May 7, 2019
Newborns experiencing milder withdrawal symptoms can avoid morphine and the Neonatal Intensive Care Unit (NICU) through swaddling, nursing and a quiet environment via the EMBRACE program at Red Deer Regional Hospital Centre.
Story by Tracy Kennedy
RED DEER — There’s nothing more joyful to a new mother than to hear the healthy cry of her newborn.
But when those cries are symptoms of opioid withdrawal, it’s even more important that mom is empowered to be a confident caregiver for her baby, supported by community.
A new program based at Red Deer Regional Hospital Centre (RDRHC) brings together community partners and a multi-disciplinary healthcare team to teach new moms who have used opioids during pregnancy how to care for their newborns — free of stigma and shame.
EMBRACE (Empower Mothers and Families, Mentorship, Building Healthy Relationships, Respect, Actively Listen and Learn, Collaboration and Engagement) launched at RDRHC on April 1 with the goal of partnering with new moms so they can be the primary source of comfort and care to their babies.
“Research suggests skin-to-skin, cuddling and swaddling, and breastfeeding work to settle the baby,” says Sandi Sebastian, director of Women’s & Children’s Health Services, at RDRHC.
“These comfort methods decrease the likelihood the newborn will need to be given morphine in the neonatal intensive care unit (NICU), which leads to longer separation between mom and baby. In the meantime, mom becomes more confident in her abilities.”
Partnering with mom to be a confident caregiver starts by connecting with doctors’ offices and walk-in clinics, methadone programs, and the Virtual Opioid Dependency Program. Once a pregnant mother comes into the program, she learns what to expect in hospital.
“Moms have a private room and family members are encouraged to stay and support them,” says Michelle McCutcheon, manager of Women’s & Children’s Health at RDRHC. “Baby stays with mom the whole time, lactation consultants are available, and we try to keep things very calm and quiet.”
EMBRACE moms and babies are kept in hospital for three to five days, longer than is typical, in order to observe any symptoms of Neonatal Abstinence Syndrome (NAS).
NAS may develop after birth, when an infant is no longer exposed to a drug used by the mother during pregnancy. After becoming dependent on the drug in the womb, the newborn may show withdrawal symptoms including irritability, diarrhea or vomiting, tremors and sleeping issues.
Physicians and nurses regularly monitor and assess the baby using step-by-step plans developed specially for the EMBRACE program. If serious symptoms such as seizures or sepsis are detected and a NICU admission is needed, babies will require a longer stay in hospital — but moms will have been prepared by already making employment, pet and childcare arrangements.
More of the proverbial ‘it takes a village to raise a child’ is called upon to help in the journey. Baby-cuddler volunteers are being trained specifically to soothe NAS infants and give mom some relief. A care plan is made for mom and baby to smooth the transition home, which includes visits with their primary care provider, public health staff and a social worker. As well, a local taxi company is developing a voucher program to help ensure moms make it to their appointments.
It’s these partnerships and the program’s welcoming and inclusive approach that will ultimately break down barriers and lead to success.
“In the past moms may have felt they didn’t want to identify that they’ve used opioids during pregnancy. This is about empowering mothers, teaching them the techniques to make them successful, and making them equal partners in care,” Sebastian says.
McCutcheon adds: “Moms have come into the prenatal consult and expressed the fact they really felt not judged — but actually embraced.”
“These are moms who are on an opioid replacement therapy program and they are motivated, they’re working, they’re here for a reason. These moms will do what it takes to keep their babies with them.”
New and expectant mothers in Red Deer with questions about the EMBRACE program can call 403-343-4856.
