Babies discharged on caffeine

[nicunana]

We just found out this morning that Medicaid will no longer cover the cost of caffeine. Virtuallly all of the babies that we discharge home on an apnea monitor are also on caffeine. A month supply will range between $105 & $300, which is way too steep for most of our parents. We were able to get Childrens Medical Services to pick up 2 months for this particular baby, but they may not be able to cover all of them in the future. Have you encounterd this? Any suggestions? Thanks!

[SteveNNP, MSN, NP]

We never discharge babies on caffeine. They complete a trial off caffeine before discharge. We also do not send babies home on monitors except in rare cases. If a baby requires caffeine to keep from having non self-limiting apnea/brady/desats, it is not safe for them to be discharged in our unit.

One unit I worked in used to wait until the caffeine level was

[ittybabyRN, RN]

I've only been a NICU nurse for about 8mos now but I've discharge home at least 3 babies on a monitor and/or oxygen...1 today actually...none on caffeine though so I'm not sure

[NJNICUCCRN]

Our babies rarely go home on caffeine but sometimes we use theophylline. Maybe they would pay for that med instead. Just a thought :)

[littleneoRN]

We often discharge home on caffeine and a monitor with parent CPR and monitor training. We generally try to have several days without apnea requiring intervention prior to discharge even with a monitor. We do not discharge on aminophylline as the therapeutic range is more tight with more frequent dosing and levels to be monitored. I don't know the details, but my understanding is most insurances don't pay for it, but our hospital just fills the rx at cost for parents.

[Imafloat, BSN, RN]

We don't discharge babies with caffeine. The only time we discharge with a monitor is they are getting home going oxygen.

[karnicurnc, MSN, APRN, CNS]

We also do not discharge on caffeine. We do send babies home on monitors and O2 if absolutely necessary.

[Love_2_Learn]

We are similar to the other posters who say we do not discharge babies home on caffeine. Ours must go a full 7 days without a bradycardia after being off of the caffeine before they can be discharged. We rarely send babies home on monitors and rarely on oxygen as well. Sorry I could not be of more help to you.

[NICU_babyRN, BSN, RN]

I am floooored!!!

Theo?? Not recommended anymore for babies since a long time ago!

Babies who still need caffeine should stay in the NICU until doing well off caffeine. specially if they have not yet reached 38-40 weeks corrected age!

it is rare for our kids to go home on a monitor, never in the last 3 years have I sent a kid home on a monitor and caffeine. AB counts are done for any kid born

Theo??? I'm bothered to know it's still being used.

Another smaller hospital where I worked also sent kids home on caffeine. I quit bc I did not feel this hospital was sending kids home ready and a lot of their were re-admitted. I felt I was putting my license on the line too much.

[gibson0726]

I used to work in a compounding pharmacy (before I became a NICU RN) and I made caffeine citrate solution all the time. It is DIRT cheap and very simple to make. We would sell prescriptions just above cost for our medicaid patients, as we did not bill insurance for compounded medications. The parents could call around to the compounding pharmacies in the area to see if they have special pricing available.

[Coffee Nurse, BSN, RN]

Same in my unit as most of the other posters -- we don't send kids home until they've gone a full seven days without A/B's once off caffeine.