dr. ronald abrahams

Family Practice

BC Women's Hospital & Health Centre

Fir Square Combined Unit - 4500 Oak Street
Vancouver, BC V6H 3N1

Perinatal Addictions

Aboriginal Health

Chemical Dependency

Harm Reduction

Fir Square Project: An Evaluation of Rooming-In in Substance-Exposed Newborns

Investigators

Ronald R. Abrahams, MD, CCFP, FCFP (Principal Investigator)

Zoë G. Hodgson, PhD (Co- Investigator)

Patricia Janssen, PhD (Co-Investigator)

Susan J. Harris, MD, FCFP (Co-Investigator)

Funding

BC Children’s Hospital Foundation, Telethon Award

The use of illicit substances such as heroin and cocaine during pregnancy is a major pediatric problem affecting approximately 3-11% of all newborns, and up to 44% of newborns within impoverished populations. Substance-exposed newborns are at risk for serious consequences including symptoms of drug withdrawal, delays in social, cognitive and physical development, and even death. The standard practice is to immediately separate substance-exposed newborns from their mothers, transfer them to a special care nursery to monitor for signs of withdrawal, and treat with morphine if necessary. However, these infants often suffer social, behavioral and developmental deficits as a result of such separation. The Fir Square Combined Care Unit (Fir Square) aims to improve outcomes of substance-exposed newborns by caring for the mother and her newborn together in the same room (i.e., “rooming-in”).

Given that rooming-in is an accepted practice in the general population with well-known benefits (e.g. increased breast-feeding rates and improved mother-infant bonding), it seems logical to apply a similar strategy in caring for substance-exposed populations. Preliminary results suggest the rooming-in model is both beneficial and safe and may be the preferred mode of care for substance-exposed newborns1. This investigation will expand upon our original study to compare outcomes of substance-exposed newborns who roomed-in at Fir Square versus those who received standard care in B.C.

This is the most comprehensive evaluation of rooming-in among substance-exposed newborns. Findings will generate critical information for the care of this vulnerable population and will ultimately lead to improved outcomes for substance-exposed newborns.

Abrahams, R., et al. 2007. Rooming-in compared with standard care for newborns of mothers using methadone or heroin. Canadian Family Physician 53(10):1722-1730

Abrahams, R. 2005. Perinatal Addiction: The Vancouver Experience. Enjeux Methadone 10:8-9

Abrahams, R. 2002. Perinatal Opiod Exposure Care of the Baby {GU0300}. C&W Hospital & Health Centre of BC Substance Use Guidelines (April)

Abrahams, R. with Graves, L., et al. 2006. Pregnancy-Related Issues in the Management of Addictions: A Reference for Care Providers. University of Toronto, Department of Family and Community Medicine