methadone effects on newborns

Specialties NICU

Published

Hello everyone! I'm new to this forum, so this is my first posting.

I'm a PHN and work with high risk infants. I'm wondering--has anyone had experience with newborns and methadone withdrawal? What are some of the signs/symptoms of methadone withdrawal in newborns?

Thanks for any responses in advance!

Specializes in Neonatal.

We see them quite often on our unit. We have a scoring system for these babies who we usually see start to withdraw within 12 hours. Our policy is to start scoring them at 6 hrs old. We score with each feed and with three scores over 8 we start them on a Morphine regimen every 4 hours. This morphine helps them to cope with symptoms....which may include all or some of these symptoms....jitteriness, irritability, high pitch cry, poor feeding, skin breakdown on face from them rubbing, diaper rash, high temp, sweating, sneezing, regurgitation, tremors, yawning, even seizures if serious. I've seen very mild symptoms and I've also seen a baby practically levitating off the matress in an isolette because they were tremoring so much!

This morphine will get decreased as the baby's withdrawal symptoms decrease. And when the baby is off morphine for 5 days then we plan discharge. Problem is that most time we are trying to track down the mother in order for her to come in to learn to feed her baby.

It's all so sad...but I'd take a methadone baby over a fetal alcohol anytime when it comes to the longterm outcomes....

What do you think about breast feeding methadone babies?

If mom is on 20mg or less of methadone, then it is not only OK to breastfeed, but encouraged to breastfeed. By the time that the methadone is broken down in mom's system, very little, if any gets into mom's breast milk. If mom had been using heroin, it is encouraged as her lifestyle may have comprised the baby's health, and if mom has weaned down to 20 mg, breastfeeding benefits greatly outweigh any risks associated with the chance of any methadone crossing over.

Sources:

Certified Breastfeeding Educator course

http://www.safefetus.com/DrugDetail.asp?DrugId=1143&TradeName=Methadone&TradeId=2750

On the above link, scroll down to breastfeeding.

I also wanted to add that not all moms on methadone are classic "drug addicts" per se, but may be taking methadone through a strict chronic pain control program. In my experience, these moms who may not be "street savvy" and taking methadone only because the benefits outweigh the risk and otherwise lead a healthy lifestyle, these moms may feel extremely guilty about seeing their baby go through withdrawal. This is due probably because they didn't know it would be so bad for the baby, or possibly their chronic pain doctor lead them to believe that methadone withdrawal is better than heroin withdrawal. This is my theory while working as a volunteer cuddler.

Specializes in NICU, Post-partum.
We have moms that get into a methadone program a couple of weeks before they deliver, so that they can prove that they are trying, and will be able to keep their babies.The babies have already suffered through heroin, sometimes cocaine or metamphetamines, and maybe a little marijuana for relaxation. Now they get methadone to add to the problems. I suppose the good thing is the moms want the babies. To me, it takes special people to adopt these damaged children.

I forgot about the sneezing, and feeding problems, and the horrible diaper rash these little ones get. We have even had to get our Wound nurse to help out with the raw, bleeding butts that we have seen.

What do you think about breast feeding methadone babies?

Breast feeding is not contraindicated with methadone infants or most other opiates as well...so if Mom wants to breast feed, we let them, however, most choose not to because of the inconvenience (I am sure that surprises folks :) ).

There are NICU's that don't allow it..and for those NICU's, they typically do not have a lacatation consultant on staff .

Hypertonicity is usually the first symptom that shows up and symptoms can start as late as 14 days after birth. However, if the infant can be swaddled and consoled, we typically do not start replacement therapy, however, if they are screaming and out of control, we put them on methadone to get the comfortable and then start weaning the dose down.

Specializes in NICU, ER.

Thank god for you and fellow PHN like you. I often worry about these babies. Nice to know someone is fighting for them.

Specializes in NICU, Infection Control.

@ triumphjetta: We cannot provide medical advice. I have removed your post.

