“So, hi, Peanut!” the doctor says to the baby. “Any concerns?” she asks Carrie.
“Coming down has been catching up with her,” says Carrie.
“Do you feel like she’s jittery?” the doctor asks.
“She didn’t want to be put down last night—like [she had] the shakes,” Carrie says.
Lexi has neonatal abstinence syndrome, and has been getting methadone treatments for it. She is getting better—most babies do—but even with treatment, she’s had tremors, diarrhea, and she’s cried and cried. Her little arms and legs tighten up, her fingers and toes clenched. She’s been feverish, her mother says.
“I know what she’s feeling,” Carrie says. “And that is the worst part.”
Carrie was addicted to heroin herself and knows withdrawal is miserable. She’s been off heroin since she found out she was pregnant, she said, with help from methadone. It keeps a low level of opioid in her system so she doesn’t go into withdrawal, but it doesn’t get her high. For Carrie and thousands like her, methadone is a lifesaver—helping them quit a heroin or oxycodone or other opioid habit for good.
But getting pregnant posed a dilemma: If Carrie stopped taking opioids altogether, she risked relapse or miscarriage. Yet, if she continued to take any opioid—including methadone—there would be a 60 to 80 percent chance that her baby would be born with neonatal abstinence syndrome, the doctors told her.
“It’s hard to watch, as her mother,” Carrie said, “because you’re helpless and there’s really nothing you can do. You are a lot of the reason why she’s going through what she’s going through.”
Babies going through withdrawal spend weeks—even months—in hospital nurseries like this one.
“Their cry is very different,” said Cindy Robin, a registered nurse at the Providence hospital, who has been caring for mothers and newborns for more than 30 years. “It’s a more distressed cry,” she said, “and it really pulls at your heartstrings to have to listen to them.”
Robin said babies with mild symptoms of the withdrawal syndrome will sneeze and sniffle. They have trouble settling down. Babies who have a more severe case can have seizures and dangerously high fevers. Robin said nurses have to dim the lights, and swaddle the newborns tightly to help keep them calm.
“They just need to be held in a nice, quiet spot,” she said. “We have nice quiet music playing, and try to keep them as comfortable as possible.”
Nurses with special training check on the babies every couple of hours.
“So these are the things that we look for … and what we teach the parents,” she said: “Is the baby crying excessively? Is it a high pitched cry? Is it just a continuous cry? How do they sleep after they eat?”
Medication, which is gradually decreased, can help ease this constellation of symptoms.
“The American Academy of Pediatrics and others recommend an opioid for the babies, because you’re giving them back what they’re withdrawing from,” said Jonathan Davis, a neonatologist and chief of newborn medicine at Tufts’ Medical Center. “Morphine and methadone are the two most common.”