Specialized Care

When identified early, most NAS cases can be managed at the hospital after birth. Hospitals should provide care using best practices, but they should also consider each family’s unique needs and wishes.
2

Continuing Care

The right support can make a big difference for families facing opioid use. We connect women enrolled in MAiN with the support they need while pregnant, and after giving birth. For example, we can provide new moms with infant supplies, housing, transportation, and more.
3

Reversing Impact

To reduce harm from the opioid crisis, we need personal effort, education, teamwork, and long-lasting solutions.

Frequently Asked Questions

General

1What does MAiN mean?
MAiN stands for Managing Abstinence in Newborns. At MAiN, we use best practices to care for all substance-exposed newborns. Our treatment prevents your baby from suffering or having negative health outcomes. MAiN supports families at every step. This means working with doctors who care for pregnant women using opioids, staying connected with the baby’s regular doctor, and partnering with local services in the community.
2Why was MAiN developed?
MAiN was developed in 2007 at Greenville Memorial Hospital to help healthy newborns at risk avoid symptoms and problems caused by Neonatal Abstinence Syndrome (NAS). Thanks to support from the South Carolina Department of Health and Human Services, MAiN is now available in a number of hospitals across our state. Thanks to support from the South Carolina Department of Health and Human Services, MAiN training has been provided in the following South Carolina hospitals: AnMed Health Medical Center, Baptist Easley Hospital, Carolina Pines Regional Medical Center, Greer Memorial Hospital, Oconee Memorial Hospital, Tidelands Waccamaw Community Hospital, and Tuomey Hospital.
3How does MAiN benefit patients?
MAiN helps families celebrate birth while providing long-term support every step of the way. A MAiN Nurse Navigator can answer questions before the birth and arrange a consultation with a hospital pediatrician. In the hospital, mothers benefit from being involved in the care of their newborns immediately following delivery. Extended rooming-in promotes bonding and gives mothers more time to learn how to recognize and treat their baby’s withdrawal symptoms. Hospital staff provide education and feeding support. The MAiN Nurse Navigator can give you infant care and safety supplies and can arrange home visits to support your needs over time.
4If I am pregnant, should I try to quit opioids on my own?
No. Quitting “cold-turkey” can be dangerous. Withdrawal during pregnancy can be stressful for you and your baby, and potentially result in still-birth or pre-term delivery. Instead, pregnant women using opioids should seek medical advice to help them have the healthiest pregnancy possible.

