General physicians volunteering time to help NAS babies

BECKLEY, W.Va. (AP) — A group of Raleigh General Hospital physicians and advanced practice clinicians are donating their time to help fight the opioid epidemic in an unexpected way — by cuddling and feeding newborns suffering from neonatal abstinence syndrome (NAS).

NAS can occur in newborns who have been exposed to drugs while in the womb. Symptoms of NAS include inconsolable crying, irritability, sleep disturbances, feeding difficulties and digestive issues.

Whenever a Raleigh General doctor or nurse practitioner has a few minutes to spare, they’re invited to the nursery to spend some quality time with the infants who need it most.

Dr. Elizabeth Thompson Nelson, a hospitalist with Raleigh General, pitched the idea to administrators after an experience with a patient in her first week back at the hospital.

The patient, 34 weeks pregnant, was diagnosed with cellulitis, a bacterial skin infection.

“The cellulitis was caused by injecting drugs into her skin,” Dr. Nelson explained. “At 34 weeks pregnant, it was a danger to her and her baby.”

After much thought and prayer, Nelson said she approached Cheryl Mitchem, director of business development and physician relations, about potential ways to help.

“Having met that patient, I decided that this is something we can easily address here as providers,” Nelson said. “Everyone I’ve mentioned it to has been interested, even in some small way.”

Once credentialed, interested health care providers go to the nursery, wash up and put on special scrubs. Then they’ll meet with the charge nurse to see if any NAS babies need care.

“We won’t always be needed when we show up,” Nelson said. “Sometimes babies are sleeping, and we don’t want to wake a sleeping baby. But lots of times, especially when there is more than one NAS baby, we’ll be much needed.”

Tammy Abel, executive director of women’s and children’s services at Raleigh General, said nurses sometimes have multiple NAS assignments, which can be particularly challenging.

“Sometimes it seems like they’re all crying and hungry at once,” Abel said. “This program will be a really big help. It will make the nurses feel like they’re making more of a difference.”

She said many of these babies are disconnected from their mothers, as their symptoms require an extended hospital stay. Sometimes the mother returns to the hospital to visit the infant, but in other cases, the baby may be awaiting a foster family.

“We’ve really needed some help for these babies in the nursery for some time now,” Abel said. “It will really help the nurses there.”

Nelson said some people think providers are too busy to help, or that their jobs already involve helping. But she believes addressing this problem can go beyond their vocation.

“When people apply to go to medical school, they ask you to write an essay,” Nelson said. “A lot of people say they want to be a doctor to help their community, but sometimes we get away from that as we become more comfortable.”

She said she believes this will be a way for providers to return to their roots and reconnect with their community.

“Having an interest is one thing, but we’re putting it to the test. We’re putting our hands on the situation, not just writing a check.”

Although the hospital is owned by LifePoint Health, Nelson said Raleigh General is really physician-driven.

“I would like that to continue, so physicians can be leaders in the community — knowing about it and caring about it.”

For her, it can all be summed up in one verse: “For whom much is given, much is required.”

The initiative began on a day that coincided with World Prematurity Day — a day highlighting premature birth as the leading cause of death in children under age 5 worldwide.

According to the March of Dimes, babies born too early may have more health issues than babies born on time, and may face long-term health problems that affect the brain, the lungs, hearing or vision.

For the second year, preterm birth rates in the U.S. have increased, rising 2 percent to 9.8 percent in 2016.

The average “report card” score for preterm birth rates is a “C” in the U.S.; however, West Virginia was given a score of “F.”

Abel said in West Virginia, one in nine babies is born too soon.

Although some premature deliveries cannot be prevented, Abel shared some tips from March of Dimes for expectant mothers to reduce their risk.

—Don’t smoke, drink alcohol, use street drugs or abuse prescription drugs. Ask your provider about programs that can help you quit.

—Go to your first prenatal care checkup as soon as you think you’re pregnant. Go to all checkups, even if you’re feeling fine.

—Get to a healthy weight before trying to conceive. Talk to your provider about how much weight you should gain during pregnancy.

—Get treated for chronic conditions, such as high blood pressure, diabetes and depression.

—Protect yourself from infections. Talk to your provider about vaccinations that can help protect you. Wash your hands with soap and water after going to the bathroom; don’t eat raw meat, fish or eggs; have safe sex; and don’t touch cat feces.

—Reduce your stress. Eat healthy foods and do something active every day.

—Wait at least 18 months between giving birth and getting pregnant again.

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