It would be a better thing if they DID NOT want the baby. It's true, many go on methadone during pregnancy to keep the baby, because they are great manipulaters of the system. I also agree that methadone is far worse than other withdrawals. Screaming, loose stools, tachypnea, sweating, inability to eat.....much rather see a family that is DRUG FREE deal with this stuff than a mom with such poor coping skills that she needs to shoot heroin AND take her methadone. Methadone clinics should REQUIRE birth control...

im a mum and im on the methadone program and i have a 5 mnth old baby and 3 others im shocked that you guys call your selfs nurses and cares after reading all of these posts i was not aware that nurses out there could be so cold hearted and have hate for something that is sometimes out of our hands, i didnt choose to be on this drug or have my baby while on it yes i could of killed my unborn baby and not given birth i was aware of what could happen to my baby but i didnt choose to be on this drug i had no option it was ethier get on the methadone prog or lose all my kids i picked what was best for my children, and i read on one post that the babys would be better off with someone that didnt have to have meds everyday to look after thier babys oh please guys the rogram is there to help us be able to live a normal life yes we have to drink it everyday yes we have to go into a cemisit every day but it in no diff then having to take and inhaler to be able to take care of your kids or other meds people are on i get up i get my kids and my self ready we eat breakfast i then take 1 to kindie 2 to school and then i go to to cem i then go into my job and where my baby comes with me i do what every other mums do i just have to have a drink of methadone instead of a coffee, it is the people out there that dont use it as a med but as a drug that are giving mums bad names while on the program, hitting it up or selling it having more then thay are given and so on...what about the hep c treatment you have to jab yourself at home everyday and cant do alot of things with your kids while on it i dont see why you guys are being so hard on methadone mums ... like all mothers i love my kids thay are everything to me and i am truely shocked at this site and posts so closed minded pick pick pick on something you do know about or have any understanding on you only see one bit of it go live with one of the mums for a week and you will see she is the same as every other mum. while i was preg i was on a low dose i kept it low becouse i was preg less chances of it affectting my baby that wayi got all the info i needed and read up about things i then did what i thought was right for me and my kids and unborn child i kept her, she was born 8pnds and huge may i add, she had a little bit of a high pitched cry witch is normal in methadone babys, we stayed in hospital for 4 days she had the scoring test done and the normal newborn testing done she pasted all we had 1 night where her temp was abit high but came down after removing some clothes as hospitals are warm as these days. i am in new zealand by the way.

i am breast feeding and have done from birth she feeds well and hasnt been any different then my other kids, i do how ever have to add that if i wasnt on the program and didnt have the insight that i have about this i would be in agreement that you shouldnt have babys on the methadone program but after being a mother that did i can understand it more but there are so many things that can go wrong with the baby as it is growing inside of you and after the birth things you cant see and may not see right up till the child is in thier teens. i have a privite docter that costs me a arm and a leg every mnth that comes to see my baby and does tests on her for my peace of mind i done this myself so i can make sure if anything shows up we get it early i know there are mums on this drug that arent like me in the way that i am normal as normal is in the way of being a mum being on the program hasnt changed me and how i parent it has just made it so im not looking for drugs using off the street like i did before i had kids and means i am able to live a normal life and feel good everyday not sick.the other mums are the ones that need to be watched with the babys i know how some methadone mums are not looking after the baby and need more help and so on. when you are on the drug and you have a baby in nz the team from a and d get hold of cypfs (the children young person and family serivces) to keep an eye on the kids babys and so on to make sure we are being mums and the kids are being looked after, there are many mums out there that you guys have seen that dont care for thier newborns the way thay are needing as thay are methadone babys my girl does need extra time but i love spending as much with her as i can she is doing more at her age then my 3 boys were she is doing well like any one that is preg you think of things that can go wrong with being on the program i had to think of double the things that could go wrng everyone out there that gets preg thier are risks things that could go wrong baby could be affected but a few extra things on the methadone shouldnt make people go on about it like we are killing our babys before thay can be born everyone that carrys a child is putting thier baby a risk anyone anywhere can have a babay with something wrong with it everyone everywhere can give birth to a child with issues and problems seid affects from normal meds people take too. soemthing you do at home a cleaning product could affect your newborn and chance the babys life you guys must see that too. im sure there are mums on the program around the world that shouldnt have had thier babys or have had them taken or given them away after seeing how hard it is for them to come off the drug thay took while preg or just couldnt cope or didnt want the child or just couldnt be a mum but thier are lots of us out here that are doing right for our babys and have taken the resonsablility to rasie the child we carryed while using the drug as a med i never wanted to have a drug baby i didnt want to hurt her make her sick or make something wrong with her i have been lucky that she is healthy happy and smart and growing well i understand this could of been diff and i will not risk having another child while on the program i am on the list to detox once i am done breastfeeding and she is at a age that she is not to dependent on me all the time has coming off it for the mother is as hard as it is for a child but if done right it shouldnt affect my life to much and i shoud be able to do everything the same

"A worried woman went to her gynecologist and said:

'Doctor, I have a serious problem and desperately need your help! My baby is not even 1 year old and I'm pregnant again. I don't want kids so close together.'

