Originally published 2019-10-19.
Yes, many US hospitals really do recruit volunteer "baby cuddlers." These trained volunteers hold, rock and soothe newborns in neonatal units, very often babies going through withdrawal from opioids they were exposed to before birth. The cuddlers do not replace nurses or medicine. What they offer is the one thing a busy unit cannot always supply around the clock: calm, steady human contact for a baby who is struggling.
The programmes grew quickly during the American opioid epidemic of the 2010s, when the number of babies born dependent on opioids climbed year after year. Below we look at what these babies go through, what volunteers actually do, what the research says about soothing care, and how you could become a cuddler yourself.
What neonatal abstinence syndrome is
Neonatal abstinence syndrome (NAS) is the name doctors give to the withdrawal a newborn goes through when a drug it was exposed to in the womb is suddenly no longer there. When opioids are the cause, which is the most common situation, it is also called neonatal opioid withdrawal syndrome (NOWS). The mother may have been taking prescribed pain medication, a treatment such as methadone or buprenorphine, or illicit drugs; the baby's body adapts to the drug either way, and birth cuts off the supply.
Signs usually appear within 24 to 48 hours of birth, though with some drugs they can start as late as five to ten days. Typical symptoms include:
- tremors, stiff muscles and overactive reflexes;
- a shrill, high-pitched cry that is hard to settle;
- trouble sleeping and feeding, poor weight gain;
- vomiting, diarrhoea, sweating and an unstable temperature;
- in more severe cases, seizures.
Volunteers who have held many of these infants say they come to recognise that distinctive cry almost at once.
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How big the problem became
The statistic most often repeated in news coverage comes from the US National Institute on Drug Abuse (NIDA): in 2014, roughly one baby was born suffering from opioid withdrawal about every 15 minutes in the United States. NIDA's figures put the total at around 32,000 babies that year, a rate of 8.0 per 1,000 hospital births, up from 1.5 per 1,000 in 2004. Treating them cost an estimated $563 million in 2014, most of it paid by state Medicaid programmes.
Later federal data showed the rise continuing: the CDC reported an 82% national increase in NAS births between 2010 and 2017, to 7.3 per 1,000 hospital births, and rates varied hugely between states. Many of these babies spend days or weeks in a neonatal intensive care unit (NICU), some of them also born early or underweight. That is the setting in which hospitals started asking the public for help.
What a baby cuddler actually does
The job is simple to describe and harder to do well. A cuddler sits with a baby, usually in a quiet corner of the unit or beside the crib, and holds it skin to clothing for a shift that might last a couple of hours. The aim is to lower stimulation, not add to it: low voices, dim surroundings, slow movement. A volunteer quoted in a 2019 report from a North Dakota NICU put it plainly, saying cuddlers try to keep the noise down and avoid rocking babies too much.
Volunteers typically:
- hold and gently soothe babies whose parents cannot be there at that moment;
- swaddle and settle infants under nurses' direction;
- follow strict hand-hygiene and infection-control rules;
- tell staff immediately if a baby seems unwell, rather than trying to handle it themselves.
It matters that parents come first. Good programmes make clear that cuddlers fill gaps when a mother or father is away, for work, other children or their own recovery, and step back the moment family arrives.
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The volunteers behind the programmes
The people who sign up tend to be patient, steady and often retired. In 2019, Iowa station KCCI reported on the Cuddler Volunteer programme at Blank Children's Hospital in Des Moines, where a retired nurse, Vicki Agnitsch, was reportedly one of about 22 volunteers. Her nursing background gave her a clear sense of how much warmth and touch matter to infants in intensive care.
At University Hospital in San Antonio, Texas, news reports from the same period described Doug Walters, an Army veteran and retired software engineer, who had reportedly spent more than three years holding babies on the unit. Through that time he became familiar with the full range of NAS symptoms, from rigid limbs and tremors to feeding problems, and learned to pick out the withdrawal cry. San Antonio was one of several hospitals that publicly appealed for more volunteers as demand grew.
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Does cuddling really help? What the research says
Volunteers are part of a bigger shift in how hospitals care for opioid-exposed newborns. For years, many babies were scored on long symptom checklists and given opioid medication, such as morphine or methadone, which was then slowly tapered. Medication still has a clear role for severe withdrawal. But doctors increasingly start with non-drug care: swaddling, a quiet environment, feeding on demand, breastfeeding where it is safe, and keeping babies in the same room as their parents.
The strongest evidence so far comes from the ESC-NOW trial, published in the New England Journal of Medicine in 2023 and led by Leslie W. Young of the University of Vermont. It tested an approach called Eat, Sleep, Console, which judges a baby mainly on whether it can feed, sleep and be comforted, and puts parents at the centre of soothing. Across 26 US hospitals and 1,305 newborns:
- average hospital stay fell from about 14.0 days to 7.8 days;
- only 19.5% of babies in the Eat, Sleep, Console group needed opioid treatment, compared with 52% under usual care;
- safety outcomes up to three months of age were similar in both groups.
That trial did not test volunteers specifically. Its message is that consistent comforting is real medical care, not just kindness, and cuddlers help supply it when parents cannot be at the bedside.
Common myths about cuddler programmes
"Anyone can walk in and hold babies"
No. Hospitals usually require an application, background checks, health screening and up-to-date vaccinations, followed by training on infection control, safe holding and the unit's rules. Waiting lists are common, and some programmes ask for a regular weekly commitment.
"These babies are addicted and will grow up addicted"
A newborn with NAS is physically dependent on a substance, which is not the same as addiction. With good care, withdrawal symptoms ease, and how a child develops depends on many factors, including the support the family gets afterwards.
"Cuddling replaces treatment"
It does not. Cuddling works alongside clinical care under nurses' supervision. Decisions about medication and monitoring stay with the medical team, and any parent with questions about a baby's withdrawal should talk to a doctor.
How to become a volunteer cuddler
If you want to help, start with the volunteer office of a children's hospital or a large regional hospital with a NICU near you. Ask whether it runs a cuddler or infant-comfort programme, what the training involves and how long the wait is. Expect to commit to regular shifts and to follow the unit's rules exactly, and if a hospital has no opening, ask about other roles that support families, such as helping in parent lounges or with family support services.
Sources: NIDA: Dramatic increases in maternal opioid use and neonatal abstinence syndrome; Wikipedia: Neonatal withdrawal; Patient Care: Eat, Sleep, Console reduces hospital stay and medication use (ESC-NOW trial, NEJM 2023); KX News: Opioid crisis leads to need for baby cuddlers; original 2019 reporting by KCCI News (Des Moines). Photos: Getty Images.
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