News
Hospitals enhance care for babies exposed to substances in womb

Providers at a US hospital have created a process for caring for women giving birth to babies exposed to substances like opioids in the womb.
The new approach, developed by a team at US hospital Oklahoma Children’s Hospital OU Health, will see providers surround mother and baby with the care they need in the hospital, at home and in their communities for the years to come.
The American Academy of Pediatrics granted funding to the University of Oklahoma for hospital providers to refine and improve the discharge process for mothers and babies with neonatal abstinence syndrome, also known as neonatal opioid withdrawal syndrome.
The project, called the Perinatal Health and Substance Use Quality Improvement Virtual Learning Collaborative, is helping establish best practices for this transition. Oklahoma Children’s Hospital is one of eight hospitals nationwide chosen for the programme.
Neonatal hospitalist Benazir Drabu, M.D. is associate professor of paediatrics at the OU College of Medicine and team leader for the project.
Drabu said: “We want to provide continuity of care for mom and baby.
“Care starts prenatally and goes through labour and delivery, and for this project, we are focusing on our discharge planning.
“This is work we are already doing, but participating in the collaborative will allow us to learn how to do it better.”
Babies born with neonatal abstinence syndrome may experience withdrawal from the drugs that crossed the placenta while in utero.
Symptoms include jitteriness, trouble sleeping, diarrhea, vomiting, poor appetite and, in severe cases, seizures. I
f symptoms can be managed in the Mother-Baby Unit, the health care team focuses on soothing techniques, feeding and sleep support.
If a higher level of care is required, including medications, the baby is transferred to the Neonatal Intensive Care Unit.
Once discharge is possible, it is essential to have a well-structured plan to ensure caregivers receive adequate guidance and support.
Mothers and babies affected by substance use usually stay in the hospital longer than the general population of birthing mothers.
When discharge approaches, an interdisciplinary team of physicians, nurses, social services providers, physical therapists and occupational therapists shifts its focus to keeping the family well-supported at home.
Soothing strategies used in the hospital are reinforced, including providing the family with a “sleep sack” that swaddles the baby and teaching them how to console a fussy baby.
Safe sleep at home is also emphasised. The team encourages caregivers to have a crib or “pack and play” instead of letting babies sleep with parents.
Neonatologist Patricia Williams, M.D. is associate professor of paediatrics at the OU College of Medicine and a co-leader of the project.
Williams said: “In many cases, families don’t have a separate place for the baby to sleep, so they put them in their own bed, which puts the baby at risk for an adverse event.”
Mothers are screened for depression and coached on successful breastfeeding.
The hospital team also aims to strengthen communication with primary care providers to ensure continuity of care.
Social service providers connect the family to community organisations, such as Sooner Start and Oklahoma Family Network, that provide everything from diapers to respite care to support groups.
In addition, families are referred to the Little STAR clinic for an appointment 30 to 90 days after hospital discharge.
Little STAR is a follow-up programme to the Substance Use Treatment and Recovery (STAR) prenatal clinic at OU Health.
Susan Redwine, M.D. is an assistant professor of paediatrics in the OU College of Medicine and co-leader of the project.
She said: “Studies have shown that babies who have prenatal substance exposure can have poor developmental outcomes, both cognitively and behaviorally.
“We want to prepare caregivers for that but also give them hope because there are clinics and programmes that can help.
Early intervention is so important, as is being non-judgmental. Our goal is to provide as much support as possible.”
When babies reach 1 year old, they qualify for services at OU’s Child Study Center, which continues developmental and behavioural support up to age 7.
Redwine said: “We want to be the bridge between the baby leaving the hospital and getting families into programmes at the Child Study Center.”
OU was previously part of a national effort to improve the care of babies exposed to substances in the womb with its participation in the “Eat, Sleep, Console” clinical trial funded by the National Institutes of Health.
The trial evaluated the “ESC” approach to caring for babies with neonatal abstinence syndrome.
ESC includes feeding babies every three hours around the clock to address the weight loss that often comes with substance exposure.
ESC also prioritises consoling and ensuring babies get adequate sleep. If a baby cannot be consoled within 10 minutes, medication may be considered.
The trial had good outcomes, including a shorter hospital stay and decreasing the likelihood the baby would need medication. ESC has now become the standard of practice.
Drabu said: “It gives us a sense of fulfillment to help these babies and their caregivers and to keep them together as much as possible.
