Heroin withdrawal

Bezoars · Feb 23, 2013

I feel just what you're saying. How frustrating. And having to be so polite while knowing what you know. I'd like to ask what is the excoriation from? Is there a severe body rash or really bad bms for the baby? We just have a rare case, so I'm not as experienced with this.

These babies will get chafing and excoriation on their cheeks, chins, noses, knees... from the tremors and being so frantic that they are rubbing these areas on the blankets and from rubbing their arms and hands on their face. The excoriation on their bottoms comes from the severely loose stool they will get and from the acidity of the narcotics being excreted from their system.

marmelloz · Feb 23, 2013

Ok, thanks. I was afraid you meant something like that. Poor little babies. So, I'm sure you get why we were wishing we could chain this mother (tongue in cheek) to a chair to stick around. She wasn't hurting for her baby, but we were. Can't imagine seeing so much more of it, as you have!

estrellaCR, BSN, RN · Mar 11, 2013

Are the babies really allowed to leave with their drug addicted mother? In NY, if a baby is born with toxicology, the facility is mandated to report it to Child Protectives Services who would then take action on this often placed in and work with the parent to go through rehab and other service plan goals if she wants her child(ren) back. Does your state not have this policy?

monkeybug · Mar 11, 2013

Are the babies really allowed to leave with their drug addicted mother? In NY, if a baby is born with toxicology, the facility is mandated to report it to Child Protectives Services who would then take action on this often placed in and work with the parent to go through rehab and other service plan goals if she wants her child(ren) back. Does your state not have this policy?

The rule where I am at is that if mom is positvie by baby is negative, baby goes home with mom. If both are positive then baby goes to foster care. Very arbitrary and stupid, I think, because it's going to come down to timing. If we test mom and then she is in L&D for a long time (and deprived of her drugs) then the baby may be negative by the time it gets out and pees.

madelynsmom · Mar 25, 2013

May I ask, how often do you see this happen? I am considering making L&D my specialty when I am finished with school but I am not sure how to handle seeing that and not wanting to rip the faces off of the mothers that did that to their children.

monkeybug · Mar 26, 2013

May I ask, how often do you see this happen? I am considering making L&D my specialty when I am finished with school but I am not sure how to handle seeing that and not wanting to rip the faces off of the mothers that did that to their children.

I've been out of the hospital a year, but I doubt it's changed very much. I watched it happen a lot. I've even seen a patient come to L&D in labor with cocaine powder all over their upper lip. I always wondered if I had "Stupid" tattooed on my forehead, because that's sure how these patients treated me (and all the other nurses). "I must have gotten that cocaine off a toilet seat" (yes, I really heard that one). "I only smoke marijuana, I don't know why that other stuff is showing up." "I was in a car with somebody that was smoking, it wasn't me." When I worked in a "ritzy" hospital I cared for more women with prescription addictions rather than street drugs, but addiction is common in today's society.

estrellaCR, BSN, RN · Mar 26, 2013

Depends what hospital you are at. City/public hospitals may have more cases as the population that is served is more often from disadvantaged living conditions and has the misfortune to be more prone to drug use or addiction. So some hospitals may have higher incidence of withdrawal babies than others.

obizyanka · Mar 29, 2013

My hospital is awful with this. Babies need consecutively high finnigans scores to be shipped to another facility for treatment. We don't treat the babies here and the drs are not eager to send them out. Ie cs 3 days ago on suboxone baby screaming all classic signs of withdrawal sent out only this past evening.

NicuGal, MSN, RN · Apr 2, 2013

We treat after 3 consecutive scores of 8 or greater. When they don't treat they aren't doing that baby any justice! All the methadone moms come to our hospital to deliver, it isn't unusual to have 2 or more of these kids at one time, some for a few months because we can't get the weaned. We never send kids home on morphine or clonidine. If the mom has a safe home and has completed parenting and drug counseling and has passed urine tests then the baby will go with her.

Some of the moms are okay, some even have a story that will strike home with you...Inhad one that was from a family like my own and she lived basically a double life when her drug habit took over. Then there are the ones that you know will never straighten out. I always give them a chance to show which one they are. And we are seeing a higher incidence of "normal" middle to upper class women on pain killers, who think it it is perfectly fine to take percosets and Vicodin and flexeril while pregnant because their doctor said it was alright, not meaning their OB. So it crosses all borders.

Kooky Korky, BSN, RN · Mar 1, 2017

I work on the drug-baby unit often at our hospital. The worst part is that a lot of these moms will come in and pitch a fit about us "keeping their baby from them" and "the baby should be home with us" and be all hovering about everything we do. They get offended at the excoriation they come out with. I'm always like "the baby WOULD have been home with you if you hadn't ingested that crap while you were pregnant". Enough said. I have no sympathy. none. Then when the other family members come in and start shooting their mouths off about it (usually because they don't know all that mom was on). I ask them politely to chill, then have them escorted off the unit. Unfortunately, it's kind of a hopeless situation. Most of these babies go home with mom and have shi**y lives.... if they make it through to their first birthday.

Is Social Services not involved? Why are babies going home with addicted parents?

What treatment do addicted newborns get?

That OB who refuses to treat addicted mothers - he needs to be reported to Management or to the licensing Board. He is not judge and jury. If he doesn't want to or doesn't know how to treat, he has to refer. He can't ethically just bow out or take out his anger on the patients. There, but for the grace of God, go you and I and he's right with us.

Kooky Korky, BSN, RN · Mar 1, 2017

These babies will get chafing and excoriation on their cheeks, chins, noses, knees... from the tremors and being so frantic that they are rubbing these areas on the blankets and from rubbing their arms and hands on their face. The excoriation on their bottoms comes from the severely loose stool they will get and from the acidity of the narcotics being excreted from their system.

What do you treat them with?

klone, MSN, RN · Mar 1, 2017

This is a 4-year-old thread