Interprofessional Practice Based Research
Dec. 19, 2019
Volunteer cuddlers for infants with Neonatal Abstinence Syndrome
When expectant mothers are exposed to opioids, their babies may suffer from withdrawal or Neonatal Abstinence Syndrome (NAS). Withdrawal symptoms can include vomiting, diarrhea, poor feeding, irritability, fever, sweating, and nasal congestion – these are tough symptoms for anyone. All newborns are adapting to a “new normal” in their first few days outside the womb, and experiencing the additional symptoms of withdrawal can make your first days in the world a bit more challenging. These infants need significant extra care.
“The discomfort babies with NAS experience is palpable. It becomes easy to recognize the cry of a baby going through withdrawal,” says Karen Carlyle, a Nurse Practitioner at St. Michael’s Hospital.
Non-pharmacological approaches for withdrawal care, known as supportive therapies, are often provided alongside medication. These therapies are believed to minimize the physiological effects of the withdrawal and can include cuddling – simply, the idea of holding a baby close and or gently rocking the baby. In 2015, the St. Michael’s Hospital Neonatal Intensive Care Unit (NICU) launched a Volunteer Cuddler program to help provide care for babies suffering from withdrawal. This program, which is exactly as cute as it sounds, brings in and trains volunteers to cuddle these vulnerable infants when the family is unable to. This is an important service in this inner-city hospital. St. Michael’s Hospital provides obstetrical care to many women struggling with opioid use. Before its introduction, little was known about whether or how this program was making a difference.
Carlyle and Amanda Hignell, a social worker at St. Michael’s Hospital, were part of the team that brought the Volunteer Cuddler Program into the NICU. They mentioned that “over the years [they saw] how infants with NAS settle while being held but nurses are often busy providing acute care to other patients, and parents are not always present in the NICU to hold their child. In the United States, there were a growing number of hospitals utilizing volunteers as cuddlers and [they] thought we could easily replicate a similar program, while also studying the impact of volunteer cuddlers as evidence is missing in this area of the literature.”
To measure the impact of this program, they used a multi-pronged, mixed methods approach. On the quantitative side, they measured the length of stay of the infants in the NICU. They also held focus groups with bedside nurses and program volunteers to get their perspectives on the impact of the program.
Carlyle and Hignell’s preliminary findings indicated that cuddling is therapeutic for babies suffering from withdrawal. Babies who are cuddled spend less time in the hospital than those who were not a part of the volunteer cuddler program. Furthermore, both bedside nurses and program volunteers are enthusiastic about the positive effects this program is having on care.
“The response that we’ve had both internally, from families, volunteers and staff, as well as externally, has been tremendous,” says Amanda. “Hospitals across the country have been reaching out to us asking how to start cuddling programs of [their] own. It is so gratifying to know that this program is not only helping infants at St. Michael’s, but across Canada”.
The findings from this pilot study are now published in the journal of Pediatrics and Child Health. Stay tuned for further details as this program continues to make positive impacts on the lives of newborns facing symptoms of withdrawal.
Connecting with IPBR
The Interprofessional Practice Based Research program at St. Michael’s Hospital assists nurses and health disciplines professionals at St. Michael’s Hospital engage in the identification, implementation, and evaluation of best practices through research. Amanda Hignell and Karen Carlyle are recipients of a 2018-2020 Interprofessional Practice Based Research Grant. This grant provides research funding and mentorship.
“This study would not have been possible without the support of the IPBR program. This was the first time either of us have led a research study; the advice from our research, library and REB mentors was invaluable throughout the process.”
- Karen Carlyle and Amanda Hignell