Moving Practice Forward: Addressing Prenatal Substance Exposure

Participants of the Substance Exposed Newborns Summit engaged in TABLE DISCUSSIOn--November 2nd, 2017

Participants of the Substance Exposed Newborns Summit engaged in TABLE DISCUSSIOn--November 2nd, 2017

To give Colorado newborns the healthiest start possible, we need to address prenatal substance exposure and its effects on children and families. Use of any substance during pregnancy is a complex issue, existing at the intersection of public health, law, behavioral health, and child welfare.

According to the 2015 Pregnancy Risk Assessment Monitoring System data, 12.0% of pregnant women reported drinking alcohol during the last three months of their pregnancy, and 4.5% reported marijuana or hashish use at some point during pregnancy. Additionally, cases of Neonatal Abstinence Syndrome (NAS), the diagnosis many babies withdrawing from opioids receive, in Colorado have increased by 83% from 2010 to 2015 based on hospital discharge coding data.

We know prenatal substance exposure is happening in Colorado, but what’s really at stake? Research shows that the impact of prenatal exposure to alcohol or other drugs on an unborn child can be devastating, including low birth weight, preterm delivery, drug withdrawal, and long-term cognitive, behavioral, and developmental delays. Additionally, we know that babies who are prenatally exposed to substances can have increased medical needs -- which can be particularly stressful for any caregiver. Lastly, there is a connection between substance use, unsafe sleep environments, and infant safety.

Additionally, it can be very difficult for women to find help decreasing their substance use. Substance use disorders are highly stigmatized in the United States, which could discourage those affected from seeking the care that they need. Additionally, soon-to-be-parents may fear that they will lose custody of their child if they admit to struggling with a substance use disorder. Some women may not be aware of the potential dangers of using substances while pregnant at all--especially those with inadequate medical care.

In an effort to address these barriers, Illuminate Colorado coordinates Colorado’s Substance Exposed Newborns (SEN) Steering Committee. The SEN Steering Committee is focused on initiatives to prevent prenatal substance exposure, identify and treat substance use disorders in pregnant women, and support the long term health and well-being of families with prenatally exposed children. Established in 2008 as a subcommittee of the Colorado Substance Abuse Trend and Response Task Force, the SEN Steering Committee is comprised of substance use and children’s safety experts, medical professionals, and advocates.

Over the last year, the SEN Steering Committee and Illuminate Colorado have supported a SEN Hospital Learning Collaborative, which included 8 hospitals across 5 healthcare systems. This year-long Hospital Learning Collaborative has explored the research and hosted expert presentations and discussions on multiple topics related to substance use and prenatal exposures--including verbal screening, newborn testing practices, treatment referrals, collaboration with child welfare, breastfeeding, and neonatal care. Together, this collaborative developed best practice recommendations, which the SEN Steering Committee used to identify six priority areas for 2018-2020. On November 2, these priority areas were presented at the Substance Exposed Newborns Summit for feedback from an even broader audience of professionals.

Now that the priority areas have been fully developed, approved and finalized, the SEN Steering Committee, the Hospital Learning and Quality Improvement Collaborative, and Illuminate Colorado will move on to implementing these recommendations--with help from people like you!

Moving forward, there are many ways to support this work:

  • Donate. It may go without saying, but your donations to Illuminate Colorado help us to continue the important work of helping children and families. Donate here today!

  • Join our next round of the SEN Learning Collaborative. If you are a medical provider who interacts with pregnant women and/or newborns, consider joining our next round of the SEN Learning and Quality Improvement Collaborative beginning in early 2018. To learn more, contact Jillian Adams, Illuminate Colorado’s SEN Program Manager.

  • Join a SEN work group. Beginning in 2018, there will be six work groups operating under the direction of the SEN Steering Committee. These groups will be the driving force for implementing the recommendations coming from the Summit. If you have expertise and experience to share, contact Jillian Adams, Illuminate Colorado’s SEN Program Manager, about joining a work group.

By developing long-term, cross-discipline solutions together, we can reduce the number of families affected by prenatal substance exposure, provide better support for families and children, and build stronger communities in our state. Join us!