Methadone babies

[gyp253]

A child that was born on December 10th, her methadone level when she left the hospital on December 20th was at 3, now the newborn is in ICU with a level 13 and the hospital has her on morphine. I don't understand how this happened? Her mother is on a Methadone program and is allowed to take some home on the weekends. Im trying not to jump to bad conclusions but Iam terrified for this child.

[karnicurnc, MSN, APRN, CNS]

Research has established that the mother's dose of medication does not directly correlate with the severity of the infant's withdrawal symptoms. In other words, if the mother's dose is high, you can not expect that the infant will experience severe symptoms. Conversely, if the mother's dose is low you can not assume the infant will be fine and not experience severe symptoms. See research citation below.

Pizarro, D., Habli, M., Grier, M., Bombrys, A., Sibai, B., & Livingston, J. (2011). Higher maternal doses of methadone does not increase neonatal abstinence syndrome. Journal of substance abuse treatment, 40(3), 295-298.

[Elvish, BSN, DNP, RN, NP]

Research has established that the mother's dose of medication does not directly correlate with the severity of the infant's withdrawal symptoms. In other words, if the mother's dose is high, you can not expect that the infant will experience severe symptoms. Conversely, if the mother's dose is low you can not assume the infant will be fine and not experience severe symptoms. See research citation below.

Pizarro, D., Habli, M., Grier, M., Bombrys, A., Sibai, B., & Livingston, J. (2011). Higher maternal doses of methadone does not increase neonatal abstinence syndrome. Journal of substance abuse treatment, 40(3), 295-298.

I don't know if you were referencing my statement or not (and if not I apologize :) ) , but I totally get that higher dose doesn't increase or decrease severity of sx. I've seen kids do great with mom on a big dose and kids that struggle mightily with Mom on a minimum dose. Just that a higher dose may lead to later onset of sx due to methadone's long half-life and first-order kinetics. Also to be factored in would be time of mom's last dose.

[LRN, RN]

Our problem currently with NAS is encouraging mom's to be more active with their NAS infant. They rarely come in, rarely help with cares and therefor often do not see their infants high withdraw scores. Also, we've had numerous mom's who want to breastfeed and will do so, but skip days or BF and then not show up again for days. Causing crazy swings in sx.