Pilot program at Schneck Medical Center in Seymour tracks newborn drug problem

Schneck Medical Center in Seymour has been involved in a pilot program with the Indiana State Department of Health to track such births for more than a year.

The program has established criteria that allow for the collection of information about how many babies are born with drugs, such as prescription pills, heroin and marijuana in their systems.

Those numbers are then reported to the state with the goal of hopefully implementing more substance abuse programs for pregnant mothers, said Lisa Eagans, director of Women and Children at Schneck.

In 2014, 72 drug screens were conducted on babies born at Schneck, and 32 of those tested positive for drugs in their systems.

One of the goals of the program is to find solutions to make those numbers go down. That’s something that been missing in the past.

“The hospitals are feeling the problem, but we don’t have any metrics out there to go off of,” Eagans said. “We want to be a part of a solution.”

The pilot program also is a way to decipher how prevalent in the county neonatal abstinence syndrome has become. That’s when women with a history of substance abuse give birth to an infant who experiences substance withdrawal.

There are not many programs available for pregnant women with substance abuse issues, and that generally means mothers usually have to travel outside the county to find treatment programs. The programs often are full.

There also is a lack of places for a mother and child to go after the baby is born.

“There needs to be a program that can take them as a family unit, which is also something that’s limited,” Eagans said.

She also said talking about the issue and exposing the numbers will help to educate the local community about a problem that continues to rise.

The drug screenings, known as meconium drug screens, are collected if the mother has had prior drug addiction problems, there is an inconsistent or lack of prenatal care or if the baby’s weight or head circumference isn’t normal. Meconium is a thick, green, tar-like substance that lines a baby’s intestines during pregnancy.

This past year, 797 babies were delivered at Schneck.

Eagans said 17 babies were scored for neonatal abstinence syndrome.

That means either the mother tested positive for drugs or the baby had symptoms and medical professionals had to complete an assessment to decide the next steps in how to treat the child. The symptom of withdrawals from those with the syndrome can exhibit signs of high-pitched cries, tremors and sweating.

Six of those 17 babies had to receive treatment, and that treatment could have included morphine, Eagans said.

Already this year, two babies born at Schneck had neonatal abstinence syndrome, and one of those had to be transferred to a different hospital because of the severity of their condition.

“(The baby) had so many complications that we couldn’t keep it here in our Level 1 nursery, so it was sent to a (hospital with) higher level of care,” she said. “That’s the first time that’s happened with any of our NAS babies, so it’s a little concerning.”

Last year, the most common drugs found from the meconium drug screens were cannabinoids (marijuana), amphetamines and opiates. Benzodiazepine, THC and amphetamines were the most common drugs found from the screenings of mothers.

Eagans said a baby born with those types of drugs in their system can eventually have learning and behavior problems.

‘Now it’s frequent’

Cara Nichols, a staff nurse at Schneck Medical Center who specializes in working with babies born with neonatal abstinence syndrome, said she has personally seen the number of babies born on drugs grow since she started at the hospital.

Six years ago, she didn’t see many babies with neonatal abstinence syndrome, but it has become more frequent.

Nichols said it often takes about three days before a baby shows symptoms of drug withdrawal after birth — depending on when the last time the mother took a drug, how much she took and based on the mom and baby’s metabolism.

She said babies tend to be increasingly irritable and inconsolable when symptoms do show up.

What scares her, Nichols said, is the possibility that a baby doesn’t show any signs of withdrawal from drugs right away and is allowed to go home before starting to exhibit signs of drug withdrawal.

“If it starts happening when they get home, that’s where you get shaken baby syndrome — parents or caregivers don’t know what to do and get frustrated,” Nichols said.

To calm the baby, she said nurses bundle the baby tightly in a blanket to feel secure. They also keep lights low and avoid loud noises and try to feed, change and medicate the baby all at one time to not be bothersome.

If nothing else works, she said nurses resort to using medications or morphine.

Early identification

The hospital currently relies on self-reporting to find out if a pregnant mother is using.

“We don’t do a universal screening, so we’re kind of going off mom’s honesty,” Eagans said.

But Eagans said that system could eventually change because the possibility of drug screening all pregnant mothers is in the works, and that could reveal even more babies being born with drugs in their system.

“I think this is just the tip of the iceberg,” she said.

She said nurses and doctors want to identify those mothers using drugs when they first find out they’re pregnant so they can offer help with a substance abuse or addiction counselor to avoid an unhealthy situation.

“Our ultimate goal is we want mom and baby to be together ... and that’s why we like to find out to build that rapport with them and establish something,” she said. “If we catch them later, there’s more of a likelihood that Child Protective Services could be involved and they may not go home as a unit, unfortunately.”

Eagans said health officials at the hospital don’t stigmatize mothers who are using because they understand that drug addiction is a disease.

That’s why she urges pregnant mothers to be open and honest from the beginning to create a safe outcome for both her and the baby.

“Nobody chooses to wake up one morning and say, ‘I want to be an addict,’” she said. “We want them to have the right resources so they know how to cope and not revert back and get them through.”