Use of Methadone for NAS Infants

  1. My unit recently switiched from using oral Morphine solution for withdrawing infants [whose mother during pregnancy had been on Methadone maiteance], to Methadone oral solution that is given daily or BID.
    Is any NICU using Methadone for NAS infants and do you have a policy on it you would be willing to share, and do you have any references on evidence based research on the use of Methadone in infants?
    We are giving this medication and can find no information on its use, and need parent teaching information for discharge home so parents are aware of side effects and complications. Thanks for any imput.
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  2. 10 Comments

  3. by   RainDreamer
    We use oral methadone for NAS infants. We initiate the abstinence scoring right away and if they score high enough they get started on methadone. I actually just had a baby last night that was scoring rather high and he was started on methadone. His momma's drug of choice was cocaine, heroin, and who knows what else. Ah good times. Poor kid.
  4. by   Zippedodah
    We use methadone for most withdrawls. We don't send kids home of methadone...esp. if the parents are users.
  5. by   TiffyRN
    I've heard of other units using morphine or opium drops (paregoric?) but ours uses methadone. The last couple of kids I've seen the moms were on methadone programs anyway (though maybe supplementing their doses with heroin? who knows). They start them on doses of either 0.1mg to 0.2mg per kg per dose, dosed q6hrs, then stretched to q8hrs then q12, then once a day, then they will start cutting the dose down. Usually works well.

    Our docs will NOT send kids home on methadone, they feel it's too high risk for the mom to take the meds. We did have to send one child home on phenobarb because he would just have seizures every time methadone was completely taken off, but did ok eventually on just phenobarb. He failed many attempts to wean off the phenobarb though. We all still think of him since he was with us so long (2months just for NAS, no other issues).
  6. by   MegNeoNurse
    Quote from Zippedodah
    We use methadone for most withdrawls. We don't send kids home of methadone...esp. if the parents are users.
    You guys send kids home with parents who are admitted narcotics users which causes the kid to be on methadone? Usually social work steps in and yadda yadda to prevent that from happening (parents like that having custody.)
  7. by   dawngloves
    Quote from CSM08MMS
    You guys send kids home with parents who are admitted narcotics users which causes the kid to be on methadone? Usually social work steps in and yadda yadda to prevent that from happening (parents like that having custody.)
    Oh yeah! If the parent is in a program and has a clean house, they go home with them, no matter their drug of choice.
  8. by   dawngloves
    Have those that have used MSo4 in the past seen a difference between it and methadone? We've alway been told that it causes seizures and that is why we use MSo4.
  9. by   PremieOne
    We are seeing major hypertension in the infants we have on Methadone. From what I am hearing from other NICUs it is taking a much longer time to wean these infants off Methadone. Our Neo Docs refuse to go back to Morphine solution because they need to give it q3-4h and with Methadone you only give it daily or BID.
    Does anyone have a list of side affects for methadone use on withdrawing infants?
  10. by   Zippedodah
    Oh yeah, if the mom is on the program and there aren't any X's in her box, then Baby goes with Mommy. Or if there aren't any foster homes available in the county, then Baby goes with Mommy. I haven't really noticed any bad side effects, and the hypertension may be because they are so agitated. I don't know.
  11. by   RainDreamer
    Quote from CSM08MMS
    You guys send kids home with parents who are admitted narcotics users which causes the kid to be on methadone? Usually social work steps in and yadda yadda to prevent that from happening (parents like that having custody.)
    You'd be amazed at what kind of "parents" we send some of these kids home with!! It's really scary .....
  12. by   TiffyRN
    Around here CPS has what they call a "safety plan". It means that the baby goes home with the mom but they have to have a responsible adult (usually grandma or husband/boyfriend) who promises to always supervise the mom and baby. Right!!! Such a complete joke!!!

    But I digress; this isn't a thread about the silliness of CPS procedures and decisions.

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