Continuing Care Nursery will care for infants with complex needs

Christiana Care Health System has opened a specialized nursery for some of its most delicate newborns. The Continuing Care Nursery at Christiana Hospital is dedicated to babies with neonatal abstinence syndrome, and was made possible through a $500,000 gift from the Junior Board of Christiana Care.

Neonatal abstinence syndrome (NAS) occurs when babies are exposed to narcotics during pregnancy. After birth, these babies can show withdrawal symptoms, including irritability, disturbed sleep patterns, difficulty feeding, gastrointestinal upsets, tremors, seizures and poor weight gain. They are often hard to calm and need special care, including gentle rocking and swaddling, and reduced noise and light.

“Babies with neonatal abstinence syndrome need a quiet environment where they can be comforted and nourished, and where they can grow developmentally,” said Laura Lawler, M.D., chief of Pediatric Hospitalists at Christiana Hospital. “Our new Continuing Care Nursery is that special place.” Previously, newborns with NAS were cared for in the Pediatric Unit or the Neonatal Intensive Care Unit.

A ribbon-cutting ceremony and tour marked the official opening of the Continuing Care Nursery on May 12. Chief Medical Officer Ken Silverstein, M.D., MBA, thanked the Junior Board, with leadership from Past President Diane Thomas and current President Nancy Rich, for “a gift that makes a measurable difference in the lives of our patients, families and community.”

Rich said the need “touched our hearts… we are honored to have played a part in the creation of this nursery and we admire and respect the members of Christiana Care’s staff who make this program the success that it is.”

The gift has enabled the complete renovation of seven rooms that were previously a part of the Pediatric Intensive Care Unit. The newly dedicated rooms are designed as single-family units and, if needed, the nursery can accommodate up to nine babies at a time.

“We encourage parents to stay with their babies in the nursery as much as possible,” said Dr. Lawler. “They are asked to assist the nurses in feeding and providing the baby’s care, and we show them how to provide comfort when the baby is showing signs of withdrawal.”

Babies are continuously monitored during their stay, which is about three weeks on average. Approximately 8 percent of babies with NAS first require a stay in Christiana Hospital’s Neonatal Intensive Care Unit, the only Level III NICU at a delivering hospital in Delaware that offers the highest level of non-surgical care to the most critically ill newborns.

While the Continuing Care Nursery is primarily for babies with NAS, it is also open to other newborns, such as babies released from the NICU but who aren’t quite ready to go home yet and babies with newborn jaundice.

“Our new Continuing Care Nursery allows us to deliver the high-quality, patient-centered care that Christiana Care is known for, in an environment perfectly suited for these vulnerable patients,” said David Paul, M.D., chair of Pediatrics. “In addition to offering the calm and quiet the babies need, we now have a centralized location where we can more effectively coordinate our team approach to evidence-based care.”

Christiana Care Health System has more than 30 years of experience caring for babies with NAS, and the need is increasing. In 2000, 19 babies received such care at Christiana Hospital. In 2014, that number rose to more than 150.

In the community, Christiana Care nurses, nurse practitioners and social workers partner with local organizations to educate women about neonatal abstinence syndrome. Their aim is to help improve care before and during pregnancy, and after birth. Once babies with NAS are discharged from the Continuing Care Nursery, the Christiana Care team works closely with health and social services programs throughout the state to ensure that the babies continue to receive the care they need to develop appropriately, and to make certain that the family and baby are doing well at home.

“Hospitalization is just one element in the continuum of care we provide for babies with NAS, but it’s certainly a very critical element,” said Dr. Lawler. “With the new Continuing Care Nursery, we’re able to deliver even better care than we could before, and can offer families a more valuable experience. We and our patients are so grateful to the Junior Board of Christiana Care for making all of this possible.”