“Sending them home happy and prepared is priceless.”
Insight
UK reviews surrogacy firm over rejected insurance claims

The UK government is reviewing a surrogacy firm after complaints that medical insurance claims involving surrogates in Mexico were rejected.
The Department of Health and Social Care (DHSC) is considering whether UK-based provider My Surrogacy Journey should remain listed on gov.uk as one of four domestic surrogacy agencies available to intended parents.
The review follows allegations concerning its Mexican sister company, where surrogates are based.
Health minister Diana Johnson said: “The department is looking into the allegations about My Surrogacy Journey.
“As part of that assessment, the department will consider whether it is appropriate for that company to remain on the gov.uk list of agencies.”
Emails sent by My Surrogacy Journey chief executive Michael Johnson-Ellis and seen by the Guardian suggest multiple surrogate women in Mexico had their insurance claims rejected.
The emails also suggest 300 couples using the company were moved to a new insurance provider because of the increased risk of claims being rejected.
Commercial surrogacy is banned in the UK, where only altruistic arrangements are permitted.
My Surrogacy Journey operates a not-for-profit UK branch alongside for-profit sister companies in Mexico and the US. All three companies have the same owners and chief executives.
The reported insurance issues relate to surrogacy arrangements in Mexico.
One couple told the Guardian they paid tens of thousands of pounds to cover medical costs after their surrogate had a hysterectomy during childbirth and an insurance claim was refused.
The Guardian said it understood that at least five sets of parents said they had to cover medical costs after insurance claims were rejected.
In an email to the couple whose surrogate underwent a hysterectomy, Johnson-Ellis wrote: “We have already told you that the insurance companies have been declining some of the claims and we are actively working with the broker to get this issue resolved but you should also consider that they may not be paid out and there is nothing we are able to do to change this …
“We appreciate this is not an insignificant sum but this genuinely is out of our control.”
Johnson-Ellis also said the company had switched insurance providers, writing: “We’re also managing this for 300 other journeys, which is a complex position to be in.”
Lawyers acting for My Surrogacy Journey said the company did not comment on individual cases, but that existing insurance policies were in place and claims continued to be accepted and processed.
They said the company understood that a small number of claims had been rejected and was supporting people seeking to resolve those claims with an insurer.
Under the surrogacy arrangements, intended parents are understood to be contractually required to cover medical costs not paid by an insurer.
The couple said they had been recommended the company’s Mexico option. Its website advertises that intended parents using the route can have a baby in “under 18 months”.
They said they were told the UK route could take up to five years and that the US option was much more expensive.
Lawyers for My Surrogacy Journey said prospective parents are given information about typical timelines, costs, legal frameworks and practical considerations, and that the 18-month timeframe is indicative only.
The couple said their surrogate developed placenta accreta, a serious condition in which the placenta attaches to the wall of the uterus.
Emails from Johnson-Ellis acknowledged that the insurance provider investigated the birth after the surrogate experienced health complications.
The parents are considering legal action, while the Guardian said it understood at least four other couples were reviewing their options.
Phil Brickell, MP for Bolton West, raised concerns in parliament about a separate couple who had used My Surrogacy Journey.
He said: “Two of my constituents recently travelled to Mexico, where their children were born by surrogacy.
“Those births were facilitated by a company called My Surrogacy Journey, which is listed on gov.uk.
“While in Mexico, they had repeated traumatic experiences with the company relating to issues including insurance for their children, accusations of bullying towards staff and repeated efforts to silence any constructive criticism.
“I understand that other members of this house have received similar complaints.”
Brickell called for My Surrogacy Journey to be removed from gov.uk pending a review by the Human Fertilisation and Embryology Authority.
Lawyers acting for My Surrogacy Journey said the company was communicating with DHSC and was confident any issues could be resolved.
News
‘Limited scientific evidence’ for most menopause supplements, expert says

Many menopause supplements contain ingredients with limited evidence for symptom relief, while formulations and prices vary widely, a study has found.
Researchers analysed 201 products sold by nine major UK retailers, comparing their ingredients, doses and monthly costs.
Prices ranged from £1.50 to £95 a month, while no single ingredient or category of ingredient was common across all products.
The study, carried out by University College London, found that 80 per cent of products contained herbs, 77 per cent contained vitamins and 74 per cent contained phytoestrogens, naturally occurring plant compounds found in foods including soy and flaxseed.
