Michigan taps opioid funds for tiny drug victims — babies in withdrawal

• Babies born to moms with substance abuse disorder often suffer withdrawal in the first days of life — shakes, sweats, fever, diarrhea, and difficulty sleeping and eating
• Medicine can help, but skin-to-skin contact with Mom is usually better, doctors say
• Michigan will use $1.3 million in opioid settlement dollars to support hospitals that, in turn, support parents who choose ‘rooming-in’

As Michigan faces down its deadly drug crisis, it will spend some of its opioid settlement funds on the tiniest victims: newborns born to moms who take opioids either illicitly or legally.

They are babies like Koby Clark, whose tiny body — less than 7 pounds — trembled with withdrawal when he was born at Hurley Medical Center in Flint.

His mother, Jessica Clark, was in recovery, prescribed methadone, a substitute opioid to keep cravings and withdrawal away. But that medication had coursed through Koby’s tiny body while in utero.

“It was horrible,” 38-year-old Jessica Clark said. She was exhausted and overwhelmed not only by uncertainty but also by guilt over her former addiction. “It was tough to watch.”

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Still, Clark had something going for her — really, several “someones.”

Hurley staff had begun efforts in 2021 at “rooming in,” encouraging new moms to stay with their babies in those first hours and days after birth, consoling their newborns through withdrawal, rather than sending them to the nursery where they would be more likely to be medicated to ease symptoms.

Clark said the biggest surprise during her stay was not in the medical care, but rather the respect she received from staff — a cascade of feelings as a new mother swaddling her tiny son rather than a recovering addict visiting him in the nursery with others watching.

The program “shows that it’s okay to be in recovery, that there is support for,” she said.

Now, the Michigan Department of Health and Human Services is setting aside $1.3 million of Michigan’s share of national opioid settlement funds to make more of those moments possible. Michigan is slated to receive nearly $1.6 billion by 2040, with half being distributed to the State of Michigan Opioid Healing and Recovery Fund and the other half being distributed directly to county, city and township governments.

The grant, announced earlier this month, will expand rooming-in to five birthing hospitals across the state: Hurley as well as Covenant Medical Center in Saginaw, OSF St. Francis Hospital in Escanaba, University of Michigan Health – Sparrow Hospital in Lansing and Bronson Battle Creek Hospital.

The spending fits into the broader four-pillar opioid strategy of prevention, treatment, harm reduction and recovery support, and it recognizes that the opioid epidemic has disproportionately impacted communities of color, Dr. Natasha Bagdasarian, the state’s chief medical executive and co-chair of the Michigan Opioids Task Force, told Bridge Michigan.

Funds pay for hospital room renovations to make the time in the hospital more comfortable for new parents — room-darkening shades, bassinets and dimmable lights.

That gives Mom and other caregivers space and time for skin-to-skin contact in those first days — crucial moments that deepen a mother’s and baby’s natural instinct to bond, make breastfeeding easier, and help the baby to stay warm and cry less.

For babies suffering neonatal abstinence syndrome, or NAS, those first hours and days can be brutal as they go through withdrawal: tremors and seizures, twitching, fussiness.

“It’s as though their nervous system is in overdrive,” said Dr. Chasity Caperton, pediatrician and regional medical director of primary care at OSF St. Francis Hospital and Medical Group in Escanaba. 

Withdrawal sometimes doesn’t show up until Day 3 or 4, she said, so Moms agree to stay in the hospital for at least five days. The Upper Peninsula hospital used some of the funds to pay for sleeper-sofas and responsive bassinets that vibrate to soothe a fussy baby.

It also paid for training for staff to fight the stigma sometimes associated with patients with addiction or in recovery, Caperton said.

The resulting rooming-in will benefit more than moms and babies; the effort can help save health-care dollars — both immediately and in the long run, Caperton and others say.

Shorter stays, numerous benefits

Research shows that babies that room-in with Mom have shorter hospital stays. For example, prior to rooming-in, the average length of stay for infants born substance-exposed at Munson Health System was 7.84 days; the average length of stay from July 2023 to March 2024 was 3.48 days, according to the state health department.

Among other benefits of rooming in, according to the evidence:

• Oxytocin, the hormone that triggers contractions, also stimulates “mothering” feelings. Endorphins enhance a mother’s responsive nature, boosting the temperature of her breasts to keep the newborn warm. Baby, meanwhile, is under a post-birth “adrenaline rush” and will be ready to nurse soon after birth.

• Baby is exposed to bacteria on the mother's skin during skin-to-skin, which may help her fight illness from harmful germs.
• Moms more quickly recognize and respond to their babies' needs.
• Baby’s body functions — breastfeeding, breathing, stabilizing blood sugar levels — are improved in skin-to-skin contact. They may sleep easier and gain more weight each day.

Long-term, research suggests that rates of child abuse, neglect, and abandonment are lower for mothers who have frequent and extended contact with their newborns during the early postpartum period. That’s because caring relationships can help babies build a resilience that can last a lifetime.

“We’re talking about preventing the intergenerational trauma of substance abuse disorder, ” Bagdasarian said.

Privacy, comfort 

At Bronson Battle Creek Hospital, about $70,000 went into technology, allowing babies to stay with their moms, said Carol Fuller, Bronson’s director of women’s and children’s services. The new technology allows staff at a nursing station to observe vital signs remotely — while Baby remains with Mom instead of a nursery where parents and staff “are coming and going. It’s not private, it's not comfortable,” she said.

Additionally, renovated rooms have comfortable rockers and sound machines that offer white noise to help keep Mom and Baby comfortable, she said.

In Flint, Hurley is receiving $256,000 of the opioid settlement funds to continue its work begun in 2021. As part of a rooming-in agreement at Hurley, Clark — now the mom of a rambunctious toddler who loves puddles and stairs and all-things boxes and building blocks and balls — stayed at the hospital for five days.

More than two years later, she’ll admit that “a lot of it’s really foggy for me,” she said.

Exhaustion overwhelmed, she said, “but I do remember the bond of being skin-to-skin with him and of how much he liked to be swaddled.” It wasn’t that Koby didn’t endure withdrawal, but “as long as he was attached to my skin or my heartbeat or the nursing or the eye contact, it seemed to be a bit more okay.”

He became calm, she said, “because I was able to be there and be constant.”