Improve Care for Babies Born Drug Dependent

From SAFE Solutions
Jump to navigation Jump to search

Introductory Paragraph

Babies who are born with an opioid dependence experience discomfort and trauma. They can scream and cry, have tremors, struggle with eating, and can struggle with being comforted. There are opportunities to help the babies while mothers, and the often overwhelmed and hospital staff that are trying to care for the babies and mothers. New approaches based on recent evidence-based research includes moving from NICU and pharmacology treatment to a mother-centered approach with eat, sleep, console. This approach emphasizes keeping the mother-infant dyad together in a calm setting while encouraging frequent feedings, comforting, and swaddling to treat Neonatal Abstinence Syndrome (NAS).[1]

Key Information

Since the 1970s pharmacology has been the standard for treating babies born drug dependent or with Neo-natal abstinence syndrome (NAS) with a greater severity or exposure. Physicians have utilized methadone or morphine in treatment of NAS born babies.[2] Traditionally infants born with drug dependent have been managed in the NICU to treat due to concerns of complications. The Finnegan Score/Finnegan Tool[3] has dictated the care level for babies born drug dependent.[4]

Treatment of infants showing signs of withdrawal includes supportive care approach to treatment and can include creating a dark and quiet environment, swaddling the infant to improve self-stimulation, and providing frequent feedings to reduce infant stress.

Other strategies include skin-to-skin contact for comfort and promotion of the infant’s attachment to the mother/caregiver, as well as other comforting techniques such as rocking or swaying the infant. Frequent feedings address hydration level. Educating families on methods of care is also important to provide ongoing supportive care of the infant.

Breastfeeding has been proven to also be an effective approach if the mother is receiving medication-assisted treatment and has no other complications that inhibit breastfeeding.

Complications from NAS can include[5]:

  • Low birthweight
  • Jaundice
  • Seizures
  • Sudden infant death syndrome (also called SIDS).
  • Developmental delays
  • Motor problems
  • Behavior and learning problems
  • Speech and language problems
  • Sleep problems
  • Ear infections
  • Vision problems

Recent research has introduced a new approach to treatment of babies born drug dependent - Eat, Sleep, Console- which is a mother-center approach.[6]

  • Eat: Is the baby feeding normally?
  • Sleep: Is the baby able to sleep?
  • Console: Can the baby be consoled within ten minutes of crying?

The Eat, Sleep, Console approach may be used alone or in conjunction with the Finnegan's model for scoring. The simple components of the approach show a decrease in overall length of hospitalization as well as a decrease in need for a pharmacological approach.

Relevant Research

Eat, Sleep, Console Approach: A Family-Centered Model for the Treatment of Neonatal Abstinence Syndrome[7]

A Novel Approach to Assessing Infants With Neonatal Abstinence Syndrome[8]

Impact of Parental Presence at Infants' Bedside on Neonatal Abstinence Syndrome[9]

Implementing the Eat, Sleep, Console Approach for NAS Management: Review of Literature[10]

Impactful Federal, State, and Local Policies

Substance Exposed Infants & States responses to the problem[11]

Available Tools & Resources

Substance Exposed Infants & States Response to the Problem[12]

Opioid-Dependent Newborns Get New Treatment: Mom Instead of Morphine[13]

Women & Infants Clinical Institute- Guide for Eat, Sleep & Console[14]

Webinar- NAS: The Eat, Sleep, Console Approach[15]

Caring for Opioid-Exposed Newborns Using the Eating, Sleeping, Consoling Care Toolkit A Downloadable Guide[16]

Care of the Newborn Exposed to Substances During Pregnancy Practice Resources for Healthcare Providers [17]

Caring For Your Newborn At Risk For Substance Withdrawal with the Eat Sleep Console Method A handout for new parents[18]

Sources

  1. ↑ http://www.advocatedocs.com/wp-content/uploads/2019/07/ESC-CBT.pdf
  2. ↑ https://www.chcf.org/blog/opioid-dependent-newborns-get-new-treatment/
  3. ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5786483/
  4. ↑ https://ncpoep.org/guidance-document/neonatal-abstinence-syndrome-overview/neonatal-abstinence-syndrome-nas/#:~:text=The%20Finnegan%20Neonatal%20Abstinence%20Scoring,Fletcher%20Allan%20Hospital%20of%20Vermont.
  5. ↑ https://www.marchofdimes.org/complications/neonatal-abstinence-syndrome-(nas).aspx#
  6. ↑ https://www.nichq.org/insight/mother-centered-approach-treating-neonatal-abstinence-syndrome
  7. ↑ https://pubmed.ncbi.nlm.nih.gov/30855311/
  8. ↑ https://pubmed.ncbi.nlm.nih.gov/29263121/
  9. ↑ ttps://www.semanticscholar.org/paper/Impact-of-Parental-Presence-at-Infants%27-Bedside-on-Howard-Schiff/9880e862e325f5e443091b2d6961488f65d62ac5
  10. ↑ https://openprairie.sdstate.edu/cgi/viewcontent.cgi?article=1115&context=con_dnp
  11. ↑ https://ncsacw.acf.hhs.gov/files/Substance-Exposed-Infants.pdf
  12. ↑ https://ncsacw.acf.hhs.gov/files/Substance-Exposed-Infants.pdf
  13. ↑ https://www.chcf.org/blog/opioid-dependent-newborns-get-new-treatment/
  14. ↑ https://doh.wa.gov/sites/default/files/legacy/Documents/Pubs/CSH-ESCPlaybookElectronic.pdf
  15. ↑ https://wvperinatal.org/event/webinar-nas-the-eat-sleep-console-approach/
  16. ↑ https://docplayer.net/87738560-Caring-for-opioid-exposed-newborns-using-the-eating-sleeping-consoling-esc-care-tool.html
  17. ↑ http://www.perinatalservicesbc.ca/Documents/Guidelines-Standards/Newborn/Practice%20Resource%20ESC_WEB%202020_11_20.pdf
  18. ↑ https://momsandkidssask.saskhealthauthority.ca/sites/default/files/documents/esc-parent-handout.pdf
Retrieved from "https://yoursafesolutions.us/mediawiki/index.php?title=Improve_Care_for_Babies_Born_Drug_Dependent&oldid=2521"