Doctors Rethink Treatment For Babies Born With Opioid Dependencies

For decades, the common practice of treating babies born with opioid dependencies — known as neonatal abstinence syndrome formally — involved separating the infant from their mother immediately, and transferring them to neonatal intensive care. And, as part of this treatment, newborns would often not be comforted as they recovered under the light of the NICU warmer. But as the country continues to grapple with an opioid epidemic affecting all populations, doctors are now rethinking their approach to treatment for babies born dependent on opioids. And it's an important step forward for the one out of every 50 newborns who has neonatal abstinence syndrome, as recent data found.

The emerging idea is that, rather than taking infants away from their mothers, they should instead be kept together so that babies can be consoled as they experience symptoms of withdrawal — muscle clenching, sleep troubles, inconsolable screaming — according to NPR. At the same, the newborns would be given opioids in doses that decrease gradually in order to ease withdrawal until they can be weaned off of them, which a JAMA Pediatrics study published in April found to be more effective than the current standard practice of placing babies in NICU, NPR reported.

And there is one physician who is leading the charge, according to NPR: Dr. Jodi Jackson, a neonatologist at Children's Mercy Hospital in Kansas City, Missouri. Jackson is spearheading a statewide effort in Kansas to get hospitals to implement this new approach in treatment opioid dependency in newborns, NPR reported. She told the outlet of her work:

What happened 10, 15 years ago, is [drug dependent] babies were immediately removed from the mom, and they were put in an ICU warmer with bright lights with nobody holding them. Of course, they are going to be upset about that! And so the risk of withdrawal is much higher.

Touch — and skin-to-skin contact, more generally — has been shown to have a tremendous effect on a baby's growth, development, and well-being. A study published last year in the journal Development and Psychopathology found infants who are held and cuddled less show genes that are considered underdeveloped for their age. And another 2017 study out of the Nationwide Children's Hospital in Ohio discovered that early displays of affection can boost a baby's brain responses.

Although the needs of newborns with neonatal abstinence syndrome are complex, it's not surprising that incorporating touch — in particular, their mother's touch — would make treatment more effective. Babies would become healthier more quickly because they have someone giving them comfort.

But taking a "low-tech, high-touch" approach to treatment isn't only beneficial to infants born dependent on opioids. It helps mothers, too.

Recent data published by the U.S. Centers for Disease Control and Prevention show that the rate of pregnant women with opioid use disorders has more than quadrupled between 1999 and 2014. Many of those women enter recovery either during pregnancy or right after birth, and have to manage their own treatment. But taking away their children makes that process more difficult.

The new approach to treatment, though, would allow mothers and their babies to build a loving bond as they both recover, according to NPR. And there's science to back that up: Studies show that kangaroo care promotes secure attachment, as well as eases maternal anxiety, Motherly reported. Although the needs of the mother, like their infant, are more complex, adding touch can only bolster their treatment and recovery, not hinder it.

Getting hospitals to change to this new approach will take a lot of time and education, as NPR has noted. But it's worth making the effort — for mother and child.