Babies born exposed to drugs experience withdrawal in their first days, leaving them trembling, sleepless and inconsolable. Even a human touch can be painful.
But drug-dependent newborns are arriving in neonatal intensive care units at alarming rates. Intakes have increased nationally more than five-fold since 2000, research shows. It’s not just street drugs; babies exposed to prescription painkillers such as hydrocodone or oxycodone are becoming increasingly common.
Deaconess Hospital officials have watched those numbers climb over the years. So when a Tennessee hospital opened a unit dedicated to babies suffering from drug withdrawal symptoms, hospital officials researched what they needed to open one here.
“We knew we had a need in Eastern Washington,” said Maureen Shogan, a clinical nurse specialist in the neonatal intensive care unit. “We’ve cared for the babies for a number of years in the NICU, but never in a concentrated area.”
The hospital opened Washington’s first neonatal abstinence unit on Oct. 1.
Deaconess treats close to 100 drug-dependent newborns each year, or 29 percent of the newborns brought into its neonatal intensive care unit each year. Providence Sacred Heart Medical Center treats 20 to 25 drug-dependent newborns annually. The hospitals didn’t have an explanation for the disparity.
Only about 30 percent of the babies have been exposed to illicit drugs. The majority have been exposed to prescription painkillers. “We have a huge population of moms who have been taking prescription drugs because of accidents or whatever reason,” said Patrice Sweeny, Deaconess’ NICU director. “There’s a lack of information on what these prescriptions do to babies.”
Not all drug-exposed infants require treatment. Babies born exposed to drugs are evaluated at birth.
The new four-bed unit at Deaconess is dimly lit and only whispering is allowed there. Additional stimuli like unnecessary foot traffic or noise are eliminated. Every space is equipped with a specialized infant swing that moves slowly in a back-and-forth, up-and-down motion while playing soothing nature sounds, such as ocean waves or crickets. It’s all designed to soothe the often-irritable babies.
Nine nurses and three occupational therapists are trained in infant massage, a fairly new procedure that helps calm the infants.
“Massage decreases their heart rate, increases sleep and changes their breathing pattern,” Sweeny said. “After a massage, babies can sleep. Sleep is a huge issue for them.”
The babies are given small doses of morphine or methadone to help with the withdrawal.
“We withdraw them very slowly and carefully so they don’t experience distress,” Shogan said.
Sacred Heart’s NICU team has participated for two years in a clinical quality work group focusing on drug withdrawal in infants, said Jean Kelleher, NICU nurse manager there. The work has looked at treatments, physical environment and the involvement of the mother, she said.
Washington has not established a medical protocol for treating drug-dependent newborns. Shogan sits on a statewide committee working toward a uniform approach.
Deaconess’ new unit offers firsthand research, and she’s already gathering data.
“The goal of this unit is to make the baby’s stays shorter” than the current 30-day average, Shogan said.
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