Pubdate: Fri, 13 Jan 2017
Source: Philadelphia Daily News (PA)
Copyright: 2017 Philadelphia Newspapers Inc.
Author: Marie Mccullough


[photo] Addy Schultz, 72, cuddling a baby going through opioid withdrawal
at Thomas Jefferson University Hospital, ( DAVID SWANSON / Staff
Photographer )

Marie McCullough covers health and medicine, with a special focus on
cancer and women's health issues.

Study suggests prevention efforts are having an effect on melanoma in Pa.,

As the 13-day-old infant scrunched up his face and squirmed in obvious
pain, Addy Schultz tightened her embrace. The baby relaxed in her arms
almost instantly.

"When he cramps up, I hold him harder and pat a little firmer," explained
Schultz, 72, sitting in a rocking chair in the newborn intensive care unit
at Thomas Jefferson University Hospital. "They don't like to be stroked or

"They" are the most helpless, hapless victims of the opioid epidemic,
babies born addicted to the prescription or illicit drugs their mothers
took. Many of them spend weeks or months in the hospital, gradually being
weaned from opioid dependence by getting decreasing doses of oral morphine
or methadone.

Even mothers who are in recovery may not be able to visit their babies
every day over such a long period, so many hospitals have enlisted helpers
- - volunteer cuddlers like Schultz.

"These babies going through withdrawal need to be held for extended
periods," said Jane Cavanaugh, the nurse who created Jefferson's cuddler
program a year ago. "They need human touch. They need soothing. They need

Or other comforting sounds.

"I hum and chant," said Schultz, of Haddon Township. "My kids would say I
can't carry a tune in a paper bag."

All newborns need such nurturing. But for those in the throes of neonatal
abstinence syndrome, or NAS, cuddling helps relieve the drug-induced
turmoil in their nervous and digestive systems. The babies' symptoms
include tremors, muscle spasms, shrill crying, irritability, sweating,
indigestion, diarrhea, vomiting, poor sleeping, fever.

Studies going back to the late 1980s and '90s - when cuddlers were
enlisted to calm crack-addicted infants - have shown the benefits of the
added attention, including faster weight gain and shorter hospital stays.

"These volunteers are a godsend. They are wonderful as far as pacifying
the babies," said Maryann Malloy, a nurse manager at Einstein Medical
Center, another Philadelphia hospital with a similar initiative.

Cuddling isn't exclusively for babies going through withdrawal.
Pennsylvania Hospital, for example, has a 30-year-old program, initially
begun to provide extra TLC for premature babies in its large newborn
intensive care unit.

But the opioid crisis has amped up the need. In Pennsylvania, the rate of
newborn hospital stays for substance-abuse problems soared 250 percent
from 2000 to 2015, when nearly 20 out of every 1,000 newborns faced
withdrawal issues, according to a recent report by the Pennsylvania Health
Care Cost Containment Council. The council estimated the hospitalizations
added almost 28,000 days and $20.3 million in costs.

Even women who try to get off drugs when they learn they are pregnant may
not be able to protect their babies. That's because going cold-turkey
while pregnant increases the risk of miscarriage. So moms-to-be seeking
addiction treatment are usually put on methadone - and thus give birth to
an opioid-dependent baby.

In the Philadelphia area, Einstein and the Virtua Health System in South
Jersey are among centers that have trained volunteer cuddlers in response
to the crisis.

"Babies with NAS are among the most vulnerable infants in need of
cuddling, as the process of opioid withdrawal is so very difficult for
them to endure," said Arlene J. Verno, a developmental specialist in
Virtua Voorhees' neonatal intensive care unit.

Cavanaugh, who has been a newborn critical care nurse at Jefferson for 42
years, worked with the hospital's volunteer coordinator to create a
four-hour training class for the cuddlers. After the state certifies that
they have never abused a child, cuddlers learn about hand-washing and
infection control. Like the babies' parents, cuddlers also are taught how
to wrap and hold the babies.

"We swaddle them tightly and hold them firmly," Cavanaugh said. "The
babies need that because they shake so badly. It brings comfort and
control. But we want their hands free so they can touch their face and put
their fingers in their mouth."

The volunteers don't feed babies or change diapers, and their three-hours
shifts are always under the supervision of a nurse.

Jefferson now has 25 trained snugglers, including students, employees, and

Schultz, a speech therapist at Jefferson, cut back from full-time to
part-time about a year ago. That freed her to spend an afternoon each week
holding babies - and satisfying her (so far) unmet craving for

"I've always loved babies and holding babies," she said as she grasped the
trembling hand of the baby boy, who was born two weeks early, weighing
just over five pounds.

Research suggests that babies like him can do well over the long term, but
it depends on family and social service supports. Schultz tries not to
dwell on the implications of the addiction epidemic.

"One time I thought, 'What am I doing here? I'm just a drop in the
bucket,' " she said. "But what I decided to do was just give the babies a
lot of positive energy. I say, 'You're going to be okay. You're going to
be happy. And you're going to have a wonderful life.' "

The cuddlers aren't just good for the babies. The extra arms have relieved
a strain on Jefferson's nurses, who sometimes have 10 or 12 babies going
through withdrawal out of 25 infants in intensive care. And the volunteers
often serve as ambassadors to parents.

"Sometimes the moms feel stigmatized," Cavanaugh said. "They feel the
nurses are judging them."

"When I see the parents," Schultz said, "I say, 'Oh, what a beautiful
baby,' and 'Congratulations.' They're doing the best they can.' "
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