October marks Neonatal Abstinence Syndrome (NAS) Awareness Month. NAS is the result of the sudden discontinuation of fetal exposure of a substance, typically an opiate such as methadone, heroin, or prescription opiates. It can give afflicted newborns a constellation of symptoms such as: vomiting, loose stools, high-pitched crying, irritability, inconsolability, tremors, sweating, sneezing, poor feeding, or even seizures.
Because of the opioid epidemic in the United States, the incidence of NAS has skyrocketed over the past decade. For the NICU physicians and nurses that care for such unfortunate infants on a regular basis, following best practices for NAS care is crucial.
Standard Treatment for NAS Babies
First-line treatment for NAS is always to help comfort the baby with being in a quiet room, kangaroo care, breastfeeding, frequent holding and on-demand feeding. Should this approach not work, then treatment with medication, typically morphine or methadone, is started. The infants on medication typically remain in the hospital for several weeks while weaning off their medication.
Even after discharge, infants exposed to opiates during pregnancy can show lingering symptoms such as difficulty feeding, poor sleeping and fussiness for up to 6 months. Add this to a household which is already dealing with challenges and one can imagine the difficulty these families face. This makes it critical for health plans to provide dedicated case management resources – nurses with NICU experience who understand how to manage the crucial first twelve months of life.
Children born with NAS are also at high risk for issues that require specific care after discharge, and for the years that follow, including:
- Prevention of SIDS
- Monitoring for signs of child abuse
- Neurodevelopmental assessments to identify problems with motor skills and learning delays
- Psycho-behavioral assessments to identify hyperactivity, impulsivity, and attention-deficit in preschool-aged children
- Performance assessments related to absence, failure, and other behavioral problems in school-aged children
The increase in the incidence of NAS and the complications associated with this diagnosis has been met with an increase in the activity of ProgenyHealth’s NAS program. While health plans around the world are working to manage the quality of care and cost associated with this high-risk group, Progeny is providing care coordination services exclusively for the NICU members of our health plan partners. Our case managers, social workers, nurses and physicians devote an increasing amount of their time and expertise to solving the unique challenges of the growing NAS population. It isn’t easy to be on the front-lines of this battle every day.
Since we started the company, we have provided care management services to tens of thousands of babies with complex medical conditions and have consistently delivered healthy outcomes. We’ve accomplished this in close collaboration with our provider colleagues in hospitals and NICUs across the country. Today, we honor them all and share their wish for an end to this tragic epidemic that impacts so many innocent lives.