Opioids taking greater toll on NICU newborns
One in five show withdrawal signs as use among expectant moms rises
Twenty per cent of the 294 medically fragile newborns admitted into Windsor’s neonatal intensive care unit last year were suffering withdrawal symptoms because their mothers were taking opioids while pregnant.
It’s a concerning number that’s rising annually, according to the NICU’s medical director, Dr. Godfrey Bacheyie. It’s also yet another sign of the rampant local use of oxycodone, fentanyl and other narcotics, and their terrible effects.
Last week, the Windsor Essex County Health Unit reported that the opioid-related death rate here was more than double the provincial average in 2015 and near-triple the number from just eight years earlier. A provincial report in November indicated this region has the seventh highest rate of opioid use out of 49 counties, beaten only by a few counties in the north, Brant County and Niagara. Also in November, addiction nurses who counsel kids in area high schools said opioid use by teens had reached epidemic proportions.
Bacheyie said in the years after he founded the NICU in the early 1980s, “if we saw a baby with opiate withdrawal symptoms, it would be once or twice a year.”
The number in 2016 was close to 60, not including the nine newborns with mild symptoms who didn’t need admission to the NICU. The severity of withdrawal symptoms ranges, depending on whether the mother took opioids throughout the pregnancy, how much she took and how frequently, Bacheyie said Wednesday as the NICU announced a new program — enlisting volunteers to snuggle with NICU newborns — that will be especially helpful to babies suffering withdrawal.
Bacheyie said the babies with the worst symptoms are basically drugged throughout the pregnancy. “The symptoms can be very severe,” he said.
“They’re very tense, irritable, difficult to settle, due to the irritation of their brain because the medication affects their brain while in the womb.”
In the worst cases, babies have convulsions, feeding problems, elevated heart rate, vomiting and diarrhea that gets so bad their bottoms suffer from exfoliation requiring pastes and medication. Bacheyie, a pediatrician, said the new cuddling program will help all babies who don’t get much physical contact with their parents. But the benefit will be “much more so” for opiate withdrawal babies.
“If it is keeping them quiet, cuddled, touched, rocked, spoken to, it calms them down and reduces the chance you need drugs,” to treat the withdrawal symptoms, he said.
He said the mothers of these opioid-addicted babies can be categorized into several categories. Some are legitimately taking prescription medication for pain, and are usually on-hand in the NICU holding and helping to care for their babies. Others have addiction problems and are taking opioids illegally, and are often not as available.
And others have lost their babies, with the Children’s Aid Society taking custody with an expectation that the babies will end up in foster care.
There are also mothers who are taking opioid-based drugs like methadone to treat their opioid addictions. Their babies can still end up with withdrawal symptoms, said Bacheyie.
The new volunteers will come in and cuddle with a newborn — only with the parents’ consent — if parents aren’t available and nurses are too busy, said Josie Piazza, the unit’s clinical practice co-ordinator. The mom may be very ill, there may be transportation or work issues preventing the dad from being there, or the dad may have to stay home to take care of their older children.
The new cuddling program augments the NICU’s Kangaroo Care program, which encourages both mom and dad to go shirtless to snuggle their newborns for maximum skin-to-skin contact. The long list of well-researched benefits include reduced stress and crying, and better regulated temperature, breathing, blood pressure and heart rate.
Heather Ryan, the NICU program manager for Windsor Regional Hospital, said the volunteers could sit in a rocking chair with an infant, rocking and singing, for a couple of hours.
“You can imagine if (the baby) is in a crib and crying, all those vital signs escalate, so when you hold them they go right down,” she said of the idea, proposed by NICU nurse Anne Trepanier who read research about the benefits. It’s an idea that’s being embraced by NICUs across the country.
“Just rocking an infant in your arms, singing softly and cuddling them with warmth and tenderness goes a long way in nurturing the child during early stages of life,” WRH director of women’s and children’s services Deb Parent said in a news release.
The volunteers are being selected to form a very small roster of NICU cuddlers. They’ll need to go through a health screening, police background check, interviews and training. Two longtime NICU volunteers who are already chosen for the team, Marie Anne Sasso and Diana Learn, said they’re excited about their new role.
“I think it’s kind of in our nature as mothers and grandmothers to nurture,” said Sasso, whose current volunteer work involves helping with laundry and running various errands. Her grandchildren are now too old for cuddling, so she misses that physical contact.
“It’s just a special feeling about holding a newborn baby and being a service to others,” she said.
Every baby, every person, needs a hug, a touch, said Bacheyie, patting a reporter on the shoulder. “Didn’t you feel good when I touched you? It is very important.”