With most of the media coverage focusing on the number of overdoses per day we have forgotten about the growing population of infant “addicts”. Those who suffer with no comprehension as to what is happening inside their tiny bodies. They have no way of knowing that their physical suffering is not a normal part of infancy. These innocents are the babies born to addicted women.
The medical community refers to these infants as suffering from Neonatal Abstinence Syndrome (NAS). NAS is a diagnosis of symptoms related to opioid withdrawal in infants whose mothers used either illegal or legally prescribed drugs during their pregnancy. Symptoms of NAS vary depending on the length of time and variety of drugs ingested by the pregnant woman.
During my years spent in NICU nursing I witnessed many a heartbreaking situation. Full term babies born with undiagnosed genetic conditions who died shortly after their birth. Multiples born too early to survive in spite of the technology we used to save them. But the patient’s that hit me the hardest were the infants born to experience the horrors of withdrawal. The innocents. The casualty of their mothers addiction.
As a NICU nurse, I’ve experienced addiction at the very beginning of life. I took care of the littlest beings who knew nothing about opioid abuse. These babies were bathed in a world of feel good drugs. Their placenta joined them to their mother and carried the poison directly to their cells. Opioids would pass through the placenta along with oxygen and nutrients bathing their forming organs with the mother’s highly addictive drugs.
These babies become addicted to the exact drugs that have hijacked their mothers brains. After birth, the infant is still dependent on the blood supply of drugs that has been cut off cold turkey at the slice of the cord. Within hours of their drug supply ending, these precious innocents would start to experience the ugliness known as Neonatal Abstinence Syndrome.
Some would experience a withdrawal so profound that many days I would shed tears as I held, swaddled and rocked these precious victims of addiction. Unconsolable screams secondary to neuro irritability would shatter the NICU atmosphere. These infants screamed like their skin was being ripped off their bodies. Shrill and high pitched. Nothing like the cries of a healthy newborn but reminding me of a wounded animal caught in a death trap. I would spend hours offering the comfort of pacifiers, swaddling and rocking to no avail. Their cries were only the beginning of the hell they would suffer. Soon the tremors would shake their tiny bodies. Some so severe they would experience seizures. Muscles would become tight enough for these babes to stand upright in my lap.
These babes would vomit any nutrition we would attempt to feed, their brains unable to coordinate the normal feeding patterns of suck, swallow, breathe. NAS infants would bite the nipple and thrust themselves backwards as if doing a backflip into a swimming pool. Feedings would take hours of trial and error, finding the perfect hold and nipple that would be accepted by these confused babes. I remember feeling like I won the lottery after getting several ounces into my tiny patient only to be heartbroken as I held the same babe minutes later as he vomited every ounce into my lap.
Deep sleep eluded this babes. Vibrating chairs and swings were the go to aids that helped these irritable souls find much needed rest. Keeping their cubbies quiet and dark and daring anyone to disturb when finally asleep. I would stand guard over the sleeping baby to the point of arguing with doctors who picked these precious few moments to do an exam. Hours were spent walking my tightly swaddled babes as I prayed for a miracle. Periods of quiet and comfort were rare. NAS babies experience an overstimulated central nervous system as their dependence on moms drug continues weeks and in some cases months after birth. I became attached and felt an overpowering responsibility for the care of these babes.
Chronic diarrhea kept their bottoms raw. Every diaper change was met with wails that would break the hardest of hearts. Tomatoes red bottoms would be revealed. I would cringe as I gently wiped with one hand while trying desperately to comfort with the other. Blood tinged wipes were evidence of their bodies attempts to rid itself of the poison that bathed their cells since conception. I remember using an oxygen mask on a babies bottom as he lay with butt exposed on my lap. Oxygen was known to help heal the broken down skin and I would position myself in a rocker with a tight hold on my squirming patient hoping to provide moments of comfort.
My NAS babes also needed constant clothing changes. Excessive sweating was another symptom their bodies struggled to overcome. These babes looked like they just ran a baby marathon in 100 degree heat. Droplets of sweat falling from their wet foreheads kept me constantly changing tee shirts and crib sheets.
Somedays my attempts to keep them warm and dry, to provide moments of comfort and sleep, to feed their trembling bodies and prevent further injury reminded me of watching my adult son suffer from the same withdrawal from opioids. Seventy percent of NAS babies experience the exact same abstinence symptoms as an adult. The withdrawal experienced by these innocents is as raw and ugly as any I’ve ever witnessed with my son. Their tiny bodies going through a hell they could not control and had no way of understanding.
The only humane thing we could do was to give these infants what their bodies craved. Infant medically assisted treatment. (MAT). Yes, that’s exactly what we did. Just like Methadone or Suboxone for an adult, except we used liquid Morphine. Every three to four hours depending on the severity of their symptoms I would draw up a syringe and drop the precious liquid into the mouth of babes and hold them close to my heart hoping to feel their bodies relax. Praying for sleep for my exhausted patient.
Giving a narcotic was a double edged sword for me but knowing it would help minimize the hell that is their first experience with life, knowing it would help decrease the cravings that kept them from enjoying the comforts of being a baby eased my troubled heart. Hoping that in the weeks to come we would slowly be able to wean the drug allowing my tiny patients to experience the comforts of a normal infancy and a nurses loving touch. ❤👣