NAS Babies

[Bezoars]

Just wondering.... what is your current experience with these babies? We have a huge problem with this in my area.

[Elvish, BSN, DNP, RN, NP]

We deal with them fairly frequently and have NPs that are well-versed in their care. Anyone who scores 8 or higher 3 times in 24 hours gets started on morphine, usually 0.05mg/kg q4 hours around the clock and from there get weaned every day or every other day depending on their scores.

A few things I have found:

It is much easier to get them settled when the symptoms first start to show than to wait until they're scoring 15 to do something.

If the morphine isn't doing a great job, phenobarb is a great tool to have.

Expect them to stick around for 3-4 weeks. That's average.

In my experience, severity of withdrawal doesn't always depend on maternal dose, although the AAP says otherwise. We have seen kids have a terrible time when Mom was on 10mg methadone, and kids whose mom took 110mg stay for 5-7 day obs and never go on meds.

Dim the lights, swaddle, keep things around them as quiet as possible. It does make a big difference. These kiddos have a very low threshold for overstimulation.