- Associated Press - Saturday, February 22, 2014

PITTSBURGH (AP) - Nicole Ehredt of East Liberty was in methadone treatment when she delivered three of her four children, struggling to break a drug habit that started when she was 12.

The youngest suffered tremors from addiction when he was born underweight two years ago at a Cambria County hospital.

Ehredt, 30, took her son home and breastfed, providing the methadone and easing his symptoms. When he was 6 weeks old, she weaned him by switching to formula.

“(The tremors) went away after he (nursed),” Ehredt said. “He’s still a small baby.”

The state doesn’t mandate substance testing for newborns, track the number of babies born addicted or require hospitals to report women who are in drug rehabilitation when they deliver. Reporting is mandatory only when babies born to mothers not in rehab have withdrawal symptoms.

At least 648 babies were born addicted or treated for addiction last year at Uniontown, Magee-Womens Hospital and West Penn and Forbes hospitals. Although hospitals aren’t required to track them, officials agree the number has multiplied in a decade in tandem with a statewide surge in heroin and prescription drug abuse.

At Excela Health Westmoreland Hospital, which delivers about 1,800 babies a year, addicted infants typically fill two of the six beds in the special care nursery, nurse practitioner Kathy Eisensmith said.

“We have had times when every baby in that unit has been in drug withdrawal,” she said.

Nearly 30 percent of the babies delivered at Uniontown Hospital in one year were addicted, said nurse Lea Walls, director of Family Beginnings Birthing Center. Their mothers used opiate street drugs - heroin, morphine, oxycodone - or prescription pain medication while pregnant, she said.

Nationally, the number nearly tripled between 2000 and 2009, to 3.4 per 1,000 hospital births, according to the Journal of the American Medical Association. Sixty to 80 percent develop Neonatal Abstinence Syndrome, a withdrawal condition.

Because newborns in withdrawal need more intensive care and hospital stays of four weeks to several months, medical costs, too, more than tripled, data show. Hospital billings to private insurers or Medicaid rose from $190 million in 2000 to $720 million in 2009, when the average was $53,400 per baby. Medicaid paid for 77 percent of those deliveries, including Ehredt’s son.

In Pennsylvania, the number of addicted births covered by Medicaid rose from 883 in 2010 to 1,122 in 2012, according to the Department of Public Welfare. In 2012, Medicaid paid $17.3 million - an average of $15,449 per birth - compared to $15.1 million in 2010.

The actual hospital billings were higher, according to welfare department spokeswoman Kait Gillis.

PRENATAL SAFEGUARDS

The long-term effects of prenatal exposure to drugs aren’t certain.

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