How The Opioid Epidemic Has Changed Care For Newborns With Withdrawal Symptoms

August 29, 2016

The national opioid epidemic’s effects are most often measured in number of deaths.

More Americans, in fact, now die from drug overdoses than in car accidents. And drug-related deaths now approach the death rates of the AIDS epidemic in the 1990s.

But in neonatal intensive care units at hospitals across the country, the influences of opioid addiction are similarly evident in more and more births — every 25 minutes, says the National Institute on Drug Abuse, a baby is born with opioid withdrawal. The number of such births increased 400 percent between 1999 and 2013: These latest figures, released this month by the Centers for Disease Control and Prevention, reflect a new reality in the treatment of babies born with what is known as neonatal abstinence syndrome.

At the Hospital of Central Connecticut and MidState Medical Center, for instance, nursing teams in January upended traditional care for babies born with withdrawal symptoms in what has become Hartford HealthCare’s“Neonatal Abstinence Syndrome – You and Your Baby” program. Where babies who once required medication treatment would remain in the hospital while the mothers were discharged – separated from their child, often feeling guilt and shame – mother and child now remain at the hospital, together, for up to seven days. Research has shown that babies who receive this treatment and support fare better and go home sooner.

“Rooming-in and skin-to-skin has shown to reduce the need for medication and decrease babies’ symptoms,” says Kate Sims, director of Women & Infant Services for Hartford HealthCare’s Central Region. “It also helps provide a low-stimulation environment while promoting bonding and confidence among Moms.”
Neonatal abstinence syndrome cases in Connecticut hospitals almost tripled from 2003 (137) to 2014 (384), according to a state Department of Public Health study released in May. The DPH, in assessing the economic impact, listed the average hospital stay of a newborn with neonatal abstinence syndrome at 15.8 days at a median cost of $13,421 and total cost of $8.7 million. (The average newborn stays 3.8 days at the hospital at a median cost of $1,862.) From 2005 through 2014, says the DPH, care costs for 83 percent of infants hospitalized with neonatal abstinence syndrome were covered by Medicaid.

At the Hospital of Central Connecticut, where 41 patients have taken advantage of the program, the average stay for all babies in this category has decreased to 15.15 days from 18.86 days. For babies not receiving medication, the average stay has decreased to 5.1 days from 6.8 days.
The new care program represents a marked shift in both perception and treatment of addicted mothers and their newborns.

“You know,” Carolyn Rossi, clinical manager of nurseries at The Hospital of Central Connecticut and registered nurse for 27 years, told WNPR’s Jeff Cohen, “we looked at it like, ‘They are drug addicts and the baby is born a drug addict and we’re trying to protect the baby from the mother.’ Like we were going to cure the baby, but not cure the mother and the family. So it was a lot about taking babies away from Moms.”
Babies born with neonatal abstinence syndrome are often hyper-responsive, irritable, shake a lot, have difficult sleeping and feeding, experience diarrhea, sweating and, later, growth problems.

“These babies require more nursing care and we do a lot of teaching with the parents,” Sarah Bouchard, nurse manager of the Backus Hospital Birthing Center, told The Day of New London. “These babies need decreased stimuli, low lights, low sound and lots of skin-to-skin contact.”

Now Hartford HealthCare’s program maintains the critical bond between mother and newborn with skin-to-skin, breastfeeding (if not prohibited by doctors), diaper care and recognizing the infant’s daily routine and care needs. A social worker provides support and resources.

“This environment is free from judgment and more conducive to Mom’s recovery,” says Sims.

For more information on Hartford HealthCare’s “Neonatal Abstinence Syndrome – You and Your Baby” program, contact Pam Tempe-Gaffey (860.224.5900, Ext. 2070) at The Hospital of Central Connecticut or click here.

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Hartford HealthCare’s “Neonatal Abstinence Syndrome – You and Your Baby” program
Hospital of Central Connecticut
860.224.5900, Ext. 2070