Labor & Delivery tech fosters drug dependent baby

When one baby in Orange Park Medical Center’s care wailed in pain, a telling symptom of drug withdrawal or neonatal abstinence syndrome (NAS), it was Donna Hightower who could comfort him.

The labor and delivery operating room technician took it a step further: she fostered the then five-week-old baby boy and one of the smallest victims of the opioid epidemic.

“I started seeing how these children were being dealt a life that they have no control over,” said the mother of two grown children, a 21-year old son and 19-year old daughter.  “I personally wanted to step up, somehow, someway and my only means to help was through fostering.”

A baby is born suffering from opioid withdrawal approximately every 15 minutes. In 2016, more than 4,000 babies were born addicted to opioids in Florida, home to Orange Park Medical Center, which was visited by former President Bill Clinton, who was there to learn about efforts to fight opioid abuse.

The baby’s mother tested positive for drugs, landing the baby as a ward of the state and in the hospital’s neonatal intensive care unit (NICU) for five weeks.

“Sometimes I would go and assist in the NICU with vitals, feedings, changing the babies’ clothes or linens – anything to help make the load a little lighter,” Hightower said. “On this particular day, I saw him and remembered thinking he was such a cute baby. I picked him up and formed an instant bond.”

Hightower says it pained her to watch him hurt and unable to articulate his anguish. She would sing to him, pray for him and do whatever it took to help console him.

“It was hard. He cried a lot, shook, screamed in pain,” she recalled. “The nurses would call and say, ‘Your baby is crying,’ and without hesitation, I would say, ‘I’m on the way.’”

Hightower thinks the bond was mutual between her and the baby. He would calm down when she picked him up, and when he was two weeks old, she told him that she wished she could take him home.

“You deserve to be loved,” she remembered telling him.

After realizing there was no home for the baby at the time, Hightower, who had served as a foster parent for years, told one of her colleagues, a NICU nurse, that she would be interested.

“He was going to be my first infant,” Hightower said. “I usually fostered older children, so I didn’t have anything at home for newborns.”

Within a couple of days, she had everything she would need – a crib, car seat, stroller, clothes, and bottles. The outpouring of support from her co-workers and family was overwhelming.

“Walking out of the hospital with him, I was all smiles,” said Hightower of the newborn who was still withdrawing when she took him home. “It was challenging, at first, but I just found things that he enjoyed like warm baths and massages.”

Hightower fostered him for about a month until he was placed with a family member. While the time they had together was short, and most certainly sweet, she wouldn’t change it for the world.

“All I do is keep praying for him and hoping that he’s with good people,” she said.

Watch Donna Hightower talk about her journey to foster the baby who captured her heart on News4Jax here. Learn more about neonatal abstinence syndrome and what it means for opioid-dependent newborns from Dr. Craig Sussman, a neonatologist at Orange Park Medical Center, a hospital in HCA Healthcare’s South Atlantic Division.  

1. What is neonatal abstinence syndrome or NAS?

A drug withdrawal syndrome seen in infants that have been exposed to drugs during pregnancy.  Most commonly seen with exposure to opioids or narcotics.

2. What causes NAS? 

Exposure to specific drugs, prescription and/or illegal, during pregnancy.

3. How is NAS diagnosed?

NAS is diagnosed by a combination of clinical findings in a newborn during the first few days of life. These findings usually coincide with a history of maternal drug use, or a positive drug test in the mother and/or infant.

4. How many babies does NAS affect in the U.S.?

The data is unclear in this area. We do know this number is on the rise. In the US, reported maternal opioid use is increasing.  One recent study spanning 28 states, demonstrated an incidence of 6 NAS cases per 1000 live births.  In addition, NICU admissions and NICU length of stay have increased specifically due to NAS in recent years.

5. What are the symptoms of babies dependent on opioids?

There are a wide range of symptoms associated with NAS, however, the most concerning symptom is seizure activity.  More common symptoms include high pitched cry, poor sleep, abnormal tone, feeding problems, vomiting, diarrhea, sweating, sneezing, fevers, nasal stuffiness, and poor weight gain.

6. How do you treat babies with NAS?

NAS is treated with both supportive care and with medications.  Supportive care includes creating a calming environment, positioning, rocking, music therapy, massage therapy, skin care, nutritional support, and support of mother-infant bonding.

Pharmacologic therapy includes the use an opioid such as morphine or methadone.  If required, infants are started on a dose of opioid that controls their symptoms and allows them to develop appropriately.  Once the symptoms are controlled, the medication is weaned slowly.  In most cases, this weaning process takes weeks to achieve.

7.    Who takes care of babies with NAS at Orange Park Medical?

The Neonatal Intensive Care Team consisting of the Neonatologist, Advance Neonatal Practice Professionals (NNPs and PAs), NICU Nurses, Therapist (Occupation, Physical and Speech), Pharmacist and Case Manager.  It is truly a team effort to provide adequate care.

8. Is NAS fatal?

NAS in itself is usually not fatal.  Complications of NAS such as seizures can place the infant at a high risk for death if not treated promptly. Further, children with NAS are more likely to be re-admitted to the hospital for maltreatment, trauma, mental and behavioral disorders.  Some of this maltreatment and trauma will result in death, but this is not directly related to the history of NAS.  Also, the risk of Sudden Infant Death Syndrome may be increased in infant affected by NAS.

9. What are the long-term effects of NAS?

It is believed that children with NAS are more likely to have difficulty in school, perform worse on standardized testing, and have a lower IQ then non-exposed children. Further, children with NAS are more likely to be re-admitted to the hospital for maltreatment, trauma, mental and behavioral disorders.