Number of Pennsylvania babies treated for drug exposure levels off, report shows
After spiking for more than a decade, the rate of Pennsylvania newborns hospitalized for drug withdrawal at birth leveled off and remained stable for the last two years, a new report reveals.
The report from the Pennsylvania Health Care Cost Containment Council said Pennsylvania babies were hospitalized for Neonatal Abstinence Syndrome, or NAS, 1,833 times last year. That’s down slightly from 1,912 NAS hospital admissions the prior year.
Experts say NAS babies are more likely to be premature, have low birth weight and experience trouble breathing, feeding and sleeping.
This year’s report put the rate of hospitalizations for such infants at 14.4 per 1,000 Pennsylvania newborns. That’s a dramatic increase from 1.2 per 1,000 newborns in 2000, but still slightly lower than last year’s rate of 15 babies per 1,000.
Much of the increase in NAS over the past two decades is fallout from the opioid epidemic.
Experts say the good news is they’ve learned how to help mitigate the impact of drug exposure among infants.
Dr. Andrea Willeitner, a neonatologist at Excela Westmoreland Hospital in Greensburg, said the facility routinely screens new mothers for drugs.
“Often if the mothers are on Subutex or methadone (addiction treatment medication) we know about that, and if something pops up on the screen we monitor the babies. Not every baby that has been exposed needs pharmacological treatment. It depends on the variety of medication, the dose and genetic factors. Today, I think only a minority of babies who are exposed in the womb need hospital treatment for withdrawal,” she said.
Doctors have found that whenever possible, mothers are the best treatment available.
Willeitner said Westmoreland Hospital will provide a room for mothers who have been medically discharged so they can stay with their babies and breast feed them until the infants are ready to be sent home.
“We made the mother a part of the care team rather than an outsider,” Willeitner said. “It used to be we’d let the mother go home on the second day and keep the babies. But those babies were more inconsolable for not having the mother here.”
Dr. Giovanni Laneri is a neonatologist at Allegheny Health Network’s West Penn Hospital, where he has been on staff for nearly three decades. He said doctors have found NAS babies respond best when mothers breast feed.
It may be the skin-to-skin contact, eye contact or even the small amount of drug that is passed through the breast milk, but he said it helps soothe NAS babies.
Laneri said the importance of hands-on care and human contact is evident in the fact that nearly every hospital now provides teams of “cuddlers,” specially trained volunteers who will step in to rock and hold babies whose mothers can’t be present for one reason or another.
Willeitner and Laneri said babies exposed to opioids can do well and often can avoid any kind of drug treatment if a mother’s addiction is being managed with Subutex or methadone and there are no other aggravating factors, such as smoking or other drugs or alcohol use.
“We used to treat 80% of all babies exposed to opioids with medication. Today in our institutions, less than half of the babies exposed are being treated with medication,” Laneri said.
In addition to providing a soothing environment, devoid of loud noises, West Penn has been turning to infant massage, Laneri said.
“It has long been practiced in the Middle East and India. We’re beginning to use it on infants with neonatal abstinence syndrome. It’s very influential in calming the babies and helping them with sleep and digestion,” he said.
He said West Penn has reduced the average stay for babies with NAS to about 10 days. That is well below the statewide average of 15.9 days for such infants.
Willeitner said NAS babies are benefiting from a return to time-tested wisdom about infant care.
“You’d think it would be commonsense, but it took the medical community quite a while to find the most effective way to care for these babies,” she said.
Even so, officials say the number of infants born with NAS and the cost of treatment is troubling.
“While the rates might be leveling off, and that is encouraging, it is too soon to tell whether these numbers will begin to steadily decline or spike upward again. Still, with just over 1,800 babies born addicted in the most recent year studied, this remains a serious and heart-wrenching problem,” said Joe Martin, executive director of the Pennsylvania Health Care Cost Containment Council.
Deb Erdley is a Tribune-Review staff writer. You can contact Deb at 724-850-1209, [email protected] or via Twitter .