HARTFORD, Conn.聽鈥斅燙arolyn Rossi has been a nurse for 27 years, and she鈥檚 been fiercely protective of infants in her intensive care unit 鈥� babies born too soon, babies born with defects and, increasingly, babies born dependent on opioids.
Rossi works in the neonatal intensive care unit (NICU) at the Hospital of Central Connecticut near Hartford. Like many hospitals across the country, it has seen the number of babies born with go up dramatically in recent years. The National Institute of Drug Abuse reports more than in the U.S. were born in withdrawal from opioids in 2012, the most recent year for which data are聽available. The hospital says each baby costs roughly $50,000 to treat.
These fragile and fitful babies present new challenges for hospitals. There鈥檚 research that suggests they may do best when they can be held for hours, by their mothers, in a quiet, private room as they go through the process of being weaned off the drugs. But delivering that care means changing hospital systems and attitudes about addiction among doctors and nurses.
鈥淚t was a lot about taking babies away from moms,鈥� Rossi said, describing the way she first learned to care for babies in withdrawal. The nurses saw their role, she said, as 鈥渢rying to protect the baby from the mother, basically. Like we were going to cure the baby but not cure the mother and the family.鈥�
It wasn鈥檛 the best strategy. The babies can often be soothed best by their mothers. But mothers are struggling, too.
鈥淪o, [a mother] comes in with a stigma,鈥� said Kate Sims, who directs the hospital鈥檚 women and children鈥檚 services. 鈥淪he鈥檚 feeling guilt herself. And unfortunately, as best as we are as providers and nurses, we鈥檙e also judgmental.鈥�
Sims said that feeling 鈥� that lack of trust between a mother and a nurse 鈥� can push that mom away, making treating the baby even harder.
So the hospital has started to retrain its nurses to think differently. The biggest change? Treating mom as a mom, and not as an addict. That means recognizing that addiction isn鈥檛 a moral failure, and that many people who are addicted come from a lifetime of trauma. Rossi said it鈥檚 been hard for nurses who are baby specialists to be mom specialists, too.
鈥淚t鈥檚 a big culture change for me personally, and I know for the NICU nurses that are in here. You really do believe you鈥檙e doing the right thing until something like this comes along.鈥�
Along with changing a culture of nursing, it鈥檚 changing a hospital鈥檚 approach, too. Dr. Annmarie Golioto, chief of pediatrics and the head of the hospital鈥檚 nursery, says a bright, loud, bustling intensive care unit is a hard environment for a baby going through withdrawal. So she鈥檚 gotten approval to use a few rooms just outside the intensive care unit 鈥斅爍uiet, monitored spaces for the baby and mother to stay for as long as the baby needs it.
鈥淲e鈥檝e had to figure out, how can we use our rooms differently?鈥� says Golioto. 鈥淗ow can we use our space differently? And how we can partner with mom differently to have that relationship with her to say, 鈥榃e expect you to stay here with your baby and take care of the baby after you鈥檝e been discharged.鈥欌��
Golioto hopes the new setting could shorten recovery times and decrease the amount of morphine a baby needs to ease withdrawal. She鈥檚 also hopeful these moves will inspire some mothers to think differently about their newborns.
Nurse Rossi says she only needed to see the change in attitude and approach work once to see the culture shift pay off. It was back in December, and she gave a mother a room to stay in for more than a month while her baby went through withdrawal.
鈥淪he was just thrilled. And she wasn鈥檛 here 24/7. She couldn鈥檛 be here 24/7,鈥� says Rossi. 鈥淪he was here as much as she could and, just knowing that she had the flexibility, for me, helped me understand that she is a mom, she is a great mom, she wants to be a better mom.鈥�
Nearly every aspect of the opioid epidemic worsened in 2014, according to the government鈥檚 . And even though this hospital鈥檚 programs are just a few months old, it鈥檚 hoping that this culture change will, at the very least, give at risk moms and babies a better start.
This story is the second聽in our four-part series, 鈥淭reating the Tiniest Opioid Patients,鈥澛燼 collaboration produced by Kaiser Health News, NPR and聽local NPR member stations.