As overdose deaths from fentanyl are soaring across the nation, researchers at Washington State University Spokane are focusing on a new way to help the youngest victims of the opioid crisis — babies going through substance withdrawal after being exposed before birth, a condition known as neonatal abstinence syndrome. Often referred to as NAS, it can cause a wide range of symptoms, including tremors, seizures, poor feeding, and excessive crying. If left untreated, it may have long-term impacts on a child’s mental and behavioral health.
As part of a state-supported pilot project, a team of researchers in the WSU colleges of nursing and medicine will spend the next year studying health outcomes at Maddie’s Place, a newly opened, Spokane-based transitional care nursery that provides care and support for drug-exposed babies and moms.
The only such facility of its kind in the state and one of only a handful in the nation, Maddie’s Place offers an alternative to extending babies’ stay at a hospital neonatal intensive care unit or discharging them to the care of a parent who may not be ready to handle their unique needs.
When babies are given the appropriate treatment and attention right after birth, most do just as well as babies born without drug exposure, said WSU research team member Ekaterina Burduli, an assistant professor in the College of Nursing.
“Babies exposed to opioids in utero tend to do best in low-stimulating, soothing environments where they get to room in and be with mom or a caregiver 24/7,” Burduli said. “Unlike many hospitals, neonatal transitional care nurseries like Maddie’s Place provide that kind of environment, along with specialized attention from trained nurses and wrap-around support for parents who may be struggling with substance use disorder, housing, food, employment, and other needs.”
She said that although some babies may need medications to treat severe withdrawal symptoms, most benefit from non-pharmacological care such as that provided at Maddie’s Place, which involves swaddling, skin-to-skin contact, and feeding on demand.
The researchers’ evaluation of Maddie’s Place will be based on health-related data from medical records of babies and moms, as well as interviews with moms and caregivers about their experiences at the nursery. In addition, the research team will also estimate the prevalence of NAS in Spokane County.
“With the opioid epidemic continuing to increase, we’re going to see more and more babies born with neonatal abstinence syndrome,” said WSU research team leader Celestina Barbosa-Leiker, a professor in the College of Nursing and executive vice chancellor for WSU Spokane. “Having an accurate picture of how common NAS is in this community is an important part of addressing the problem. Given inconsistencies in medical diagnosis codes used for the condition, currently available prevalence statistics are most likely significantly underreporting the number of NAS cases.”
Maddie’s Place CEO Shaun Cross agrees, noting that in its first 15 months of operations the facility treated 60 infants with NAS and received inquiries about another 63. That’s almost three times as many babies as expected based on nationwide prevalence estimates of six babies born with NAS for every 1,000 hospital stays, which Cross said would translate to about 36 newborns with NAS each year for Spokane. He expressed concern that Maddie’s Place may only be aware of a fraction of NAS cases in Spokane.
The WSU study is funded by a $189,496 grant from the Washington Health Care Authority, which is part of a larger package approved by the Washington Legislature and drawn from the state’s opioid settlement funds. That funding package also includes a $5.3 million allocation for Maddie’s Place that is designed to support the facility’s operations for two years while a permanent funding source is sought. Currently, services provided by transitional care nurseries are not reimbursable under Washington’s Medicaid program.