Vitamin B6 was the most common vitamin, while red clover and sage were the most frequently identified plant ingredients.
Researchers said more evidence was needed on the effectiveness and safety of supplements marketed for menopause symptoms.
Professor Joyce Harper, senior author of the study and professor of reproductive science at University College London, said: “The menopause supplement market is growing rapidly, despite limited scientific evidence that many of these products improve menopause symptoms.
“Some social media influencers promote these products as effective solutions, despite many claims not being supported by scientific evidence.
“This can contribute to the spread of misinformation and help drive a rapidly growing menopause supplement market, leading some women to spend substantial amounts of money on supplements in the hope of improving their symptoms and overall wellbeing.”
Half of the supplements did not contain vitamin D, while less than 24 per cent contained calcium.
The British Menopause Society and International Menopause Society have highlighted vitamin D and calcium as important for maintaining bone health and preventing osteoporosis after menopause.
Researchers also identified botanical ingredients that may carry risks, including black cohosh.
Poppy Sullivan, first author of the study, said: “Certain botanical ingredients in some menopause supplements may also have risks.
“Black cohosh, in particular, is known to carry a potential risk of liver toxicity.”
The amounts of vitamins and minerals included in different products also varied widely.
Sullivan said: “Some nutrients can have adverse effects when consumed in excess over time.
“For example, excessive vitamin D intake can theoretically lead to high calcium levels, which could cause adverse effects such as vomiting and confusion.”
The study found little empirical evidence supporting the effectiveness of even the most expensive products.
Researchers called for more high-quality research, including clinical trials, to determine whether menopause supplement ingredients are effective and safe.
They said the findings could also help healthcare professionals understand the wide variation in supplement formulations.
The researchers acknowledged that the analysis may not have included every menopause supplement available in the UK.
Pregnancy
Ultrasound Direct extends Trice Imaging partnership

Ultrasound Direct has extended its Trice Imaging partnership for three years, adding a reporting tool across its 70-clinic UK network.
The private ultrasound provider will continue using the Tricefy platform for secure image storage and patient engagement, alongside TriceIQ for efficiency and productivity analytics.
It will also introduce Trice Workspace Reporting across its network. The companies say the tool will help standardise ultrasound reporting templates and workflows and reduce variation between clinics.
Ultrasound Direct carries out an estimated 120,000 patient scans each year across services including pregnancy, fertility, women’s health, men’s health and other diagnostic pathways.
Its network uses a large pool of sonographers working across different ultrasound systems and serves referral routes including self-referring patients, GPs and commercial partners.
Mike Steward, founding director at Ultrasound Direct, said: “Having worked with Trice Imaging since 2018, we first partnered to replace manual methods of providing scan images to expectant parents with Trice’s secure electronic image-sharing platform. Today, every study performed across the Ultrasound Direct Network is recorded and stored on Tricefy, while our clinical services have expanded considerably beyond pregnancy into fertility, women’s health, men’s health and other diagnostic pathways.”
He added: “To continue futureproofing our image management strategy across a network of 70 clinics, a large team of sonographers, varying ultrasound systems and a growing number of referral partners with different needs, we decided to extend with Trice Imaging. This includes the introduction of the new Trice Workspace Reporting module to help us scale and standardise our ultrasound reporting templates and workflow, reducing variability between clinics.”
The partnership began in 2018, initially focusing on replacing manual methods of sharing pregnancy scan images with expectant parents.
Johanna Wollert Melin, founder and chief executive of Trice Imaging Europe, said: “Ultrasound Direct has been a valued partner in the UK for 8 years.”
She added: “At the heart of the relationship is a willingness to explore new ideas, test new tools and the spirit to solve real challenges across a large and complex clinical network.”
Mark A. Samii, chief revenue officer at Trice Imaging, said: “We are delighted to retain and extend our relationship with Ultrasound Direct.”
He added: “The addition of Trice Workspace Reporting addresses a challenge we hear from multi-site providers globally – keeping reporting quality consistent across many users, systems, referral or payer relationships.”
Steward said Ultrasound Direct continues to see growing demand for private diagnostics alongside NHS care from self-referring patients and an increasingly diverse range of professional and commercial referral partners.
He added: “As that development continues, scalable digital infrastructure becomes increasingly important. Our focus is on ensuring that a growing national network can support consistent clinical workflows, different referral pathways and the technology requirements of the future, while continuing to provide patients with accessible diagnostic services.”
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