ETSU hosts discussion on infants born with NAS

Brandon Paykamian • Updated May 17, 2019 at 9:46 PM

For adults, opiate withdrawal symptoms can include abdominal pains, muscle pains, vomiting, restlessness and tremors, just to name a few.

But for infants who’ve just entered the world, it’s even worse, according to Dr. Shawn Hollinger, a neonatologist at Niswonger Children’s Hospital and an assistant professor in Quillen College of Medicine’s Department of Pediatrics.

“It can be difficult to see as well — to see a baby struggling or suffering,” he said. 

On Friday, Holliger met with Dr. Eric Avery, an artist, physician and spring 2019 ETSU Basler Chair of Excellence for the Integration of the Arts, Rhetoric and Science, to discuss neonatal abstinence syndrome at East Tennessee State University’s Reece Museum.

Neonatal abstinence syndrome — sometimes referred to as neonatal opiate withdrawal syndrome, or NOWS, in the case of opiate dependence — occurs when a child is born dependent on medicines or substances the mother used during pregnancy. Babies with NAS can experience withdrawal symptoms, including seizures, irritability and difficulty eating.

While it can be more difficult to identify other drug withdrawal symptoms in infants, such as methamphetamine withdrawals, Hollinger said he can almost immediately spot a baby with NOWS from across a room.

“They tend to be very irritable. They cry a lot,” Hollinger said. “And that cry is kind of a distinctive, high-pitch cry.”

When an infant’s neurological system is “off,” Hollinger said it’s hard to feed them. This is a common symptom of NAS, which can also cause gastrointestinal issues and abnormal breathing patterns.

“It’s a lot of disorganization in the way that a baby feeds,” he said.

When Hollinger began his residency in 2008, he said Tennessee was tracking about 100 babies with NOWS a year.

“That number from year-to-year skyrocketed, and for I think three years in a row, we were somewhere close to 1,000 babies,” he said.

That number plateaued from 2015 to 17, then went back down to the 800s, Hollinger said.

“It’s still 800 babies, so it’s still a huge problem,” he said.

There’s still a lot of work to do, according to Hollinger. That work includes continuing to crack down on overprescribing and combatting the stigma against mothers with an opiate abuse disorder.

Hollinger said mothers will “immediately pick up on” when a health care professional is being judgmental, and he believes that’s not helpful to the process of helping both the infant and mother.

“We see a lot of moms in there that are feeling incredible guilt,” he said.

Hollinger said it’s important for mothers to understand that government agencies like the Department of Children’s Services, which often work closely with local health care providers, are there to help first and foremost.

“The stigma is there that they’re concerned that this is the government here to take my baby, and really, that is not DCS’s focus at all. Their main focus is making sure that child is in a healthy and safe environment,” he said. “That is the goal every time.”

Friday’s opioid discussion was the second of two held this week at Reece in conjunction with the “Epidemic” visual art exhibition, open until May 31. The exhibition features prints, 3D art and projections by Avery and fellow printmaker and graphic designer Adam DelMarcelle of Pennsylvania, who lost his brother to an opioid overdose in 2014.

“It’s really important that the museum is being used for public health purposes,” Avery said ahead of Friday’s event.

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