Following completion of this course, learners should be able to:
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Recognize and diagnose NOWS
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Identify common clinical manifestations of NOWS using standardized assessment tools (e.g., Finnegan Scoring, Eat-Sleep-Console method).
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Understand the pathophysiology of opioid withdrawal in neonates and factors influencing severity.
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Evaluate and implement current best practices for managing NOWS
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Compare and contrast non-pharmacologic (rooming-in, breastfeeding, skin-to-skin) vs. pharmacologic (morphine, methadone, clonidine) interventions.
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Understand the role of maternal opioid replacement therapy (buprenorphine vs. methadone) in reducing NOWS severity.
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Critically assess emerging pharmacologic treatments
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Analyze recent research on clonidine monotherapy and buprenorphine as alternatives to traditional opioid-based therapies.
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Discuss the potential benefits and risks of alternative pharmacologic strategies in reducing hospital stay and improving neonatal outcomes.
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Understand the long-term neurodevelopmental and behavioral outcomes of opioid-exposed infants
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Examine neuroimaging and neurodevelopmental studies highlighting white matter changes and cognitive risks in opioid-exposed infants.
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Explore strategies for early intervention and developmental follow-up for high-risk infants.
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Apply a multidisciplinary and family-centered approach to NOWS management
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Discuss the importance of family engagement, social determinants of health, and policy changes in improving neonatal outcomes.


Rupin Sharma, MD is an Assistant Professor of Pediatrics at the University of Kentucky and a board-certified neonatologist specializing in neonatal opioid withdrawal syndrome (NOWS) and and neonatal point-of-care ultrasound (POCUS). She serves as the Director of the Neonatal POCUS Program and Assistant Program Director for the Neonatology Fellowship at UK, and also serves as a consultant neonatologist at Baptist Health Hospital Corbin and Frankfort Regional Medical Center. Dr. Sharma is actively involved in medical education, mentorship, and POCUS curriculum development, as well as with the UK PathWays program and provides antenatal counselling to pregnant mothers who are enrolled in substance use recovery programs.
Following the completion of this course, learners should be able to:
- By the end of the presentation, maternal healthcare providers will be able to articulate the role of doulas and identify at least three ways doulas enhance patient care and birth outcomes.
- At least 80% of participants will correctly answer three out of four post-presentation quiz questions on the benefits of doula support in hospital settings.
- Equip healthcare providers with evidence-based strategies to collaborate with doulas, ensuring complementary and effective patient-centered maternity care.
- Provide actionable insights on how doulas can reduce intervention rates, improve communication between providers and patients, and enhance maternal satisfaction with the birthing experience.
- Encourage attendees to implement at least one strategy for improved doula collaboration within their hospital or clinic within the next three to six months.
- Present case studies from diverse patient populations, emphasizing how doulas can improve birth outcomes across different cultural and socioeconomic backgrounds.
- Address systemic barriers that limit access to doula support, including insurance coverage, hospital policies, and provider-doula communication challenges, while promoting solutions for equitable maternal healthcare.

Victoria Wilson is a certified birth doula through DONA International and has supported over 100 families since 2015, and many others through classes and community involvement. Past clients speak to Victoria's compassion, expertise, and intuition as a birth doula. Victoria has participated in numerous professional development programs to continuously enhance her skills. She is also an experience entrepreneur and marketing expert. As the owner and lead doula of Mother Well Doula Service, LLC, she has maintained a successful doula practice since 2015, fostering positive relationships with clients, healthcare providers, and the wider birth community. Her expertise extends to childbirth education, as well as advocating for low-intervention births in hospitals and collaborating with clinicians for better birth outcomes. Her birth work is driven by the belief that fostering relationships is the way to positively impact individual births and the entire maternity care system. Victoria has spoken on college campuses, in professional groups, and in private settings on the topic of birth and doula work. She is supported by her husband and four daughters, and as of 2024 is in the process of earning her BSN.

Dr. Ljuba Mirsky, MD is a Maternal-Fetal-Medicine Fellow at the University of Kentucky (UK). She attended UK for her undergraduate studies and medical school, then completed her Obstetrics and Gynecology residency at the University of Tennessee Medical Center in Knoxville, TN. She has always been interested in substance use in pregnancy and completed research on Neonatal Opioid Withdrawal Syndrome (NOWS) in medical school and on a novel neonatal syndrome related to fentanyl exposure in fellowship. She currently works at the Pathways clinic when on rotation and is passionate about providing equitable care to this underserved population.
Cradle Cincinnati is a collective approach to ending infant mortality. They are a network of community members and organizations working across sectors to measurably improve Cincinnati's infant mortality rate, they bring together services and systems to help moms and, in turn, save babies' lives.
The Cradle Cincinnati Learning Collaborative (CCLC), launched in 2015, is a network of more than 200 healthcare professionals representing hospitals, community health centers, home health agencies, and social support organizations. These representatives are committed to transforming prenatal care for women and their families. At the heart of our work, we believe in providing equitable care that centers on women’s voices and experiences. Using data-sharing and an “all teach, all learn” model, the CCLC serves as an opportunity to activate change within the prenatal care space. We aim to lower infant mortality by focusing on activities and interventions related to the following focus areas: reducing extreme preterm birth, eliminating sleep-related infant death, preventing birth defects, and reducing the racial disparity in birth outcomes.
Presented by
Senior Data Management Specialist, D. Walker MPH, CHES
Senior Program Manager, L. Everett MPH
Learn more about Cradle Cincinnati

J. Murphy, MPH Kentucky Department for Public Health Division of Epidemiology and Health Planning Viral Hepatitis Program |
K. Gardner,
Kentucky Department for Public Health
Division of Epidemiology and Health Planning
Viral Hepatitis Program Coordinator

A new offering by Dr. Jessica Young, the Medical Director of the Firefly program, Acudetox is a treatment method that involves placing acupuncture needles gently in the ear at specific points. The intervention can provide symptom relief, relax the nervous system, calm emotions, and support patients in their recovery.
Background : Vanderbilt has been caring for women with substance use disorder and their children since 2011. In 2020, the program received funds from the Centers for Medicare & Medicaid Services (CMS) through the Maternal Opioid Misuse (MOM) model, in partnership with TennCare. This influx of support lead to the official launch of Firefly in 2021, an expanded, multi-disciplinary outpatient clinical program spanning OB/GYN, Pediatrics, & Psychiatry.
