how are NAS babies cared for in your nicu?

  1. 1
    I am part of of a 57 bed NICU/Special care nursery (we call that CCN). We began housing all our NAS babies in one "pod" of 8 beds about a year ago. We have had between 2-10 babies at any one time since then. This is challenging to say the least. I am wondering what other hospitals, especially urban centers are doing with their NAS babies. Our numbers are steadily increasing. I love these babies and their families and want to do the best I can for them!Thank you!
    Last edit by shelsby1992 on Feb 11 : Reason: missed a word
    poppycat likes this.

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  2. 9 Comments...

  3. 0
    My hospital has a six bed Peds unit that doesn't see a lot of patients since there is a children's hospital down the road. So we try to have some of our NAS babies out there. Gives them a census, and more importantly it allows the parents to be there with their babies as much as they want to/are able to be there. We have seen a huge improvement in the scores of the babies who get to be out there since it's quieter and they get a more favorable nurse to patient ratio.
    Our NICU census is usually 40-50, and most of the NAS babies are just interspersed with all the rest of the babies in intermediate care. Charge tried to not put them in 4- baby assignments, or have more than one in any given assignment.
  4. 0
    When it is not RSV/flu season, we sometimes transfer our NAS babies whose families want to be in house to care for them to our peds unit once they are well-controlled on morphine. If a baby's family is not super involved in his or her care, however, they stay on the intermediate side of our NICU. We try to keep them in a three-baby assignment so that the nurse can give them the attention they need.
  5. 0
    Here's how our regional children's hospital is handling NAS babies.

    - Children's Hospital News

    East Tennessee Children's Hospital treats drug-dependent babies ยป Knoxville News Sentinel

    Jump in drug-dependent babies worries hospitals

    It's a 60 bed unit and last year about half were NAS babies. It's been as high as 37 at one time. Less severe babies stay at area hospitals and the children's staff advise the area hospitals on the treatment protocol. It's become an epidemic in the last few years. In 2008 they had 35 NAS babies in the whole year. Now they have that many at one time.

    They built a special unit with all private rooms designed to be soothing to NAS babies. They have specially trained volunteer cuddlers 8am-8pm. The only good news is that they have all the cuddlers they can use and have a waiting list of volunteers.
  6. 0
    I'm in a level II nursery...we have a level IV but the NAS babies stay with us unless they're <35 weeks. At any given time the level 2 usually has at least 2 NAS kids.

    We start q3h morphine for 3 scores greater than 8. Some NPs want it started for 3 consecutive high scores, others for 3 high scores in 24 hours. If scores are still consistently high after morphine, we start daily phenobarb, which usually makes a HUGE difference. We do the usual low-light, swaddling, holding, and we have a really nice swing.

    Most of these kids grow on me after a while. Most go home in about 4 weeks, but the longest stay was 94 days.
  7. 0
    Though I can't explain it, we have only had 2 NAS babies in my NICU in the nearly 5 years I have worked there. Realistically, being on the Mexican border, we should be seeing a lot more (based on the drug use statistics both here and across the border in Mexico).
  8. 1
    Maybe it's because fewer of the moms are on methadone/suboxone maintenance? There are plenty of people who believe that babies don't withdraw as much from street drugs because the use is less regular. We do have some babies who are at risk for NAS who never have to come to the NICU because their scores never get high enough for treatment.
    Bortaz, RN likes this.
  9. 0
    Quote from Bortaz, RN
    Though I can't explain it, we have only had 2 NAS babies in my NICU in the nearly 5 years I have worked there. Realistically, being on the Mexican border, we should be seeing a lot more (based on the drug use statistics both here and across the border in Mexico).
    A lot of it must depend, like NICURN29 said, what they are using, and who is doing the using. If the folks using aren't the same ones birthing babies, I guess that is the silver lining.

    Just as an aside, I wonder how much use and withdrawal we miss because we don't test everyone who walks through our door.
  10. 0
    A lot, I'd reckon.
  11. 0
    Due to the dramatic increase in NAS babies we have implemented a policy. 3 scores of 9 or more or 2 scores of 12 or more admission to NICU. We start with morphine, weaning over several days. But will also add methadone if needed after 2 days. Still doesn't work we add nuero meds such as nuerotin or baclofen. It has been successful having all the providers on the same page.


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