Page 17 - Delaware Medical Journal - April 2016
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PUBLIC HEALTH
and availability of treatment interventions, all of which are challenging.
FAMILY RESPONSE
Parents of children born with NAS perceived themselves to
Additionally, they were often separated from their children by incarceration, hospitalization, or drug seeking behaviors. Health care professionals must target treatment and support at family systems, not just individuals, ensuring continuity of care and caregiving for children.27 Interventions will need a systematic population health focus. Medicaid will have a role, especially given that these infants are at higher risk of re-hospitalization than their non-exposed peers.4
HEALTH CARE CHALLENGES
Professionals need up-to-date education regarding substance abuse care to decrease challenges and stress. Also needed are evidence-based strategies that are shown to aid mother and infant through the crucial early withdrawal and bonding moments. Mothers may struggle to interpret infant cues and provide appropriate care. It is incumbent upon health care professionals to asses maternal and infant interactions, improving maternal 12 thereby creating successful mother-infant bonds.
It is increasingly clear that keeping the opioid exposed mother/ infant dyad together in the same room and breastfeeding
leads to shorter hospital stays and increased bonding.14,15 Non- pharmacologic intervention and complementary therapies are used in neonates, but they have not been widely studied and use is inconsistent. While things like decreased stimulation and skin to skin care have anecdotal success, they do not have proven 14,28 Validating and implementing potential interventions may go a long way toward increased understanding on the part of health care professionals and increased success of the mother/ infant dyad.
CONCLUSION
The number of substance abusing mothers in Delaware is increasing. While current national trends may encourage punitive responses to these mothers, ever growing bodies of evidence show treatment and support are better options for families.
Professional organizations are unanimous in calling for non-
to opiates may provide data to drive interventions, having the
NAS epidemic to individuals and society. Screening and reporting can be viewed as part of a larger issue of policy and practice interventions for individuals, families, and communities. Policy solutions may include increasing priority for pregnant women
in treatment centers, increased funding for research on short
term and long term outcome of infants with NAS, and assisting nursing and state agencies to optimize follow up of infants and mothers, to name a few. There is a need to educate health care professionals, legislators, and society about the addiction disease process. Issues such as reasons that lead to opiate abuse should
be addressed upstream. Finally, the role of both legislation and coordinated, thoughtful, evidence based approach to this growing epidemic.
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