When Donna Francisco poked her head into the hospital room, she found tiny Luke asleep in his open crib, the only noise coming from the machines he was hooked up to.
"Caution: Fragile bones. Please be careful" read a small sign taped to the bed at Nemours A.I. du Pont Hospital for Children. Nurses helped Francisco pick up Luke, and she sat with him in a nearby rocking chair.
For the next 30 minutes, she would rock him while reading the children's book, "Corduroy" to him and then singing "You are My Sunshine" before she left.
Franciso is a cuddler, a hospital volunteer who spends a few hours every week holding, singing and reading to the smallest and weakest babies in Delaware. At Christiana Care Health System and Nemours, the cuddlers belong to an exclusive club of volunteers — one that consists of a long wait-list, a vetting process and extensive training.
Luke's parents likely were taking a short break or a shower or maybe picking up a shift at work. Their son was born prematurely, and the hospital declined to give his age or diagnosis.
Some of the babies in Nemours/A.I. duPont Hospital for Children's NICU will be in the hospital for months, and their moms and dads can't be there with them 24/7. That's where cuddlers come in (and sorry, both hospitals aren't in need of any more cuddlers).
Doctors say there's more to the cuddling programs than holding cute babies. For NICU babies, hearing words when volunteers sing lullabies or read books can help with cognitive development. And for babies exposed to opioids in their mother's womb, the skin-to-skin contact helps them battle the toughest moments of their young lives — withdrawal.
“The role for me is to cuddle and make that baby feel secure," said June Emory, a volunteer at Christiana Care. "You can see it in their little faces, they’re struggling for these first few days. And so we’re offering that little extra TLC.”
At Nemours, the Baby Bookworms program is focused on the cognitive development of newborns, said Judy Lieberman, director of volunteer services. Most of the babies the cuddlers read to at Nemours have "medical challenges."
"It's really about language nutrition. The more words an infant hears, it will affect their cognitive development," she said. “Yes, cuddling is just as important and comforting. But they’re affecting that child’s future.”
According to the Journal of Developmental and Behavioral Pediatrics, the more words babies, including those in the NICU, are exposed to, the better prepared they are to start talking.
The Nemours cuddling and reading program started about a year ago as a way for high school and college students to get involved with volunteering during the summer, Lieberman said.
It's since grown to include dozens of volunteers of all demographics and has made its way into different hospital wings, she said. The volunteers have recently started reading to children in the cardiac unit.
"Different units have seen the impact and they’re asking us to come to their floors," Lieberman said.
Since Christiana Care's Cuddlers program started in 2014, more than 7,184 babies have been cuddled, hospital officials said.
Dr. David Paul, chair of the hospital system's pediatrics department, said most of the Christiana Care cuddlers focus on babies with neonatal abstinence syndrome, a condition that can result in babies being irritable, sleep-deprived, prone to tremors and vomiting and difficult to feed.
As the opioid epidemic continues to worsen in Delaware, state and hospital officials are seeing a growing number of babies born addicted to drugs.
From 2010 to 2015, there were 1,172 babies born with neonatal abstinence syndrome, according to state health officials. The rate doubled from 11.9 babies per 1,000 births in 2010 to 23 babies per 1,000 births.
When babies are exposed to opioids in utero, they experience withdrawal symptoms when they're born, Paul said. And these symptoms can be painful.
"It's especially important for those babies to be cuddled during that period of time," he said.
Cuddling can help soothe babies who experience withdrawal symptoms, Paul said. Human touch can also help offset the negative stimuli babies experience in the NICU, particularly bright lights and loud noises.
The cuddlers are a part of Christiana Care's non-pharmacological management approach. A majority of babies exposed to drugs during pregnancy will require morphine to help with withdrawal symptoms, Paul said.