It wasn’t that long ago that babies born dependent on opioids or narcotics would spend weeks crying in a hospital nursery without their mother nearby as they suffered through the symptoms of withdrawal.
“Our nurses would do their best (to hold the babies), but they have other duties as well,” said Dr. Tiffany LaBella, chief of pediatrics at Bristol Hospital. “It’s very frustrating when you have babies in the hospital for a long period.”
But a new protocol developed by doctors at Yale-New Haven Hospital has changed all that, now giving the babies and their families a better start in life as their mothers work toward recovery.
“I think it’s been life-changing for these babies compared to the old way,” LaBella said. “This is a game changer.”
Since November when Bristol Hospital staff attended training in the Yale-New Haven method, nine babies born dependent on opioids or narcotics have successfully been released from the hospital in five to seven days of their birth. The Hospital of Central Connecticut, New Britain Campus, has employed a similar method for a few years in their Neonatal Abstinence Syndrome program with equally successful results, said Dr. Ann Marie Golioto, chief of pediatrics and director of the Neonatal Intensive Care Unit and Newborn Nursery at HOCC.
“We used to see our jobs as protecting this baby from its mother who had harmed them by being addicted,” Golioto said. “We learned that that’s not the right approach. We certainly weren’t helping the situation and it was causing moms to lose the incentive to get healthy. We now see mom as a traumatized patient who needs help. Doing it this way empowers her to seek treatment for herself.”
Both hospitals report that the number of babies born dependent in their maternity wards has about doubled in the past five years as increasing opioid addiction has become a national crisis. HOCC sees about 40 opioid or narcotic dependent newborns a year. Bristol Hospital has had between 15 and 17 a year, over the past few years, LaBella said.
“We’re seeing a lot more,” Golioto said. “But we’re seeing a change in the type of patients. Previously we were looking for the ‘traditional’ IV (intravenous) drug using. Now it’s more prescription pills. We also are looking for heroin and Methadone. We have moms who come in and say ‘I take Percoset every day for my back pain’ without realizing that will also impact the baby.”
Many of the maternity patients interviewed by HOCC social worker Sarah Benham say they started on prescription drugs and moved on to illegal drugs to deal with their addiction. The regulated use of Methadone, a drug used to manage opioid addiction, will also impact a newborn, causing the baby to feel withdrawal symptoms after it’s born.
The most important thing a mother who is in a Methadone program, or addicted to opioids or narcotics, can do is be honest with their OB/GYN so the hospital can prepare for the birth, Golioto said. “There is help available and this is not something you want to keep from your health provider,” she said. “Please tell your OB/GYN so we can help during the pregnancy.”
Prior to a few years ago, the staffs at HOCC and Bristol Hospital handled the birth of an opioid or narcotic dependant newborn by gradually weaning the baby from the drugs with medication. “The second we started giving medication for withdrawal, we’d be administering 100 to 120 doses slowly weaning them off,” LaBella said.
The process could take four to six weeks and leave the baby crying continuously as they suffer through withdrawal. The protocol would often require mothers to be discharged weeks before the child, leaving her without the skills to care for a baby when the newborn was finally released, LaBella and Golioto said.
HOCC does not automatically alert the state Department of Children and Families if the mother is in a tightly regulated Methadone program working on recovery and showing good parenting skills, Benham said. Bristol Hospital does routinely notify DCF of the birth but in most instances, the cases are closed without serious intervention if the mother is doing what is required to maintain a safe environment for the baby, LaBella said.
Under the new protocol both hospitals have adopted, mother and child are placed in a private room with low noise and low lighting providing plenty of opportunities for skin-to-skin contact and breastfeeding, which is not only nutritional but can take the edge off withdrawal symptoms in the newborn.
If a mother is still actively using illegal drugs, the case must be assessed and it is likely that breast feeding will not be allowed. But in most instances, the new protocol has worked wonders to provide the baby with a good start in life, both doctors said.
“I think it has been amazing,” LaBella said. “It’s changed the way that all of our staff and the families dealt with this. It’s totally life changing for the baby.”
Lisa Backus can be reached at 860-801-5066 or Lbackus@centralctcommunications.com.