On-call cuddlers

Sometimes, all you need is a hug. This is especially true for infants suffering with Neonatal Abstinence Syndrome, or those going through withdrawal after being exposed to drugs—most commonly opioids—while in the womb.

“All these babies are irritable—they’re anxious, they’re agitated, they’re hard to console,” explained Dr. Amy Dolinar, a pediatrician at Enloe Medical Center. “They just want to snuggle.”

Officials at Enloe are trying to lend exactly this approach to the neonatal intensive care unit (NICU) with a new program that brings volunteers in to cuddle the most vulnerable newborns.

Administration and health care providers at the hospital are hoping the new volunteer program will not only help console babies in the short term, but also shorten their hospital stays, which can help alleviate resources and lower hospital bills for parents.

“They have better outcomes sooner,” said Roseanna Galindo-Kuhn, director of Volunteer Services. “Just the holding of these babies improves their overall well-being.”

The program, Cuddle Care Volunteers, will bring dozens of volunteers into the NICU, providing therapy for what hospital officials say is an increasing number of premature babies, including those exposed to drugs. The volunteers hold, comfort and console the newborns, with direction from NICU nurses. Hospitals around the country have implemented similar programs in response to the opioid epidemic that is affecting more pregnant mothers and their babies than ever before.

Withdrawal can be painful and include symptoms such as tremors, sweating, nausea and even seizures. But to a baby who’s already struggling to understand a new world outside the womb, the experience can be especially traumatic. The most common substances affecting newborns are opioids—including morphine and heroin—and phenobarbital, which is a drug to help prevent seizures in people who abuse several drugs at once.

Dolinar explained that when a baby is in utero, drugs the mother ingests go straight to the placenta, meaning the effects of the drugs affect the baby even before the mother. When the cord (and therefore, the drug supply) is cut at birth, NAS babies often exhibit signs of withdrawal that include high-pitched crying, irritability and poor feeding.

“Withdrawal is painful,” Dolinar said. “We do everything we can to make sure they’re comfortable and cared for.”

During the initial stages of planning for the Cuddle Care Volunteers program about a year ago, administrators were hoping to focus solely on babies suffering from NAS, but they soon realized NICU nurses had their hands full and administrators decided to include all NICU babies in the program.

“They love these babies. They just can’t hold all of them at the same time,” said Galindo-Kuhn. “They’d have to be an octopus.”

Newborn babies can stay in the NICU for anywhere from 48 hours to two months, depending on various health issues including the severity of withdrawal symptoms. The NICU holds up to 12 babies at a time. With four nurses dedicated to the unit during any given shift, it can be a bit overwhelming, with each crying baby setting off the next.

“They are really welcoming the help,” Galindo-Kuhn said.

Breanna Rose, a student at Chico State who’s interning at Enloe, was the first volunteer and is now taking a lead roll in training others. She says cuddling is a little more technical than one might think.

“There are ways to soothe the baby,” Rose said. For instance, they “need a really tight swaddle.”

The hospital doesn’t let just anyone volunteer in the NICU. There is an extensive screening process that includes an application and two letters of reference. Applicants are interviewed to see if the volunteer position is a good fit. Then there’s a background check and a health screening, including checks on immunizations.

“You’re working with a really vulnerable patient population,” Galindo-Kuhn said.

The training process is extensive, too. It takes each volunteer from six to nine weeks to complete the process. The first training session started earlier this month and includes four hospital employees.

“It’s really a nice cross- spectrum of different ages,” Galindo-Kuhn said.

Galindo-Kuhn said the program still needs about 16 to 20 additional volunteers. However, she’s convinced she’ll find ample help.

“I’ve had so much interest,” she said.