For Patients, Regarding Hospital Care

1What is NAS?
NAS stands for Neonatal Abstinence Syndrome and refers to withdrawal symptoms in a newborn. NAS happens when a baby is exposed to certain drugs during pregnancy and then has withdrawal symptoms after birth.
2What treatment options are available for pregnant women taking opioids?
Treatment really depends on several factors and needs to be tailored to each individual. One treatment option could include medication that is prescribed by a doctor. You might hear them called Medications for Opioid Use Disorder (MOUDs for short), Medication Assisted Treatment (or MATs), like methadone, buprenorphine, or suboxone. During pregnancy especially, these medications are safer than opioids obtained without a prescription. They can help reduce your cravings and withdrawal symptoms. Many people using opioids find that medications can help them get back to their lives. Doctors approve of these medications, and you won’t face legal consequences for taking them.
3What is a MAiN Nurse Navigator?
Our MAiN Nurse Navigator connects with you during pregnancy or in the hospital during birth to support you. They are specially trained in how opioid use disorder affects families. They can offer referrals, evaluations and feeding support, infant care and safety supplies, home visits, education, and much more. Each MAiN Nurse Navigator will follow a small number of families and hopes to be a true resource for them.
4How do I sign up?
Your OB/GYN doctor can refer you to MAiN, or you can self-enroll by visiting the “Sign Up” tab on this website.
5What is a MAiN Prenatal Consult?
After you enroll in MAiN, we will reach out to you to schedule a phone call. During this call, we can answer all your questions about pregnancy and what to expect in the hospital. We will estimate your baby’s risk for NAS and recommend a plan based on the medicines you are taking. We will also discuss any special circumstances or concerns you may have, such as DSS involvement or hepatitis C virus. Our goal is to be as helpful as possible!
6How long will my baby be in the hospital?
Your baby will be monitored in the hospital for at least 5 days. Babies treated with medication will be in the hospital for 2 weeks or more. You will leave the hospital when your baby is feeding well, not losing weight, and has low withdrawal symptoms while off medication. Some babies need extra days in the hospital to learn feeding skills.
7Will I be able to stay with my baby?
Mothers provide better comfort to their babies than anyone else. Your touch, your smell, and your voice are all therapies for your baby. If your newborn does not require Neonatal ICU care or close monitoring after birth, your baby will stay by your side as long as you are a patient. After you are discharged and depending on room availability, you may be encouraged to continue “rooming-in” with your baby until they are ready to leave the hospital.
8What will I learn if I enroll in MAiN?
You will learn how to soothe your baby, how to help your baby deal with symptoms of withdrawal, how to breastfeed, and much more.
9How will I know if my baby is withdrawing?
There are several signs you can look for to know if your baby is having withdrawal symptoms. Here are a few:
  • High-pitched crying that lasts more than a few minutes.
  • Not sleeping, especially after feedings. Most newborn babies sleep for 21 hours a day.
  • Feeding poorly or losing too much weight. Babies in the hospital are weighed every day to make sure they are on track.
  • Tremors or shaking of the hands and feet that lasts for a few seconds.
  • Watery stools or vomiting. Stools that soak into the diaper are considered watery.
10How can I comfort my baby if they have withdrawal symptoms?
  • Keep your room quiet with dim lights.
  • Keep the room a comfortable temperature– not too hot.
  • Talk to your baby in a soft and soothing voice.
  • Swaddle your baby in a thin blanket, or use a light swaddle outfit.
  • Avoid hats and extra layers unless your baby is born early.
  • When your baby is upset, try rocking, bouncing, patting, or swaying.
  • Some babies like to be held sideways.
  • Many babies with NAS like to suck, so offering a pacifier may help.
11Can I breastfeed my baby?
Breastfeeding is the best food for your baby and can help with NAS symptoms. Skin-to-skin contact while breastfeeding is comforting for your baby. You can usually breastfeed if you are not using any drugs that could harm your baby (MATS/MOUDs are safe). If you are also taking medications for mental health, ask your baby's doctor or lactation consultant if you can safely breastfeed.
12Will my baby need medication for withdrawal?
Every baby is different. Your baby's physician will talk to you about your baby's risk level and medication options in the hospital.
13Will my baby be okay?
Yes– your baby can do well, especially with a loving and supportive home. Loving care, positive parenting, and good nutrition have a big effect on their development, more than medicine or substances during pregnancy. You can track your baby’s progress using the CDC's Milestone Tracker App. Tell your doctor if you’re ever worried about how your baby is growing or behaving.
14Do you refer all mothers taking long-acting opioids to the Department of Social Services (DSS)?
The MAiN program is here to give you information and guidance, without judgement. Certain situations might require MAiN staff to make a report to DSS, but this would be rare. Most families enrolled in MAiN don’t need DSS involvement. If there is involvement, typically it is because of a report filed before they enrolled in MAiN. In any case, we are here to advocate for you as best we can.
15How does a MAiN provider react when women say they are using opioids?
Our providers and nurses are committed to showing you empathy and having a non-judgmental approach to your care and treatment. We know that stigma around opioids and addiction can prevent people from recognizing a problem and from seeking help, and so we work to minimize and eliminate stigma in all that we do. We believe that every woman deserves a positive birthing experience. No matter what they are going through, MAiN is here to help.
16Can I still get help from MAiN if I already delivered my baby?
Yes, our special funding allows us to serve families for up to five years after they join MAiN during pregnancy or with a baby under 1 years old. MAiN can assist you with supplies and services that are tailored to your needs, such as car seats, feeding supplies, breastfeeding support, clothing, vitamins, transportation, and much more. Even if you don’t have custody of your baby, or if you are a kinship or foster care giver for an opioid exposed infant, we can help you.