Maddie’s Place: Health Outcomes for Mothers and Babies in Pediatric Transitional Care Centers
“I was in tears this morning. I walked in the kitchen and I was just thinking to myself – because I had just handed my baby off to one of the cuddlers, and one of the ICS was holding one of the other ones. And I was just thinking like, wow, what a blessing to be able to know like I handed my baby off and to know like he’s being so loved right now by somebody that wants to care for him, that wants to hold him, that wants to be there.”
The Study:
Title: Research and Analysis of Neonatal Abstinence Syndrome
Washington State Health Care Authority Report to the Legislature, December 1, 2024
Summary in Plain English :
What the Study Was About
The State of Washington’s Health Care Authority and Washington State University studied how often babies are born with Neonatal Abstinence Syndrome (NAS) and how babies and moms are doing in special care centers. They looked closely at Maddie’s Place, one of only two pediatric transitional care facilities in the state that cares for babies with NAS, to see how it helps both the babies and their mothers.
What They Found
Maddie’s Place is a special care center in Washington State that helps babies in a gentle and caring way. The goal is to help babies get healthier and maybe even lower hospital costs. This report shares what they’ve learned so far by looking at numbers and stories about how the care is helping.
Limitations and Challenges
In the first part of the study, they talked to doctors and nurses in Spokane County to learn about the problems with finding and treating NAS. They said that more moms are using strong drugs like fentanyl and other substances together, which makes it harder to treat the babies and help the parents recover.
“The rate of NAS in Washington State from 2016-2022 has been consistently higher than the national rate. The most recently available data from 2021 included a national rate of 6.2/1,000 live births, while the Washington State rate was 10.3/1000 live births. Of note, the Washington rate has also increased year-over-year from 2019 to 2022 while the national rate of NAS has remained stable during this period.”
Even though reporting of NAS seemed accurate, the rise in fentanyl use has made care for both moms and babies more difficult. The healthcare providers said they need clear rules for treatment and more services to help moms recover—especially those dealing with mental health issues and other health problems during and after pregnancy.
Health Outcomes
Next, they looked at the health of 71 moms and their babies who got help from Maddie’s Place. Most of the babies were exposed to about four different drugs before they were born. The most common were methamphetamine, a man-made stimulant drug (81%) and fentanyl, a synthetic opioid (74%).
Maddie’s Place provides a sensory-protective environment that controls sound, light, and visual stimulation, complemented by techniques like vertical rocking, swaddling, c-curl positioning, pacifiers, sound machines, yoga balls, large joint pressure, and deep-water baths. For noisesensitive infants, the facility uses medical-grade hush hats, and beanie hats for those sensitive to light.
Babies stayed at Maddie’s Place for about 56 days on average, and most were able to go home with their parents or relatives. While the babies did get better during their time there, we’re not sure how much better they did compared to babies who didn’t get help from Maddie’s Place. More research is needed to know for sure.
Parental Experiences
In the final part of the study, 15 moms were interviewed about their time at Maddie’s Place, from pregnancy through after the baby was born.
“And then, um, this is kind of like been a problem, I guess, with like a lot of girls that are pregnant with methadone. They tell you like if you stop methadone, you’re gonna have like a miscarriage and all this stuff. And actually, in your pregnancy, you need to go up because the baby is like taking some, so like you’re not getting all of it. So like, yeah, ‘cause I wanted to get off of it, but – so that wasn’t really a choice. I had to actually stay on it and then I had to keep going up. So that was really stressful. […] I asked them. ‘Cause that was my biggest thing -- I’m still very mad about it. I was like, “Well, is my baby gonna have like withdraw symptoms?” It’s the same thing as using basically. And, they said no – they were telling me no and saying like even if he does -- on the rare chance that he has withdraw symptoms, they’re not gonna be that noticeable. I also went to an OB/GYN who like supports methadone. So I literally didn’t like worry about it at all during my pregnancy. And then an hour before I gave birth to (name reference), like a pediatrician came in and like told me basically what to expect with him. Like the withdraw symptoms, how long, and all this stuff. And then like all this like guilt and shame came over. And, yeah, it was really bad. It just sucks that I’m like clean technically like – but now my baby is still going to have all these withdraw symptoms from drugs. You know? I was completely like blindsided.”
Most of the moms had good things to say and were thankful for the help they got. Some also shared ideas to make things better. The biggest problem many parents faced was not having a safe place to live. Maddie’s Place helps families find the support they need to recover and care for their babies. Because there aren’t enough homes in Spokane, parents are signed up for housing help early in their stay. Maddie’s Place makes sure parents leave to a safe place—whether it’s a treatment program, sober housing, or staying with family—and they help with temporary shelter if needed.
Recommendations
The study authors made recommendations based on their findings. One focus suggested the state could ask for more money and do more research to see if Maddie’s Place helps save money in the long run for babies covered by Medicaid (a health insurance program for people with low income). Right now, most of the care at Maddie’s Place isn’t paid for by Medicaid. To get more help from Medicaid, the state would need to show that the program doesn’t cost more than what Medicaid already spends. Medicaid only approves new programs if they don’t raise costs. Since most babies come to Maddie’s Place after they leave the hospital, the costs are extra on top of regular hospital costs.
Many thanks to the authors of this article
