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NEW HAVEN, Conn. (AP) — Jessica had been hooked on heroin for two years when she found out she was 4 1/2 months pregnant.
Shortly afterward, while in prison, she decided to start taking methadone to treat her addiction. She had been told if she quit cold turkey, she had a higher chance of miscarrying.
But she was also told her baby would go through withdrawal once he or she was born because of the exposure to methadone, which — like heroin — is an opioid.
Jessica, 21, worried about this for months, knowing firsthand how awful withdrawal can be. Finally, on April 9, she gave birth to her son, Nicholas.
She whispered to him over and over, "I'm sorry."
"I love you."
"I only did it to try to help you."
Jessica, who grew up in New Fairfield, was terrified what would happen to Nicholas. Babies withdrawing from opioids can have seizures, fevers, breathing difficulties, diarrhea, excessive sweating and high-pitched crying, among other symptoms.
Would Nicholas suffer as the opioids left his tiny body?
As the opioid epidemic surges in Connecticut, so has the number of babies born with neonatal abstinence syndrome, a set of problems experienced by newborns exposed to opiate drugs in the womb.
The number is small, but has more than doubled in a decade, from 0.27 percent of all births in 2002 to 0.73 percent in 2011, according to a report by the state Department of Public Health.
Nationwide, nearly 22,000 babies were born with the syndrome in 2012, a five-fold increase since 2000, according to the National Institute on Drug Abuse.
Doctors and nurses statewide commonly use a version of the Finnegan Neonatal Abstinence Scoring System, a tool developed in the 1970s, to determine whether a drug-exposed baby needs treatment. The tool employs a list of questions about symptoms and a range of scores, which doctors tally to make a conclusion.
If the babies score high enough, medicines like morphine are commonly used to manage their withdrawal symptoms. Morphine depresses the symptoms but prolongs the time the baby needs to stay in the hospital after birth.
A new approach is being taken at Yale-New Haven Children's Hospital, which has campuses in New Haven and Bridgeport, allowing babies with neonatal abstinence syndrome to spend less time in the hospital and receive less medication.
The main idea is to bring parents into the treatment process.
"They are not included in the care; they are the care," said Dr. Matthew Grossman, who worked with a team at the hospital to reform the way they cared for babies with the syndrome.
"We tell the parents, 'You are the treatment and you need to be here as much as possible,' " Grossman said. "You have everything your baby needs."
The infants and their parents stay in their own rooms in the general ward, which is important because these babies need a low-stimulation environment. Parents are encouraged to swaddle, rock and feed their babies more often.
"If the baby is in a quiet environment, being fed by the mother frequently, comforting the baby, holding the baby, it seems to make a big difference in terms of reducing the hospitalization for the baby," said Dr. Robert Herzlinger, director of neonatology at the Bridgeport Hospital campus of Yale-New Haven Children's Hospital.
The hospital has decreased the average length of stay for babies with the syndrome from 28 days, as was typical from 2003 to 2007, to 7.4 days. Morphine use decreased from 98 to 24 percent, and the maximum dose administered was reduced by more than 50 percent, Grossman said.
For its innovative approach, the hospital was selected to receive the 2015 Pediatric Quality Award from the Children's Hospital Association, which represents 220 hospitals nationwide.
Other area hospitals use a combination of parent bonding and medications to treat babies exposed to opioids, which include heroin and prescription painkillers like Vicodin and Percocet.
Dr. Kristen Hougland, director of the neonatal intensive care unit at Danbury Hospital, called the bonding a "crucial" aspect of the treatment.
"One of the main things that we can do in the NICU for any family is to ensure that they have good bonding with their babies, and that they feel both bonded and comfortable with the infant when they take them home," Hougland said.
"Sometimes you're able to interact and help with that," she said. "Sometimes people aren't at the point where they are able to work on the issues."
Babies born with the syndrome stay in the hospital's NICU, which has individual rooms where parents can stay with them.
At Stamford Hospital, doctors use morphine and a drug called clonidine to treat babies with the syndrome.
Dr. Gerald Rakos, chairman of the hospital's pediatrics department, said hospital staff decided to add the second medication about two years ago. Since then, Rakos said, it has helped cut hospital stays almost in half.
He, too, stressed the importance of involving parents. "There's no question that we try to involve the parents as much as we can," he said.
Years afterward, he added, these children do seem to have higher rates of learning disabilities and behavioral issues.
"There is some biological basis for it, but a lot has to do with resources and child-rearing," he said.
What is important is the environment the babies go home to, Herzlinger added.
"They need to go home to a nurturing environment," he said. "If the mother is unable to provide or meet the physical and emotional needs of the baby, then that really could have an adverse effect."
After 24 hours of labor, Jessica gave birth to Nicholas, who weighed 7 pounds 7 ounces, at Yale-New Haven Children's Hospital.
Five days later, sitting side by side on a bed, she and Nicholas's father, Mike, changed their son's diaper. They took turns holding their son, who has deep blue eyes and a full head of dark brown hair.
Nicholas slept most of the time, letting out a cry every now and then. Nicky, as they call him, had mild withdrawal symptoms and didn't have to take morphine. Mike and Jessica said they were happy with the care they received at the hospital.
For the parents, their son symbolizes a new chance at life — a chance to live their lives the way they had hoped before they became addicted to heroin.
Jessica and Mike took Percocet, a powerful prescription painkiller, before switching to less expensive heroin. They lived in abandoned buildings and the backseats of cars. They stole to pay for their drugs.
They both ended up in prison.
Jessica had been living in a treatment center in New Haven for the three months leading up to her birth. She and her son were discharged from the hospital on Thursday and will live at the center for another month while she finishes her rehabilitation.
Mike, 26, a certified machinist, hopes to find a job soon. He waits for Jessica and Nicholas to join him in Waterbury, where he lives with his parents.
"Our baby has given us a reason to do better in life," Mike said. "He's truly a gift from God."
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Information from: The News-Times, http://www.newstimes.com
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