Methadone and cleft palate

Elvish, BSN, DNP, RN, NP · Mar 21, 2009

We keep our kids until they're completely weaned, but we wean them on morphine. (I wish we used methadone but that's outta my control.) We don't let them leave the hospital on the morphine because we deal with some mothers who've sold the morphine on the street for drugs (and sometimes food ) instead of giving it to the baby. Of course it's not everybody, and it probably would not even be more than a handful, but to stay on the safe side we keep the kids til they're completely off the morphine.

Generally the average stay for us is around 4-8 weeks. Anecdotally, I've not seen any easier withdrawals with mom using Subutex/Suboxone.

BittyBabyGrower, MSN, RN · Mar 21, 2009

We don't release them to mom if the baby is on any controlled substance...the moms have been known to take or sell babies stuff. We have had to send several kids to long term care facilities because we just couldn't wean them. Veryy sad!

Loralai · Mar 21, 2009

As just a note, since I have a child with a bilateral cleft lip and palate and was actually and truly confronted by a NICU nurse who accused my husband and I of inbreeding, clefts can be caused by a number of reasons.

Certain medications can cause clefts (seizure medications), smoking and alcohol can, vitamin deficiencies, environmental, or genetic. Sometimes it's a fluke as well, as was the case of my son considering I can rule out everything else. I just thought I would pass that along since I was confronted by a nurse who had that wrong impression.

dawngloves, BSN, RN · Mar 22, 2009

We don't release them to mom if the baby is on any controlled substance...the moms have been known to take or sell babies stuff. We have had to send several kids to long term care facilities because we just couldn't wean them. Veryy sad!

Our babies wean on mso4. There is no way we'd release them to mom with an rx for that!

littleneoRN · Mar 22, 2009

If our moms aren't in a stable place, complying with their treatment program, and demonstrating reliability that way, they don't get to take the baby home. Of course, we never know for sure, and surely there are some situations where trust is misplaced. But those who clearly aren't there....their babies go to foster care.

dawngloves, BSN, RN · Mar 22, 2009

If our moms aren't in a stable place, complying with their treatment program, and demonstrating reliability that way, they don't get to take the baby home. Of course, we never know for sure, and surely there are some situations where trust is misplaced. But those who clearly aren't there....their babies go to foster care.

So the babies go home with methadone? Because I don't know of any adults on methadone that take that home. They have to go to the clinic daily because the risk is so great of them abusing/selling it.

BabyLady, BSN, RN · Mar 22, 2009

The number of meth babies have increased dramatically often the past few years. We always have at least 1 and had 5 a few months ago. In the past 6 months, 3 meth babies have had cleft palate. I have been a NICU RN for 7 years and have had 1 cleft palate before this (that I recall). Has anyone else noticed this?
Also, these moms are telling me that the OB told them that the meth wasn't bad for their babies and said that their babies would mostly likely be discharged with them. If they had to stay in the hospital, it would only be a few extra days. This is crazy. Meth babies typically stay for AT LEAST 2 months. I don't think the OB's are lying or negligent, I think that it is an education issue. Has anyone else been told this

This is very interesting...thanks for giving me a great idea for a future research paper. :)

prmenrs, RN · Mar 22, 2009

Some foster homes do "medically fragile" infants, which might mean they're w/drawing from methadone, or some other drug. I don't know whether they can give methadone @ home or not.

BabyLady, BSN, RN · Mar 22, 2009

Some foster homes do "medically fragile" infants, which might mean they're w/drawing from methadone, or some other drug. I don't know whether they can give methadone @ home or not.

I'm guessing that the foster family, with proper training, probably could keep it at home.

I agree that addicts have to go to a clinic because if they have a stash to abuse, they'll just trade one for another.

If the caregiver has no hx of addiction, then I would say there is no reason they couldn't have it.

dawngloves, BSN, RN · Mar 23, 2009

Some foster homes do "medically fragile" infants, which might mean they're w/drawing from methadone, or some other drug. I don't know whether they can give methadone @ home or not.

Not here. I've sent withdrawing babies (be it from drug abusing mothers or kids that were on versed/mso4) home to foster, adoptive, grandparents. Everyone does their withdraw in the hospital and the strongest thing anyone goes home on is caffeine.

littleneoRN · Mar 23, 2009

Well, some of the moms on methadone weren't necessarily abusing illegal substances. Sometimes we get those kids whose moms have had chronic pain issues, and that's why they've been on the methadone. We do send kids to foster care who will get the methadone at the foster home. I haven't discharged a kid to their biological mom on methadone, so I don't know the details...but I know it happens. I'll have to ask around. We are a major center in a major city, but we don't get a ton of kids withdrawing from methadone. Maybe a few a month?

BittyBabyGrower, MSN, RN · Mar 24, 2009

It doesn't matter why the mom is on methadone, they can't be sent home while on methadone/morphine. we have been bit in the butt one too many time!