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Addicted babies
Addicted babies: Babies born dependent on addictive drugs commonly have to spend weeks or months in the neonatal intensive care unit. Video courtesy of Lee Memorial Health System.
Megan Mulholland, a nurse in the NICU's Progressive Care Nursery, soothes a baby with neonatal abstinence syndrome. / news-press.com file photo

Drug-dependent newborns

Neonatal abstinence syndrome can affect newborns whose mothers used drugs containing addictive opiates or substances that mimic its effects. These babies are born chemically dependent on the drugs and, if untreated, will go through the painful effects of withdrawal. Symptoms include tremors, low birth weight, abnormally loud and prolonged crying and difficulty breathing. Long-term effects are unclear.

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The newborn baby lets out a high-pitched wail, all the time twitching uncontrollably in the tiny hospital bassinet — the result of a drug dependency inherited in the womb.

It’s a disturbing scene, taken from a new educational video, that Lee Memorial Health System hopes will be burned in the brains of doctors, pain-pill addicts of child-bearing age and legitimate users of prescription painkillers contemplating pregnancy.

The health system has seen a sharp rise in such cases over the last decade, but this and other public awareness campaigns may be slowing that trend, the organization said Friday.

“I’m actually encouraged that we’re starting to bend the curve,” said Dr. William Liu, medical director of the neonatal intensive care unit at the Golisano Children’s Hospital of Southwest Florida. “I think we’re bending the curve because of a lot of state initiatives. I think this is great.”

In 2012, Lee Memorial hospitals counted 75 newborns with this drug dependency and symptoms of chemical withdrawal – a condition known as neonatal abstinence syndrome. The number was 74 in 2011. The previous two years, the count was 65 and 53, respectively. The year 2005 saw a mere eight cases.

Liu said he believes it’s too early to say the problem is abating. This leveling off may be a temporary statistical anomaly, he said.

Symptoms of the syndrome include prolonged high-pitched crying, tremors, seizures, inability to eat or sleep properly, diarrhea and trouble breathing.

Doctors and nurses here usually wean infants from their dependencies by providing them diminishing doses of morphine and Phenobarbital, painkillers to ease their withdrawal discomfort. Their hospital stays may last weeks or months.

Drug dependency is passed to the infants while they are still in the womb. Commonly, the mothers have used drugs containing opiates or their synthetic equivalents. Many are addicted, though large numbers are taking them on the advice of their doctors.

Once pregnant, women are often discouraged from stopping the drugs cold-turkey because it may lead to a miscarriage. They are often switched to a monitored methadone program, which can also cause this newborn drug dependency.

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Commonly they don’t know the drugs will cause problems for their babies, said Michelle Waddell, director of neonatal services at the Children’s Hospital.

“These women don’t want to harm their babies,” Waddell said. “I believe that from the bottom of my heart.”

Lee Memorial created a task force nearly three years ago to address the problem. Efforts include more educational materials for physicians and patients – largely videos and brochures – and closely tracking the extent of the problem, something many hospital systems still do not do.

A News-Press investigation in December 2010 found that statewide cases of neonatal abstinence syndrome had grown 275 percent, to roughly 1,000, between 2005 and 2009, a figure doctors and social workers said was likely an undercount. In Lee County, cases grew by 650 percent during that time.

But this is not just a Florida problem. The Journal of the American Medical Association reported last year that U.S. cases tripled between 2000 and 2009. That study concluded that 3.4 of every 1,000 U.S. newborn were born drug dependent in 2009.

Aside from the increased incidence the health system has continued to track here, state officials have since formed a task force to help prevent increases in newborn drug dependency.

Its final report issued earlier this month called for more public awareness of the issue, better tracking of the problem, and increased drug testing and treatment for pregnant women.

“I’m really impressed with what we’ve put together,” State Attorney General Pam Bondi told the task force at that Feb. 4 meeting. “I think we can save lives and help keep mothers with their mothers and help keep babies from being born with NAS, neonatal abstinence syndrome.”

Connect with this reporter: @FrankGluck (Twitter)

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