Nebraska babies, parents and medical professionals have been involved in what a local doctor called a groundbreaking clinical study to improve outcomes for infants exposed to opioids.
“It’s about getting moms and babies help they need to have a successful start to their lives,” said Dr. Ann Anderson Berry, primary investigator for the local study site. “It’s an investment well made, and the right work to be doing.”
Anderson Berry, vice chair of research for the University of Nebraska Medical Center’s pediatrics department, also heads the Child Health Research Institute, a partnership of UNMC and Children’s Hospital & Medical Center.
The Omaha-based CHRI is one of 26 hospitals in 18 states participating in the Eat, Sleep, Console for Neonatal Opioid Withdrawal study that enrolled 1,307 babies.
Results of an initial phase were just published in the New England Journal of Medicine. Ongoing is a two-year followup study.
Anderson Berry said researchers found that the eat, sleep and console approach was more effective than the traditional method of treating opioid-exposed infants — decreasing by nearly seven days the time that infants were medically ready for discharge from the hospital.
Also, she said, the newborns were 63% less likely to need opioid drug therapy, compared to exposed babies cared for under the usual approach.
Safety outcomes, at three months of age, were similar between the two groups.
The study is funded by the National Institute of Health’s Helping to End Addiction Long-term Initiative — a multi-agency effort formed to speed scientific solutions to the national opioid crisis.
Anderson Berry said the study afforded Nebraska the opportunity to be represented in an effort that, in addition to positioning babies for a better start, could pay off in hospital cost savings.
She said continued research potentially could reveal benefits to the education system and workforce availability as well.
Overall, she called the research a “great example of back-to-basics in medical care.”
UNMC and other medical systems across the country are often recognized for “incredibly high tech interventions” and for the “amazing work we do at the cutting edge.”
But, Anderson Berry added, “Sometimes what we need to evaluate is the basic interventions … like use of the family unit over use of a narcotic.”
Opioid-exposed newborns can suffer tremors, excessive crying and problems with sleeping and feeding. Hospitals have different approaches to caring for the babies and for the past 50 years have traditionally used the Finnegan Neonatal Abstinence Scoring Tool. A UNMC statement said the Finnegan approach has raised concerns about subjectivity and overestimation of the need for opioid medication.
In the study, priority was placed on non-drug treatment and increased family presence, swaddling and skin-to-skin contact in low-stimulus environments. The process highlighted the family member as the primary caregiver as opposed to a nurse.
Indeed, parents had hospital beds to sleep on to remain close to the baby. Anderson Berry said that tools taught to the families during the study period also transfer to at-home parenting scenarios.
The eat, sleep and console approach was developed about eight years ago, UNMC said, but before the trial, it hadn’t been rigorously evaluated in a large and diverse population of infants with neonatal opioid withdrawal syndrome.
“The study included rural and medically underserved communities that have been hard hit by the opioid crisis,” Matthew Gillman, director of the NIH’s Environmental Influences on Child Health Outcomes Program, said in a statement. “These findings promise to improve outcomes and address the long-term needs of opioid-exposed infants and their families.”
By Cindy Gonzalez – Nebraska Examiner
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Tags: Child exposure Harm Reduction Neonatal Abstinence Syndrome Opioid Epidemic Programs Recovery Assistance Research Study
