Originally published 2017-03-04.
Yes, hospital “baby cuddler” volunteers are real, and the job is just what it sounds like: trained volunteers hold, rock and soothe newborns, many of them babies going through drug withdrawal after birth. These are unpaid volunteer roles, not paid jobs, and they sit inside the nursing team’s care plan rather than replacing it. Nurses who run these programmes say that steady human contact helps the babies settle, and that settled babies often need less medication and can go home sooner.
Here is what the work involves, why it matters, what the evidence says, and how to find a programme near you.
Why some newborns go through withdrawal
When a pregnant woman regularly takes certain drugs, the baby’s body adjusts to them in the womb. At birth the supply stops abruptly, and the infant can develop a cluster of withdrawal signs known as neonatal abstinence syndrome, or NAS. When opioids are the cause, doctors often use the newer name neonatal opioid withdrawal syndrome (NOWS).
The wording matters. A newborn can be physically dependent on a substance and go through withdrawal, but that is not the same as addiction, which is a behavioural condition. Calling these infants “drug-addicted babies” is common in headlines, yet it is inaccurate and adds stigma to families who are often already in treatment.
Opioids are the most frequent cause. They include heroin and prescription painkillers, and also methadone or buprenorphine, the medicines that doctors prescribe to treat opioid use disorder during pregnancy. Staying on those medicines is usually the safer choice for mother and baby, even though the infant may then need help after delivery. Other substances, including some antidepressants, benzodiazepines and alcohol, can produce similar signs.
How common it has become
The rise of NAS in the United States tracks the opioid epidemic. A 2016 report in the CDC’s Morbidity and Mortality Weekly Report noted that national studies found the rate climbing from 1.2 to 5.8 cases per 1,000 hospital births between 2000 and 2012, the roughly 383% increase often quoted in news stories.
The same CDC report looked at hospital data from 28 states and found the rate nearly quadrupled between 1999 and 2013, from 1.5 to 6.0 per 1,000 births. The averages hide huge local differences. In 2013 West Virginia recorded 33.4 cases per 1,000 births, while Hawaii recorded 0.7. Maine, Vermont and West Virginia all passed 30 per 1,000. In some hospitals in hard-hit regions, that means several babies in withdrawal on the ward at any one time.
What withdrawal looks like in a baby
Signs usually appear within one to two days of birth, though with longer-acting drugs they can start as late as five to ten days. Babies with NAS tend to be:
- very irritable, with a high-pitched cry that is hard to soothe
- shaky or stiff, with tremors and overactive reflexes
- poor sleepers and poor feeders, sometimes with vomiting or diarrhoea
- sweaty, sneezy or congested, with fast breathing or a fever
- slow to gain weight; in severe cases they can have seizures
Blotchy skin colouring is another sign that MedlinePlus lists. How severe it gets depends on the drug, how long and how much was used, how premature the baby is, and other factors. Nurses track the symptoms with a scoring tool, most often a modified version of the Finnegan scale, to decide whether a baby needs medicine.
Why holding works: comfort as part of treatment
Before reaching for medication, neonatal teams start with comfort care. Medical references list the same basics: swaddling, a calm and dim room, gentle handling, small frequent feeds, breastfeeding where it is safe, and keeping the baby with the parent (“rooming in”). These steps can lower symptom scores and shorten hospital stays. Babies with severe symptoms still need medicine, usually an opioid such as morphine, methadone or buprenorphine that is tapered off slowly.
The difficulty is time. An unsettled newborn in withdrawal may need to be held for long stretches, around the clock. Parents are the best people to do it and are encouraged to stay. But some cannot be there all day. They may have other children, a job, their own treatment appointments, or a long journey to the hospital. Nurses, meanwhile, are caring for several patients at once.
That is the gap volunteer cuddlers fill. Nurse Jane Cavanaugh, who set up a programme at Thomas Jefferson University Hospital in Philadelphia, put the need simply: these babies “need human touch.” Maribeth McLaughlin, chief nursing officer at Magee-Womens Hospital of UPMC in Pittsburgh, said infants who are held regularly in her hospital’s programme tended to need less medication and went home sooner. Speaking to Today.com, she described the work as “swaddling them and giving them that comfort and safe, secure feeling.”
Those are observations from nurses rather than results from a controlled trial, and they should be read that way. Still, they fit the wider research: in recent years many hospitals have shifted towards care models that put soothing, feeding and parental presence first, and they report shorter stays with fewer babies needing medication.
What a cuddler volunteer actually does
Programmes differ between hospitals, but a few features are common:
- Screening. Expect an application, an interview, a background check and proof of vaccinations, often including the flu jab and whooping cough.
- Training. Volunteers learn hand hygiene, safe holding and swaddling, how to read a baby’s cues, and when to call a nurse.
- Commitment. Many hospitals ask for a regular shift, such as two to four hours a week for at least six months, because consistency matters on a busy ward.
- Boundaries. Cuddlers do not feed, change or treat babies unless trained to, and they do not discuss a family’s situation outside the hospital. Privacy rules apply.
- Health. Anyone with a cold, cough or other infection stays home.
Some programmes also have waiting lists, because these roles are popular. Retired nurses and teachers, grandparents and students make up a large share of volunteers in many hospitals.
Common myths about NAS and baby cuddling
“Cuddling cures withdrawal.” It does not. Holding is part of comfort care that can ease symptoms, but babies with severe withdrawal still need monitoring and sometimes medicine, decided by their medical team.
“These babies are permanently damaged.” Withdrawal is temporary. Long-term outcomes vary and are shaped heavily by the home environment, support and follow-up care. Stigma does not help any of that.
“It’s a paid job.” Viral posts have sometimes framed it as a hiring call. In almost every case it is unpaid volunteering through a hospital’s volunteer office.
“The volunteers replace the parents.” The aim is the opposite. Good programmes support parents to be with their baby as much as possible and step in only when they cannot be there.
How to find a programme near you
Start with the volunteer services office of hospitals that have a neonatal intensive care unit or a special care nursery. Ask whether they have a cuddler, “baby holder” or “comfort care” volunteer role, what training is needed, and how long the wait is. If there is no programme yet, ask whether the nursing team would welcome one; several of the best-known programmes began because one nurse saw the need and pitched it to her hospital.
If you are a parent-to-be who takes opioids or a medicine for opioid use disorder, talk to your doctor or midwife before delivery. They can explain what to expect, how you can be part of your baby’s comfort care, and what support is available.
Sources: CDC MMWR, “Incidence of Neonatal Abstinence Syndrome — 28 States, 1999–2013” (2016); MedlinePlus: Neonatal abstinence syndrome; Wikipedia: Neonatal withdrawal. Quotes from Jane Cavanaugh and Maribeth McLaughlin as reported by Today.com and Good Housekeeping.
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