Penn Medicine Lancaster General Health’s Women & Babies Hospital is using a new, evidence-based approach to help babies born with addiction manage withdrawal, and it’s yielding significant outcomes. When a mother uses substances during pregnancy, her baby may become addicted and begin withdrawal upon birth – a condition called neonatal abstinence syndrome (NAS).
This includes babies born to mothers who are “clean” and being treated with medication-assisted treatment such as methadone. Traditionally, NAS babies are assessed against a list of clinical criteria to determine if they need help managing symptoms, which can include extreme irritability, tremors, vomiting, fever and diarrhea. Babies who fail these checks are moved from the well-nursery to the Neonatal Intensive Care Unit (NICU) and given controlled doses of morphine.
The new program, Eat, Sleep, Console, is a simplified approach to monitoring and treating newborns with NAS. Nurses in the Couplet Care Unit teach the mother and her support person how to manage symptoms by comforting the baby, which can reduce the need for medical intervention.
“We look at whether the baby is able to eat, sleep and be consoled. If any of these are being impacted by withdrawal, we encourage the mother to try methods like skin-to-skin contact, frequent nursing, and holding her baby in a quiet room with low light,” explained Alyssa Livengood Waite, MHA, MSN, RN, director of nursing, Women & Babies Hospital.
“It sounds counterintuitive, but sometimes NAS babies need a bit of medication to help them over the hump. They will still need to go through a carefully monitored withdrawal,” Livengood Waite said.
The goal of Eat, Sleep, Console is to avoid separating mom and baby with a NICU stay and having to administer morphine. Prior to introducing the program in February 2021, 51% of NAS newborns at Women & Babies Hospital were admitted to the NICU. As of September, it’s dropped to 18%.
The hospital was recently awarded $15,000 by the Jewish Healthcare Foundation for reaching program milestones established by the Pennsylvania Perinatal Quality Collaborative, an initiative to improve the identification and care of mothers and babies affected by NAS and Opioid Use Disorder. The funding will help offset costs and support future efforts.
Multidisciplinary leadership behind Eat, Sleep, Console is preparing to roll out the next phase of the program early this year by training the NICU staff to follow these same protocols.