Improving Care for Opioid-Exposed Newborns (ICON)

The ICON project partners with the Vermont Department of Health and the University of Vermont Children's Hospital to improve health outcomes for opioid-exposed newborns. 

Improved health outcomes are achieved by provision of educational sessions on up-to-date recommendations and guidelines to health care professionals who provide care for pregnant people with substance use disorder and their infants.

The project also maintains a maternal and newborn population-focused database for tracking process and outcome measures. This data is used to identify gaps in care and systems related resources. The project addresses these gaps through quality improvement initiatives, focused on enhanced care processes and systems changes. 
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Goals &
  • Improve quality of prenatal and postnatal care for pregnant people with substance use disorder and their infants.
  • Improve availability, access, efficiency, and coordination of care services for pregnant people with substance use disorder.
  • Provide support to health care professional who care for opioid-dependent pregnant people and their infants and improve systems for implementation of current guidelines and best practice recommendations for care.
  • Provision of support and guidance for the Vermont Plan of Safe Care (POSC) with the Vermont Department of Health Division of Family and Child Health and the Department for Children and Families.
  • Collaboration for the statewide adoption of DCF CAPTA notifications for substance exposure in utero as outlined in Federal CARA (Comprehensive Addiction and Recovery Act) including engagement for planning and development of a revised Plan of Safe Care (POSC) and the development of a POSC supportive structure to assist providers in the state.
  • Provided support and guidance for Vermont community hospitals implementing the Eating, Sleeping, Consoling (ESC) care tool for symptom assessment of opioid-exposed newborns.
  • Regional collaboration with neighboring states via Northern New England Perinatal Quality Improvement Network (NNEPQIN).
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2024 Annual Statewide Improving Care for Opioid-Exposed Newborns Conference: Substance-Exposed Newborns and Families: Creating a Community of Practice Materials


Opening Remarks (pdf)                                                                                  presented by Dr. Michelle Shepard


Clinical Utility of Perinatal Toxicology Testing (pdf)                                presented by Dr. Davida Schiff 


The New Academy of Breastfeeding Medicine Guideline for Breastfeeding and Substance Use: Putting it Into Practice (pdf)                               presented by Dr. Adrienne Pahl and Dr. Molly Rideout 


Parental Education and The Family Care Plan in 2024 (pdf)                        presented by Dr. Michelle Shepard


Panel: Peer Recover and Parenting: The Power of Lived Experience


Click the play button in the video below to watch the recording. (After clicking play, click the arrows in the bottom right of the screen to view in Full Screen.)


  • Vermont In-Depth Technical Assistance is an interdisciplinary team developing systems of care and support for perinatal people with substance use disorder (SUD), including updating guidelines for the Community Response Team (CHARM) model and supporting the expansion of a perinatal peer support network.

Statewide Call

  • On October 31, 2023, the PQC-VT ICON team hosted a webinar, Demystifying Nurse Home Visiting: Increasing Acceptance of Prenatal and Postpartum Services. Guest speaker Katy Leffel, RN BSN, IBCLC, Nurse Program Coordinator, Division of Family, presented reflections from physician champions about how to talk to families about the benefits of nurse home visiting, and how they promote and integrate referrals to nurse home visiting in their practice.

View the recording here.  |  Review the presentation slides here.

Preparing for Hospital Stay and Preparing for Baby

  • short video to help pregnant people with a history of opioid use disorder (OUD) prepare for their hospital stay and what to expect after their baby is born. 
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Project Team

Michelle Shepard, MD, PhD, and Lead Faculty

Molly Rideout, MD, Faculty

Adrienne Pahl, MD, Faculty

Julie Parent, MSW, Project Director

Avery Rasmussen, MPH, Data Manager

Angela Zinno, MA, Project Coordinator

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