Purpose: To compare infant and family demographics and weaning and discharge outcomes of infants with Neonatal Abstinence Syndrome (NAS) treated with morphine only versus treatment with morphine and phenobarbital in a post-acute care hospital setting. 

Design: Electronic medical record review of 76 infants with NAS admitted to a pediatric post-acute hospital from local tertiary-care neonatal intensive care units. Descriptive statistics were calculated for the total group and compared for two weaning medication subgroups (morphine only (n=25) and morphine and phenobarbital (n=51)). 

Result: Thirty-nine (51%) infants were male and 49 (65%) were White, non-Hispanic. Average admission age was 17.31 days.  Average length of stay (LOS) in the post acute care hospital was 35 days.  All infants began treatment before admission to the post-acute care hospital and 92% weaned from all medications before discharge. Group differences were found for admission age (p=0.04), discharge age (p=0.005), LOS (p=0.033), days to wean morphine (p=0.004) and referring acute care hospital (p=0.01). 

Conclusion: A greater number of infants in post-acute care required phenobarbital as well as morphine than morphine alone. These infants were older at admission, took longer to wean and stayed in the hospital longer, indicating a more difficult course.