For Babies Born Addicted to Opioids, Doctors Try New Caregiving Approach

Now doctors have a new treatment: Mom. Doctors and researchers are encouraging parents to soothe their newborns as they shed their dependence on opioids, and using morphine as a last resort.

The number of newborns in opioid withdrawal has risen in recent years as illicit fentanyl has supercharged the potency of the illicit drug market. About six in 1,000 babies have been born drug-dependent in each year since 2017, according to an analysis from healthcare-data company Truveta. The rate in 2009 was half that, federal data show. 

“The patients seem to be sicker,” Dennis Hand, an associate professor of obstetrics, gynecology and psychiatry at Thomas Jefferson University in Philadelphia, said. “They’re using more potent drugs with fentanyl.” 

In the world of illicit-drug treatment, caring for mothers using opioids and their babies is particularly fraught. The 2021 National Survey on Drug Use and Health conducted by the Substance Abuse and Mental Health Services Administration indicated that nearly 8% of pregnant women among the 60,000 respondents overall had used illicit drugs in the past month and some 1% of pregnant women had taken illicit opioids. 

The American College of Obstetricians and Gynecologists and the World Health Organization recommend treatment medications over detoxification for pregnant women addicted to opioids, because quitting increases the risk of relapse and deadly overdoses. Some public-health officials want to protect infants from the harmful effects of opioids without deterring moms from seeking prenatal care and addiction treatment. Many states require that mothers who test positive for opioids be reported to child services.

“These policies really create a lot of fear,” said Anna Austin, an assistant professor at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill.

Doctors have used a 21-item scoring system to decide whether to treat newborns for opioid withdrawal, typically by tapering morphine or methadone doses over days. Matthew Grossman,

“Treat the baby like a baby,” Dr. Grossman said. 

The system called “Eat, Sleep, Console,” simplifies the assessment for newborns to three items—whether they are sleeping, feeding and can be consoled quickly—and raises the bar for administering opioids. To soothe upset babies, caregivers are encouraged to try things such as swaddling, dimming the lights and skin-to-skin contact.  

The system reduced the average hospital stay for babies from 22 days to six days, and the share of newborns of mothers on opioids being treated with morphine dropped to 14% from 98%, according to findings from 287 infants published in 2017 in the journal Pediatrics. 

“Mom is the treatment,” Dr. Grossman said. “Treat the mom with the same respect you would any other mom.”  

The practice has caught on across the country. Hushabye Nursery in Phoenix has followed the Eat, Sleep, Console method since 2020 and houses parents with babies going through withdrawal. Most moms stay about a week, said Michael White, Hushabye’s director of community programs.

Queeon Hamilton came to Hushabye in 2021, ahead of the birth of her fifth child. She was six months pregnant and addicted to opioids when a medical emergency landed her in a treatment facility where she learned about Hushabye. Staff at Hushabye helped her prepare a binder of paperwork to present at the hospital when she was admitted to give birth, demonstrating that she was taking anti-addiction drugs that are opioids. 

The day after her daughter Tiye was born in a Phoenix hospital, Ms. Hamilton, 39 years old, called child protective services, pre-empting the report she knew the hospital would make of a child born in withdrawal. She and her newborn stayed at Hushabye for eight days while her baby experienced withdrawal symptoms including irritability and rapid breathing. 

“They let me be a mom,” she said.

Write to Julie Wernau at [email protected]