Dependent babies benefit from more health care and less hype, experts say 

More help, less hype

click to enlarge NICUs may not be best for babies. - JESSICA KUHN
  • Jessica Kuhn
  • NICUs may not be best for babies.

Back in the 1980s, everyone was talking about crack babies. Even the New York Times predicted a generation of children carrying a horrible legacy of long-term impacts.

But you don't hear about crack babies anymore.

In 2009, the Times reported that researchers had followed those babies and found "the long-term effects of such exposure on children's brain development and behavior appear relatively small."

In other words, while cocaine certainly isn't good for developing fetuses, the kids largely recovered. They were normal.

Now some experts are saying that the media is following the same alarmist path with the babies of opioid-dependent mothers. An "Open Letter to the Media and Policy Makers Regarding Alarmist and Inaccurate Reporting on Prescription Opioid Use by Pregnant Women," dated March 11, 2013, and signed by 27 doctors, professors and other experts, and provided to the Independent by the National Advocates for Pregnant Women, points to the sensationalism and provides citations to studies that suggest it's unwarranted.

The letter's experts argue such treatment only stigmatizes the kids, and demonizes moms.

"The most respected and objective authorities in the U.S. and throughout the world, including the World Health Organization, have determined that drug addiction is not a 'bad habit' or willful indulgence in hedonism, but a chronic medical condition that is treatable but — as yet — not curable," they write. "Demonizing pregnant women creates an environment where punishment rather than support is the predominant response, and will inevitably serve to discourage women from seeking care."

Dependent moms, they write, aren't helped by the threat of criminal prosecution, rather they need treatment, to include medications like methadone and buprenorphine. (It's worth noting that the federal Substance Abuse and Mental Health Services Administration even recommends that new moms using methadone nurse, saying it's safe.)

Finally, the letter states, studies show babies do better when they're kept with their moms, rather than housed in newborn intensive care units (NICUs). Skin-to-skin contact appears to be particularly helpful.

Lynn Paltrow, a lawyer and the founder and executive director of the National Advocates for Pregnant Women, says that part of the problem is that most doctors are only given a few hours of training in drug addiction (an issue that many addiction counselors also often cite), and thus many hospital policies may not be based on the best research when it comes to babies experiencing withdrawal, known as neonatal abstinence syndrome (NAS).

But the panic over NAS, she says, isn't helping anyone.

"I'm a nicotine baby," she says, "but I wasn't taken away from my mother at birth."

Rather than panicking, Paltrow says it's important to recognize that pregnant women are human beings, and not perfect ones. And providing these women with reliable health care, in a non-threatening environment, provides the best chances for a healthy mom and baby.

Moms who feel safe are more likely to get prenatal care and treatment for addiction, which helps the baby. Ones who feel threatened are more likely to lie about drug use to their doctors and avoid vital prenatal care.

Overall, she says, "The best thing we could do if we want to have a healthy society is having a universal health care system so that people can get the help they need before they ever get pregnant or get somebody pregnant. And focusing on — these are not unimportant issues — but the proportional attention to issues like opioid use by pregnant women and NAS is a brilliant distraction from the things that the government could be doing that would genuinely be helpful."

— J. Adrian Stanley


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