Dr. Elena Rossi
In 32 years of practicing medicine, neonatologist Elena Rossi, associate chair of pediatrics for Akron Children’s Hospital Mahoning Valley, has pretty much seen it all - until recently.
Last month, Dr. Rossi visited the Federal Correctional Institution in Lisbon, Ohio, and addressed a group of inmates about the dangers of drug use in pregnant women. The inmates were participating in a parenting program that promotes and reinforces positive relationships, family values and mutual support among their families.
Her presentation focused on neonatal abstinence syndrome (NAS), which refers to a group of problems a baby experiences when withdrawing from exposure to substances in the womb. According to research, the number of babies born with NAS has tripled in the past decade, with one born each hour.
In the Mahoning Valley alone, Dr. Rossi has seen the number of drug-addicted newborns escalate over the past 5 years. Between Akron Children’s special care nursery at our Beeghly campus and our neonatal intensive care unit in Boardman, we care for 50 to 100 NAS babies each year.
Most of the mothers of NAS babies are Caucasian (93%) and unmarried (90%). About a third also test positive for hepatitis C.
An experience like none other
Withdrawal is extremely painful and NAS babies are hard to console. (Photo courtesy of projectbeansprout.org.)
Dr. Rossi had to get FBI clearance a month before her visit. That day she wasn’t able to take a purse or cell phone with her or have any kind of jewelry or metal on her.
“I was a bit anxious going in because I didn’t know what to expect, and I certainly didn’t think I would be so close to the audience,” said Dr. Rossi. “But I opened with a video of a baby withdrawing, asked some questions and from there it was very interactive. I was surprised by all the questions they asked.”
The inmates questioned Dr. Rossi about marijuana, cocaine, withdrawals and how kids do as they grow.
The best question she received?
“Did you ever misdiagnose?” To which Dr. Rossi explained that because of advanced methods and thorough testing, she hasn’t misdiagnosed but has been able to identify how to best help a patient get proper treatment.
“This experience was amazing,” Dr. Rossi said. “I was warned that some might walk out during the presentation, but everyone stayed. They knew a lot, asked great questions and were engaged the whole time. Our goal was to just reach someone, and I believe we did that.”
Symptoms of NAS depend on the drug but generally babies are uncomfortable, jittery, irritable and don’t sleep or feed well. They may also experience seizures, vomiting and diarrhea, among other symptoms.
Today, Dr. Rossi says 8 out of 10 maternal substance abusers are receiving prenatal care, which means they are in a program.
“We’ve worked hard to get the message to OBs and midwives to develop tools for caregivers and patients,” Dr. Rossi said. “We counsel moms on what to expect once they deliver.”
Caring for drug-addicted babies
Caring for these babies creates an additional strain on nursing staff. Staff tries to keep mom and baby together as much as possible and the neonatal unit dark, calm and quiet.
But with irritable babies who are difficult to comfort, it can take its toll.
“Our staff cares very much for these babies and they want to see them do well,” said Dr. Rossi. “So, it is very challenging for them.”
Since NAS babies demand a lot of care, the family, doctors, nurses and cuddlers (volunteers who hold the babies at the hospital) all play a part in caring for them.