So I've got this kid. Mom's been in a methadone program for two years now. He's ten days old, had been weaning with phenobarb, but yesterday they started 0.5mg/kg of morphine because his Finnegans were consistently around 15. Overnight he was getting 7s. I come in, never had the kid before, and I'm adding up to 14, 12, etc. So we increase the morphine from q6h to q4h. Hand to god, the kid gets WORSE. Won't eat (while the previous two feedings he took 35ml), writhing around, red puffy eyes, just miserable. The lowest score I got, half an hour after his last dose, was 6. He's dead asleep, but he's jittery (yes, asleep), tachypneic, congested, flaring, and I know he's got that diaper rash. So the resident, bless her heart, starts giving me static about how she's going to have to write for more morphine if I keep scoring him like this, etc, while she was actually at my bedside one time when I scored him and certainly didn't disagree with anything I found. I, uh, may have asked her if she was asking me to falsely document a low score, but in my defense it was shift change.
So my question, other than how best to hide said resident's body, is what are we missing? Baby gets almost no visitors; mom and dad come in for around five minutes per day and don't touch him, so I spent as much time holding him as I could, but clearly that's not enough. Do any of you use something OTHER than morphine to wean kids off mom's methadone? Clearly just increasing his frequency isn't working.
I hear that suboxone is supposed have less severe neonatal withdrawal but we had a kid recently whose mom took that and she still stayed with us for 30+ days. I have, in all fairness, seen more moms on suboxone within the last 6-8mo or so than prior.
We have too and honestly I have not seen that it is any better. We have so many moms with polysubstance abuse that it is hard to say what is going on with the poor babies though.
I might get totally flamed for this but I don't care. I think if you are in a methadone treatment program with the intention of getting off the methadone one day, you should be required to have 2 forms of birth control in place at all times, same as accutane. We are send methadone babies home right now, well at least over the last 10 years or so right? Only time will tell what the long term effects of being exposed in utero will be.
Aja...we've been saying that for a while...many get pregnant either because of high risk behaviours or because they don't know any better. But then again, we get repeat offenders...and that ticks me off. I think Meth is the drug of choice because it is relatively cheap.
We were just kidding around, kinda, the other day that we should just put these kids on Ritalin now. I feel for these kids in the coming years...there are documented cases of ADHD and such with these kids. I wonder if they are more prone to being some type of substance abusers themselves.
UTVOL3
281 Posts
We have too and honestly I have not seen that it is any better. We have so many moms with polysubstance abuse that it is hard to say what is going on with the poor babies though.
I might get totally flamed for this but I don't care. I think if you are in a methadone treatment program with the intention of getting off the methadone one day, you should be required to have 2 forms of birth control in place at all times, same as accutane. We are send methadone babies home right now, well at least over the last 10 years or so right? Only time will tell what the long term effects of being exposed in utero will be.