What is an NAS baby?

david-103The nurse looked at me and asked “have you ever had a NAS baby?” Nope! As a matter of fact I am a nurse and I have never heard of this acronym, not even in our foster classes. NAS stands for Neonatal Abstinence syndrome. Our girls were starting to spend over night visits with their birth mom and getting closer to reunification when we received a call for a 3 week old baby. We were told his mother left the day after he was born. He tested positive for heroin and other opioids. We arranged with the intake caseworker to see him that evening.

He was in a special care nursery. I’ll never forget the day I first saw that sweet baby. The nurse just finished feeding him and turned him around to us introduce us. She placed him in his bed making sure to bring all his wires with him. He had leads on his chest and a pulse oximeter to his foot. He began to cry and I could only try to imagine the pain this little boy has had to feel withdrawing. My eyes filled up with tears. At this point we could not sign for him to be in our care until he would be discharged. However, we decided we were going to take him in when he was ready. He needed a mommy and daddy. For three long weeks he had been fighting on his own. The nurses were great but he had no constant familiarity with their schedules.

It was not easy but we managed to arrange our work to be able to transport our girls to and from visits and take turns staying with the baby. Children under two were not aloud in the Special Care Nursery and only immediate family.Β  Thankfully they did consider our girls his foster sisters and twice they were able to see him in the hospital. We had to provide proof they were up to date on vaccines and have their temperature checked each time.

I stayed late nights with him, this made me feel guilty I wasn’t home enough for our girls. We took advantage of the girls overnight visits with their birth mom so both of us could stay with the baby. They provided us with guest rooming and we were able to be called in for all his feedings at night. We didn’t do much sleeping! If he slept for 15 mins straight it was a blessing. Each day he would be scored on a finnegan scale. Depending on his scores he would be weaned on his medication. This scale looks for common withdraw symptoms such as high pitched cry, lack of sleep, fever, vomiting, diarrhea, sweating, increased muscle tone, and tremors to name a few. His first two week treatment with methadone was unsuccessful. He was also taking phenobarbital to reduce risk of seizures as well as clonidine to help control NAS symptoms. When children services got involved the doctor tried subutex which slowly began to help him. The nurses told us they could begin to see improvement when we stepped in. We held him and talked to him for hours. Love is a powerful medicine.

I have videos of him jerking, these are called myoclonic jerks. Some things we tried to calm him down were swaddling, soothe pacifier, laying on a warm blanket on his belly, walking down the halls, music, & warm baths. Sometimes it worked, sometimes it didn’t, nothing was his ‘go to’. We often would feed him laying on his side on a pillow in our lap to help him eat a little slower. A lot of times they have trouble coordinating their suck, breathing and swallowing.

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It was exhausting mentally and physically. He was the loudest on the unit. You could hear him screaming at the ward doors as they buzzed us in each time. It takes a team! After many hours and days of weaning off most of his medication a week later he was finally approved for discharge. We got to take our little guy home! He was sent home on one medication and he would need to follow up with a high risk neonatologist as well as physical therapy evaluation. It was not the typical discharge, here we come walking out with two CPS case workers, the hospital social worker, a nurse and our now three kids!

It was a relief to be home, all of us in one place but just for the weekend, our girls would be going home forever on Monday! He brought much happiness in such a hard time. The girls were our first foster children, our first to be reunified. They loved to help out and give him lots of cuddles.

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We got to cut his wrist and leg bands off that were getting tight on his little limbs, we saved these for his life book. For the first time in his life he wasn’t attached to any cords, no beeping, no scores, no lights on 24/7. He could relax, he slept for six hours!! Although I’ll admit being home was easier on everyone it was still very hard, and still can be.

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Through many trial and errors we learned what helped soothe and what didn’t. Today we have reached many milestones and victories. He is a happy, healthy five month old baby boy. We are unsure of his possible upcoming developmental setbacks but he is thriving now with appropriate love and care. We love you buddy! πŸ™‚

For more information on NAS babies visit:

http://www.marchofdimes.org/complications/neonatal-abstinence-syndrome-(nas)

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