(Pixabay.com)

B.C. guidelines focus on mother and baby fighting opioid addiction

Recommendations include keeping an addicted mother with her newborn immediately after birth

A new set of guidelines issued this month aims to help new moms and their babies overcome addiction to opioids side by side.

The BC Centre on Substance Use and Perinatal Services BC compiled five care principles and eight treatment recommendations from prenatal to postpartum stages of pregnancy for women who use opioids.

Recommendations include offering the full scope of harm reduction supplies and services, as well as all kinds of treatment options, including methadone and suboxone, and encouraging breastfeeding while safe.

The biggest change is recommending to no longer separate an addicted mother from her newborn immediately after birth. Instead, the baby’s crib is kept by the mother’s bedside. It’s called rooming-in.

“Historically, these babies were taken from delivery and rushed off to neonatal care units, and titrated on morphine in a dark, warm box away from mom – and this was the standard care,” said Dr. Eric Cattoni, the medical lead at FIR Square, a BC Women’s Hospital unit that provides specialized services for women with substance use issues.

FIR Square offers 12 beds for pregnant women who use illicit drugs, and those beds are rarely empty, with the unit often relying on overflow beds.

“I don’t know if there’s a patient population in Canada that has changed more drastically or more quickly than the opioid substance use disorder patient population, and the same has happened in pregnancy,” Cattoni said.

Left untreated, pregnant women with opioid addictions are not only at risk of overdose and injection-related infections, but also face a higher likelihood of adverse outcomes for the baby, including poor fetal growth, increased mortality risk, and neonatal opioid withdrawal symptoms.

Meanwhile, babies too go through withdrawal. They have difficulty eating, sleeping and gaining weight.

When women and their babies undergo treatment next to each other, Cattoni said, resilience kicks in like a switch turning on.

“What’s been shown is these babies actually do far better when they stay with their mother. And that statement seems obvious in itself, but for a long time, this was not what was being done clinically,” he said.

“What we’re finding now, is when mom is staying with baby, baby is on mom’s chest, [doing] skin-to-skin care and breastfeeding when safe and appropriate, babies need far less treatment with morphine, they stay for less time in the hospital they do much much better … and mom does much better.”

Cattoni acknowledges the guidelines are harder to attain in rural regions.

In Nelson, for example, it’s common for a woman to travel as far as Kelowna to deliver her baby. This can make treatment for opioid use more complicated.

The provincial government needs to build capacity for programs focused on pregnant woman and their partners facing problems with substance use, he said, but the changes start with attitudes among frontline healthcare workers and clinicians.

“You don’t need a big fancy hospital, and you don’t need all these fancy facilities to provide effective care for these women and their babies,” Cattoni said.

“You need to have an understanding of what it means to establish a meaningful therapeutic rapport with these patients… and to work towards a healthy family unit as early as possible instead of alienating these patients and making them afraid to present to care cause they are afraid their baby is going to be taken away or they’re afraid of being treated poorly.”

The guidelines are integral, he added, especially as the opioid epidemic shows no sign of letting up.

Just Posted

PHOTOS: Annual Pilgrimage to the Grotto of Our Lady of Lourdes in Mission

A huge crowd came out to Fraser River Heritage Park for the annual event

Infrastructure strategy slated for Silverdale lands

Mission hires consultants to lay out infrastructure needs for 3,440-acre area eyed for future growth

TONIGHT: Second public hearing to be held on major development project

Developer envisions 131 apartments, community gaming centre and other commercial ventures at site

Fraser Valley Express doubles weekend and holiday bus service

Four new round trips to be added, starting Sept. 4

Parks and playgrounds getting upgrades in Mission

Some areas have been waiting years, but district vows to get to them eventually

VIDEO: Lower Mainland air quality to hit ‘extreme risk’

Smoke is pouring in from the interior B.C. and wildfires down in the U.S.

B.C. team stays alive in Little League World Series after another nail-biter

Surrey-based squad scored a 6-4 win over Mexico reps in Williamsport on Monday

Kids, seniors at risk as smoke from distant fires hangs over parts of B.C.

B.C. Centre for Disease Control says children’s lungs don’t fully develop until about age 10

B.C. mother charged in 7-year-old daughter’s death appears in court

The 36-year-old mother, of Langley’s Aaliyah Rosa, has been charged with second-degree murder

VIDEO: Teen soccer phenomenon Alphonso Davies to visit B.C. kids camp

The 17-year-old Vancouver Whitecap player is one of the youngest players in MLS history

New plan to lift more than two million people past the poverty line

Anti-poverty strategy will aim for 50 per cent cut in low-income rates: source

Liberals scrap lottery system for reuniting immigrants with their parents

Lottery for parent sponsorship to be replaced, more applications to be accepted

More bus trips coming to Metro Vancouver this fall

TransLink touts improvements when fall service changes take effect Sept. 34

Bear kills off-leash dog in North Vancouver park

There have been nearly 200 pet or livestock and bear encounters so far this year

Most Read