Fetal Alcohol newborn

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Specializes in Psych, ER, OB, M/S, teaching, FNP.

Not sure if this is the right place to put this thread. Moderators please move it if not...

I work in a tiny hospital and we deliver less than 50 babies per year. So as nurses we have basic skills for babies but we don't do high risk (at least not on purpose). I just did an NST on a mom that is about 36 weeks and will be delivering with us. She drank 1/5 of vodka daily for the first 5 months, went into detox for treatment and since that time has drank lesser amount but almost daily.

My questions are about how we as nurses can best care for this little one. What can we expect, as far as needs. I have gotten some ideas fro another online nursing community like they often need to suck a lot to console themselves and that they get diarrhea and sore bottoms quickly. My questions are in the order of should we keep stimulus to a minimum, do they have probs with temp instability, jaundice, reflux, etc. I have no idea if this mom will breastfeed or bottle feed.

I have found lots of info on preventing FAS and what happens neurologically, facial deformities, and about care of the older child with FAS but not what I am looking for.

I know the babe may go through withdrawal (we have no idea how much/often this mom really is consuming alcohol) and so what should we look for? Is it the same as adults? If the babe begins going through withdrawal we may ship to a larger hospital with a NICU.

Thanks for any help.

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Specializes in LTC.

I don't work in OB or NICU so I can't offer much advice. The one thing I can say is that I'd definitely push towards bottlefeeding this infant. How could mom seriously even consider BF'ing? If she didn't stop drinking for pregnancy, why would she stop to BF?

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If possible maybe this mother should deliver at a hospital with a NICU. Remember that the best way to transport an unstable infant is in a uterus.

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Specializes in Psych, ER, OB, M/S, teaching, FNP.

Yes, HappyBunnyNurse I would agree but I doubt that will happen. We live 75 miles frm that type of hospital and she would unlikely be willing to go there. She seldom keeps her prenatal appointments and obviously does not comply with recommendations so I am sure we will have her.

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Specializes in NICU, adult med-tele.

:angryfire Is Child Protective Services involved?

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Specializes in Psych, ER, OB, M/S, teaching, FNP.

AjaRN, not sure if they are yet,but I plan to notify if not. Adult protective services were involved to get her into the initial treatment for detox. We could not find any place that would take her. The psych hospital did not want a pregnant woman, the in-pt CD facility did not want her, finally an OB doc was granted temporary privileges at an in-pt psych unit and she was detoxed there under an OB working with a psychiatrist.

And the situation is a bit sticky because her husband is the son of our surgery tech. It is his first baby (our surgery tech's first grandchild) and I don't think grandma has a clue.

It is too bad there are not in-pt facilities in every state just for pregnant addicts of all kinds. I would rather have my tax dollars spent preventing problems in babies than the hundreds of thousands spent in NICUs, special schools, therapy and eventually detention for kids born to woman that abuse substances.

Still looking for ideas and thoughts as to what we as nurses can expect and how to best care for this little one.....

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Specializes in Vents, Telemetry, Home Care, Home infusion.

kudos for you being proactive. hope these links help

the sick neonate scroll 2/3 down page

ce article: fetal alcohol syndrome

fetal alcohol syndrome | encyclopedia of medicine | find articles ...

fetal alcohol syndrome, ncbddd, cdc

medlineplus: fetal alcohol syndrome

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