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Hospital helps drug-addicted babies

NTU
Jun. 21, 2013 @ 11:50 PM

HUNTINGTON -- This particular day was a good one in Cabell Huntington Hospital's Neonatal Therapeutic Unit. The low-stimulus, dimly lit environment that is home to as many as 15 drug-exposed newborns at one time was quiet, not always the norm for infants predisposed to crying 12 hours or more a day.

With 75 of every thousand babies delivered at Cabell Huntington Hospital born exposed to drugs or alcohol, the need for adequate facilities to care for them is mounting. Two years ago, officials at the hospital said they noticed the number of substance-abusing mothers increasing, causing an overflow in the hospital's Neonatal Intensive Care Unit after they were delivered. Then, it prompted them to set aside a special unit for the infants struggling with the side effects of withdrawal; now, they are working to expand it.

"The NICU was not, and is not, the right environment for these infants. They need to be in a quiet, darker, secure environment," said Bunny Smith, executive director of the Hoops Family Children's Hospital at Cabell Huntington Hospital. "So we began planning and did a lot of research in preparing for a separate unit, the Neonatal Therapeutic Unit."

The NTU, as they call it, is a 12-bed unit located on the third floor of the hospital, two floors down from the 36-bed NICU. The staff is specially trained, according to professional guidelines and best practices at other facilities, to handle the newborns who exhibit signs of drug withdrawal through disturbed sleep patterns, convulsions, fever, sweating and muscle rigidity, among other complications. They cannot be soothed through traditional channels such as holding or bouncing.

Lori Blackburn, nurse manager of the NICU, said the NTU differs from NICU in its approach to care.

"It's calmer and quieter with low lighting, fewer stimuli," Blackburn said. "We do therapeutic handling that we specially train our staff and volunteers to provide."

Drug-exposed newborns are also upsetting to babies in both the regular nursery and the NICU because of their continued crying. Separating them as much as possible is the ideal solution for everyone involved. It is also a more economical option, with a day's care in the NTU costing about $423, of which Medicaid reimburses $220, according to Smith.

"While the NICU is great for critical care, these babies need specialized care," Blackburn said.

Babies in the NTU are observed for at least five to seven days, according to American Academy of Pediatrics guidelines, and weaned from their withdrawal with appropriate medication. Hospital staff also work on child welfare issues with officials from Child Protective Services.

"Medically speaking, these are normal, full-term babies with the exception of their substance abuse withdrawal from their exposure in their mothers," Smith said. "In the NTU, we can work with the mothers, the fathers, the grandparents to get them ready to take these babies home.

"It's a critical time, when these babies are receiving narcotics, for them to go through the withdrawal process," Smith continued. "We want to get them through that weaning process, observe them, and make sure that infant is ready to leave our facility."

Smith said the staff to newborn ratio in the NTU is 3 to 1, not counting the department's trained volunteers who hold and cuddle the infants when family members aren't available. The NTU also provides access to a variety of support services for families, including security, a strict visiting policy and other resources, as well as ease of access to the NICU if the need arises.

Smith called the issue of drug-exposed infants a "sad, continuing problem" in the Tri-State. Besides Cabell Huntington Hospital's interest, a nonprofit organization called Lily's Place says it is working to establish a pediatric addiction recovery center in Huntington. Cabell Huntington is not affiliated with Lily's Place.

The uptick in babies born addicted in the region has also prompted Cabell Huntington Hospital administration to begin planning for an expanded unit, up to a potential 30 NTU beds. That expansion is set to be completed in the upcoming months.

"All babies are special, but these babies require that extra care," Smith said. "And, we're committed to providing that to them and their families."

Follow H-D reporter Beth Hendricks on Facebook or Twitter @BethHendricksHD.

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