FALL RIVER — Caring for babies exposed to substances before birth and their mothers in a city with the state's highest rate of infant exposure is challenging lawmakers and service providers alike, according to healthcare providers who spoke at a forum Thursday.

In 2017, Fall River led the state in the rate of substance exposure in newborns, said Executive Director of the Massachusetts Health Policy Commission David Seltz.

“This region has been hit particularly hard,” he said.

Seltz spoke at Children’s Museum of Greater Fall River to representatives from groups including Southcoast Health, People Inc. and the Department of Children and Families.

After running through key facts from a report that, among other findings, showed Massachusetts in 2017 had the highest rate of opioid-related emergency department visits in the country, a discussion launched on services that exist – and services still sorely needed – to care for infants who are exposed to substances in the womb.

“This isn’t just around mothers who are using illicit drugs in utero. These can be mothers who have taken the step to get into treatment, are in recovery, on medication-assisted treatment,” said Seltz.

Infants exposed to opioids before their birth may suffer from a group of conditions known as neonatal abstinence syndrome (NAS), which carry symptoms such as irritability and fever, said Seltz, adding that medications such as methadone are sometimes used to help manage the conditions in infants.

The average inpatient hospital stay for an infant born with NAS is 20 days, Seltz said at the forum organized by Rep. Carole Fiola, a stay that can cost as much as $66,000.

But infants who are kept near to, held and consoled by their mothers spend an average of nine days in inpatient care, said Southcoast Health Community Benefits manager Rachel Davis.

“There’s plenty of evidence to support that if you keep the mother and baby together that 20-day length of stay can be cut in about half,” she said, adding that healthcare providers should do all possible to keep the mother and child together.

Davis said “we have the highest rate of postpartum overdose in the state.”

Marianne Valle, a registered nurse at Southcoast Health, said mothers battling substance use disorders need support and services from their communities and healthcare providers providers after they give birth.

A large focus of Valle’s work is meeting with mothers during their pregnancy and discussing NAS without stigmatizing the mothers for having an addiction, Valle said.

“There’s no more stigmatized population than a woman who's pregnant and has substance use disorder. Period,” she said. “They are the best medicine for their babies.”

Valle identified a gap in services for mothers battling substance use disorder. She said prenatal services are available to the population, but there exists a need for continued care and support after a mother gives birth.

“We wrap ourselves around them when they’re pregnant. By the time they’ve delivered and left the hospital, bye bye. No services, nothing. They’re out there on their own and they relapse. And statistically we know that they’re dying,” she said.

There exists no good data on the long-term impacts on children born with NAS, Seltz said. It is nonetheless clear that the condition affects children as they grow up, said Rachel Hallene, director of the Healthy Families and Welcome Family program at People Inc.

“You don’t walk away from your birth history. It follows you all the way through,” said Hallene.

Email Amanda Burke at aburke@heraldnews.com.