A mother’s love
Spreading a Yale pediatrician’s intuitive, unorthodox, effective treatment for opioid-dependent newborns.
More than six months after his paper on his new treatment for babies born to mothers addicted to opiates appeared in the journal Pediatrics, Matthew Grossman, M.D., HS ’06, assistant professor of pediatrics, is seeing his methods slowly but steadily take hold. [See “More mom, fewer drugs,” Yale Medicine Magazine, Autumn 2016].
Boston Medical Center and Christus Regional Medical Center in Santa Fe, New Mexico, have adopted his approach, which reduces babies’ withdrawal time by replacing drug therapy with increased contact with their mothers. Hospitals in Camden, New Jersey, and Canada, and state health collaboratives in New Hampshire, Vermont, Maine, and Maryland are all talking to him about introducing the protocol. Articles highlighting his methods have appeared in The New York Times and other publications. Inquiries from medical institutions have grown over the past 18 months from infrequent to one or two a week in 2017, and Grossman has traveled extensively to give talks and help with implementation. “I don’t say no,” he says.
While he is gratified by the growing recognition and use of his treatment, Grossman wishes it would be adopted more quickly. Additional data collected at Yale New Haven Hospital and other institutions have only confirmed how well it works, he says.
Grossman’s key insight came in 2009 when he realized that babies who spent more time with their mothers left the hospital after an average of 22 instead of 29 days. That flew in the face of the all-but-universal and long-standing practice of taking babies born addicted to opiates from their mothers, putting them in intensive care, and following a rigid protocol to assist their withdrawal from morphine and other drugs. Grossman and his team at Yale New Haven Hospital started experimenting to see whether even more time with mom would further speed withdrawal. The results were dramatic: the average hospital stay plummeted by more than two-thirds to just 5.9 days, with most of the infants needing far less, (if any), medication. “More mom, fewer drugs,” is how Grossman sums it up.
Grossman is now working on a second paper that expands on and reinforces his findings. He and his team compared their actions under the new method with the traditional method, the Finnegan Neonatal Abstinence Scoring System. That method tracks 29 symptoms to determine whether a baby should receive morphine or another drug. They found improvement, for example, in 70 percent of babies who would have received medication under the old system. Amazingly, the Finnegan scoring method has never been extensively studied, he said.
Other works in progress include following the babies to see how they do long term—Grossman has met with the Yale Child Study Center about setting up a monitoring program—and ensuring that the infants receive any necessary services.
In retrospect, Grossman finds it amazing that hospitals have for so long used and continue to use the Finnegan method. “The idea that we were separating these babies from their source of love and their family just seems terrible,” Grossman says, sitting in his narrow, unadorned office at Yale New Haven Children’s Hospital. “We have something that’s really good for babies and really good for moms, really good for everyone. We think it’s a much better way.”