Hospitals in Washington state are no longer required to report babies born with prenatal drug exposure to Child Protective Services.
The change is part of an effort to “reduce stigma” against mothers who use drugs while they are pregnant.
In a press release earlier this week, the Washington State Department of Health announced that the new policy incorporates an “Eat, Sleep, Console” model of care for substance-exposed infants. The department also referred to “chestfeeding” in the announcement.
The department said that “Eat, Sleep, Console prioritizes parental involvement and non-pharmacological care such as cuddling, swaddling, rooming-in with parents, chest/breastfeeding, and a quiet, dark room. The announced change formally recognizes Eat, Sleep, Console as the new best practice for birthing hospitals, and states medications and NICU admissions should no longer be the first line of treatment for infants exhibiting withdrawal symptoms.”
Under this policy, hospitals are still required to report an infant suffering from “neonatal abstinence syndrome,” or when a baby is experiencing drug withdrawals, if there is an “imminent risk of serious harm” due to substance use,
“While hospitals are still required to report cases where there is a safety concern for the child, not all families that have a child with prenatal substance exposure require child welfare intervention. We still want to connect these families with community-based services and resources that will support the family’s needs, reduce risks, and increase protective factors,” said DCYF Secretary Ross Hunter.
All hospitals must update their practices to align with state policy and train staff by January 1, 2025.
“The opioid and overdose epidemic is disrupting the lives of a growing number of families in our state,” said Tao Sheng Kwan-Gett, MD, MPH, Chief Science Officer at DOH. “These changes will help every baby born in Washington get the healthiest start possible.”
The Seattle Times reports, “Infants in Washington have been hospitalized at increasingly high rates with neonatal abstinence syndrome since 2000, when fewer than two hospitalizations per 1,000 births was common, according to state Department of Health data from 2020. Rates dropped significantly in 2018, but had climbed back up to about nine hospitalizations per 1,000 births by 2020. More recent data is not yet available.”
The National Institutes of Health has reported that the Eat, Sleep, Console model has “not been rigorously tested in a large population” and “has raised some concerns about potentially underrating infants or discharging them prematurely.”
Tiffani Buck, a nurse practitioner with the state Department of Health, told the Times that “the shift in treatment is evidence of a push to reduce stigma and bias against those who use substances.”
“This is a big shift in recognizing the value and worth that all people have,” Buck said, “and that using substances and having a substance use disorder is a medical condition and not a moral failure.”
