Caring for the Substance Exposed Newborn at UPMC Magee-Womens in Central Pa.

Babies who are exposed to opiates before they are born will experience withdrawal symptoms after birth. The medical diagnosis for these babies is called Neonatal Opioid Withdrawal Syndrome (NOWS) and requires monitoring in the hospital. The severity of withdrawal symptoms varies for each baby and our goal is to treat each baby and family individually, based on the care they need. Withdrawal symptoms can start any time after your baby is born; they may begin soon after birth or can be delayed for up to five days. We want to make sure your baby can manage their withdrawal symptoms while doing the things newborn babies need to do like eating, gaining weight, and sleeping. In order to make sure your baby can manage their withdrawal symptoms; we will monitor their symptoms closely in the hospital for about five days. The good news is that most babies can get through withdrawal with the love and support of their family. If symptoms of withdrawal become severe, they may need medication added to the other supportive care being given. If your baby is able to eat, sleep well, and be easily consoled in the hospital, they may be discharged in as few as five days. If your baby has severe withdrawal symptoms and needs medication to help them manage their withdrawal, they may need to stay in the hospital a little longer. Every baby is different, we will make sure to include you in decisions made about the care and treatment of your baby’s symptoms.

Eat, Sleep, Console (ESC) is the model of care we use at most of our UPMC hospitals in Central Pa to treat babies with NOWS. The goal of ESC is to keep babies with their family during the time they are in the hospital, giving families the opportunity to be the “treatment” for their baby. Babies with NOWS do best when their family is close by and able to give them feelings of comfort and safety. As babies experience withdrawal, they need to be in a calm, quiet space without loud noise or bright lights. The nursing staff will help you learn how to watch for your baby’s withdrawal symptoms and teach you ways to help them manage the symptoms (i.e., consoling techniques). Sometimes babies have trouble eating when they have NOWS. The nurses can help you learn to feed your baby by breast or bottle (breastfeeding is great for babies with NOWS if there are no medical contraindications) and can arrange for help from a lactation consultant if needed.

Here is our commitment to you:

• After birth, your baby will stay with you in Maternity as long as they are born at 35 weeks or more and do not require intensive care for any reason. When you are discharged from the hospital, your baby will be transferred to Pediatrics for continued monitoring.
• Regardless of what unit your baby is admitted to, you will be able to stay in the room with them.
• Nurses will monitor how your baby is managing their withdrawal symptoms, how well they are eating, and their weight. They will provide you with education on ways to comfort your baby.
• No matter what unit your baby is admitted to, they will be monitored in the hospital for around five days. Your baby will be able to go home when we know that they have gotten through the peak of their withdrawal symptoms.
• If your baby needs medication to help them manage their withdrawal symptoms, they may need to stay in the hospital a bit longer. Once they are off medicine and can manage their withdrawal symptoms for a day or two without medicine, they will be ready to go home.
• It is important that you stay with your baby as much as possible while they are in the hospital. Remember, most babies stay calmer and manage their withdrawal symptoms better in the loving care of their family.
• While your baby is in the hospital, our social work team will check in with you to make sure you have everything you need to care for your baby when you go home. They can also help with personal needs such as arranging for transportation to and from the hospital.

What You Can Do for Your Baby:

• During your baby’s time in the hospital, you will be your baby’s primary caregiver. We will be here to help you, but your baby will do best if you are the one caring for them. You can:
• Hold your baby close to you when you are awake and not sleepy.
• Talk to and sing to your baby.
• Feed your baby when they show hunger or feeding cues (licking lips, bringing hands to mouth, opening mouth to something touching lips or cheek), at least every three hours.
• Consider breastfeeding your baby (unless told not to by a doctor for medical reason). Breastfeeding creates a special bond between mom and baby that may lessen their withdrawal symptoms.
• Let your baby suck on their fingers or a pacifier after they are fed; babies with NOWS are often soothed by sucking.
• Swaddle your baby in a thin blanket keeping the top of the blanket away from his or her face.
• Be with your baby as much as possible and keep their room calm and quiet. Babies with NOWS do not do as well when they are in bright, loud settings such as the nursery.
• We understand that you may not be able to stay with your baby during their entire hospital stay. If you need to leave for an extended time, please let the staff know. They can plan for nursing support staff or specially trained volunteer cuddlers to hold and comfort your baby while you are away.
• Help us watch your baby for symptoms of NOWS. Let us know if your baby has any problems with eating, sleeping, or calming. We can help you to help your baby manage these withdrawal symptoms.
• If you are able, make plans to stay with your baby for as long as he or she needs to be in the hospital. Your baby will be much less likely to need medicine or will need medicine for a shorter amount of time if you are the one caring for them. Remember, your baby will stay in the hospital for around five days, longer if they need medicine to help them with their withdrawal symptoms.
• When planning for your stay, make sure you have enough personal care items, clothes, etc. for five days.
• If you have other children or pets, make plans to have someone care for them while you are spending time with your baby in the hospital.
• If you will have to leave the hospital for any reason, arrange for your support person to stay with your baby while you are away.
• Plan to follow up with your baby’s primary care provider the first two days after their discharge.

We look forward to working with you to help you and your baby have the best experience possible.

Need more information?

Phone: 717-988-1672