Are we providing the best care for babies born with ‘withdrawal’?
23 June 2021
Caring for babies with neonatal abstinence syndrome on neonatal units costs the NHS over £10 million a year – is this the best way to care for these babies?
Neonatal abstinence syndrome is a withdrawal syndrome experienced by some babies after exposure to morphine-type drugs in pregnancy. These babies can be distressed when born, experiencing vomiting, diarrhoea, irritability, pain from even light touch, and sometimes fits. To provide the best care, any babies at risk of this syndrome need to be closely monitored for symptoms and sometimes need rapid treatment to help with their symptoms and ease their discomfort in the first days and weeks of their lives.
A new study of over 6,000 babies with neonatal abstinence syndrome throughout England born 2012-2017 has been carried out by a team from UCL, led by Dr Philippa Rees at Great Ormond Street Hospital and UCL Great Ormond Street Institute of Child Health. The study found that the rate of babies admitted to neonatal units with Neonatal Abstinence Syndrome increased between 2012-2017. Neonatal abstinence syndrome is rare but very serious. Neonatal admission for this syndrome accounts for around 1% of all neonatal unit admissions and 2% of all neonatal unit cot days annually in England.
When admitted to the neonatal unit, babies are provided with intensive, high-dependency or special care depending on how unwell they are. This study recommends that many of these newborns may be better cared for on the postnatal ward where they are exposed to less noise, mother and baby can stay together, and it is easier to promote breastfeeding and skin-to-skin. These factors can all help to reduce withdrawal symptoms, improving the outcomes for the baby and shortening admission times.
Keeping families together on the postnatal ward is also recommended where possible - helping with bonding, reducing withdrawal symptoms and providing family-centred care.
The direct NHS cost of caring for these babies on a neonatal unit is over £10million each year so improving their care by delivering it from less high-intensity settings could also save money.
This study also found that babies who were formula-fed, exposed to smoking in pregnancy, received medical treatment for withdrawal symptoms, and discharged to foster care had the highest care costs and longest neonatal unit admissions.
Dr Philippa Rees, lead researcher said:“Neonatal abstinence syndrome is a growing problem in the UK and globally. It’s time for healthcare systems to re-think how we provide the best routine care for these babies to promote rooming-in, breastfeeding, skin-to skin and family-centred care to improve outcomes for all.”
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