WVU Medicine is working on protocols for babies exposed to opioids

“In a report by the Centers for Disease Control put out last week, there were 33.4 cases of NAS per 1,000 hospital births in West Virginia in 2013,” said Laura Lander, a licensed social worker at Chestnut Ridge, which is part of WVU Medicine. “That’s up from .5 per 1,000 births in the state in 2000.”

“The media uses the term ‘addicted’ when describing these babies, which is misleading,” Lander said. “Babies don’t have the developmental capacity for compulsive behavior and obsessive thinking about drugs. They are born exposed to substances, develop a physical dependence and have withdrawal symptoms.”

WVU Medicine is in the process of developing a treatment protocol to identify babies at risk, which includes screening mothers during pregnancy and developing guidelines to treat babies without having to keep them in the hospital unnecessarily long, Lander said.

Courtney Sweet, a neonatal clinical pharmacy specialist at WVU Medicine, provided details on the treatment of NAS.

“We do a universal screening of moms who deliver at Ruby and a screening of babies born at Ruby,” Sweet said. “When the babies are at risk, we monitor them for five days, watch for symptoms and so we can send them home safely.

“If they are going through withdrawals, we do a non-pharmacologic treatment that involves putting them in an environment low in stimulus and teach their mothers coping mechanisms like swaddling. If that isn’t effective, we give them low doses of morphine and taper them off the drug before sending them home.”

Exposed babies experience withdrawal symptoms for as little as a few weeks to as long as eight to nine months in the most extreme cases, Sweet said.

“All hospitals do it differently, so we’re developing a standard protocol to diagnose, assess and treat babies with NAS,” Lander said. “To make the protocol standardized across the state.”

WVU School of Medicine is involved in a research study with Marshall University to examine genetic markers for neonatal abstinence syndrome, Lander said.

“We’re looking at why certain babies go through withdrawal and some do not,” said Sean Loudin, assistant professor in the Department of Pediatrics in Marshall’s Joan C. Edwards School of Medicine.

Loudin is also medical director of the neonatal therapeutic unit at the Hoops Family Children’s Hospital, which is part of Cabell Huntington Hospital. And he’s medical director of Lily’s Place, a residential infant recovery center for babies born drug-exposed.

“Two women can be on the same dose of Subutex; their babies can be delivered at the same weight; and one baby will go through withdrawal; and the other won’t,” Loudin said. “Many factors can come into play, like how the mom metabolizes the drug, how the baby metabolizes the drug, and genetics may play a role.”

Loudin explained that if the research finds a genetic marker which pregnant women can be screened for, doctors will be able to know if a baby is more at risk and potentially come up with interventions before birth, or soon afterward, to try to prevent serious withdrawal.