Brewer institute joins brain-injury initiative

Posted June 03, 2009, at 8:22 p.m.

BANGOR, Maine — Researchers and clinicians in the Bangor area are taking part in a new national initiative to develop a consistent, comprehensive approach to preventing, assessing and treating brain injury in infants and young children.

The Sarah Jane Brain Foundation, a national clearinghouse for pediatric brain injury research and funding, has named the Maine Institute for Human Genetics and Health the lead institution in the state for developing a national standard for treating pediatric brain injuries. The foundation is affiliated with the Sarah Jane Brain Project, started by a New York father whose infant daughter suffered severe and permanent brain damage when she was shaken by a nurse.

With $1.25 million in federal funding, the genetics institute — an affiliate of Brewer-based Eastern Maine Health Care Systems — will continue and expand clinical and investigative work already under way with its partners at Eastern Maine Medical Center, The Acadia Hospital and the University of Maine in caring for infants whose mothers use opiates and other drugs while pregnant.

In addition, the genetics institute has been named the regional leader among Northeastern states — including the six New England states and New York — for developing the use of computer-based “telehealth” technology for treating pediatric brain injuries and supporting affected families in rural areas.

Genetics institute researcher and UM professor Marie Hayes said Maine’s focus on brain damage caused by substance abuse is unique among the states participating in the initiative. While pediatric-acquired brain injury may be caused by physical trauma, medical disorders, oxygen deprivation during birth, strokes and other con-ditions, Hayes said the damage caused by substance abuse can be equally devastating and permanent.

Maine’s high incidence of opiate abuse and addiction in young adults, particularly in the northern half of the state, has driven clinical innovation in treating pregnant women and their chemically dependent newborns, she said.

For example, clinicians at The Acadia Hospital have established protocols for treating opiate-addicted mothers-to-be with methadone in order to minimize the abuse of other drugs and avoid complications associated with fluctuating levels of opiates in the bloodstream, Hayes said. Acadia also provides prenatal education to teach young mothers the importance of complying with their treatment plans and to prepare them for the challenges of parenting a baby affected by opiate withdrawal.

Babies born to drug-dependent mothers can suffer from a number of potentially life-threatening complications, including prematurity, low birth weight, respiratory and cardiac problems, as well as withdrawal symptoms such as seizures, irritability and other neurological problems. In addition to the physical effects of opiate with-drawal, children are at risk for developing mental health problems related to their early environmental surroundings.

Dr. Mark Brown, chief of pediatrics at EMMC, said treatment must include supporting young parents in understanding the physical and psychological needs of their babies and promoting healthy family bonding.

“A lot of these young parents have had very poor role models,” he said. “They don’t know how to do it.” Additionally, many drug-using young mothers have serious psychological problems of their own and are ill-prepared to meet the special needs of their infants. The result, Brown said, can be impaired family bonding that sets the stage for future mental illness and family dysfunction.

Funding through the Sarah Jane Brain Foundation will allow the genetics institute and its partners to expand efforts to prevent, assess and treat brain injuries associated with prenatal exposure to opiates and other drugs. The funding and participation in the national project also will enable better data collection, evaluation and analysis of those interventions, and bring Maine’s developing expertise in a relatively new field into national focus as part of a comprehensive approach to pediatric brain injuries.

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