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Protecting the littlest victims of the opioid crisis

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Posted June 6, 2018

Once you see these babies in person, you can understand how hard it is to watch them suffer,” says Susan Cacciavillano, clinical manager of Chester County Hospital’s neonatal intensive care unit and pediatrics department.

The babies she’s referring to are those born with Neonatal Abstinence Syndrome, or NAS, a group of problems that occur in a newborn who has been exposed to an addictive substance in the mother’s womb, most commonly opioids. These infants can have tremors and be inconsolable; “frantic,” as Cacciavillano describes it. “They rub their wrists and legs together, which breaks down the skin,” she says. “There’s also skin breakdown on their backsides because their stools are very acidic.”

Each time the opioid epidemic in the United States is quantified, the figures are staggering. Less than two years ago, the Pennsylvania Health Care Cost Containment Council reported that the rate of newborn hospital stays for substance abuse problems increased 250 percent between 2000 and 2015, when nearly 20 out of every 1,000 newborns faced withdrawal issues. And maternal hospitalizations involving opioids increased 510 percent over the same period.

The latest news may be the most heartbreaking yet: On average, a baby is born in withdrawal from opioids every 15 minutes in the U.S., according to recent research.

Over the last five years, an average of 32 babies with NAS have been born each year at Chester County Hospital (CCH). “At any given time, there’s a baby in the NICU going through withdrawal,” Cacciavillano says. “We have one patient now, but we’ve had as many as four or five at once. A few years ago, we could go a couple of months without seeing one. Now, if a day passes without one, it’s unusual.”

In response to the surging opioid epidemic, which is widely believed to be years from peaking, hospitals across Penn Medicine are developing protocols to improve the continuum of care for expectant moms with substance abuse issues, and newborns with NAS.

Source: Princeton University

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