So the doctor said: 'Ok and what do you want me to do?'

...

She said: 'I want you to end my pregnancy, and I'm counting on your help with this.'

The doctor thought for a little, and after some silence he said to the lady: 'I think I have a better solution for your problem. It's less dangerous for you too.'

She smiled, thinking that the doctor was going to accept her request.

Then he continued: 'You see, in order for you not to have to take care of 2 babies at the same time, let's kill the one in your arms. This way, you could rest some before the other one is born. If we're going to kill one of them, it doesn't matter which one it is. There would be no risk for your body if you chose the one in your arms.'

The lady was horrified and said: 'No doctor! How terrible! It's a crime to kill a child!'

'I agree', the doctor replied. 'But you seemed to be OK with it, so I thought maybe that was the best solution.'

The doctor smiled, realizing that he had made his point.

He convinced the mom that there is no difference in killing a child that's already been born and one that's still in the womb. The crime is the same!"

Do you agree or disagree?

Specializes in ICN.

When we get a baby on Methadone withdrawal because mom was in a program, the withdrawal sometimes seems to me worse than from Heroin. As another poster mentioned, it can take 2-3 months. The babies are put on morphine and phenobarb. We have a opiate weaning scoring sheet that has to be filled out every four hours with symptoms--if the baby scores high, the doctors are not supposed to decrease the morphine dose--but they often do and then the babies have such a terrible time. Screaming, frantic eating, sneezing, vomiting, etc... I almost wish moms didn't go on methadone during pregnancy.

knowledge.png IAM SICKENED AND QUITE SADDENED BY MOST OF THE RESPONSES IVE READ ABOUT YOUR OPINIONS OF METHADONE BABIES. IM A MOTHER OF 2 METHADONE BABIES MYSELF SO I CAN TELL YOU THE HONEST TRUTH, AS I HAVE LIVED IT. MY FIRST CHILD WAS FULL TERM AND I DOSED AT 30MG. HE WAS IN THE HOSPITAL FOR ALMOST 2 MONTHS AND SENT HOME TO COMPLETE HIS DETOX FROM .1OMG DOWN. WITHIN 2 WEEKS HE'D OUTGROWN HIS DOSE AND HAD NO SYMPTOMS WHATSOEVER. EVEN AT THE HOSPITAL HE DIDNT "SUFFER." THE DR. WEENED HIM WITH METHADONE, DECREASING AS HE GREW. MY SECOND SON WAS BORN 4 YEARS LATER. I WAS ON 100MG THIS TIME. MY SON CAME HOME IN 2 WEEKS AND AGAIN I CONTINUED THE DETOX WITH METHADONE AT MY HOME. WHILE I'LL AGREE WITH MET BABIES BECOMING EASILY OVERSTIMULATED MY SON EXPERIENCED NOTHING BUT SOME REFLUX, AND SWITCHING TO SOY FORMULA CLEARED THT RIGHT UP. IM NOT PROUD TO SAY IM AN ADDICT, BUT IM IN RECOVERY AND CAN SAY IM AS GOOD A MOM AS ANYONE ELSE.:heartbeat INSTEAD OF JUDGING THESE WOMEN WH DONT YOU EDUCATE YOURSELF ON ADDICTION. ANYONE IN THE MEDICAL FIELD SHOULD BE WELL AWARE ITS AN INCURABL DISEASE. NO ONE WAKES UP ONE MORNING AND SAYS "GEE, I THINK I WANT TO RUIN MY LIFE BY BECOMING A DRUG ADDICT TODAY." METHADONE HAS SAVED MY LIFE AND IF I NEED TO TAKE IT FOR THE REST OF MY LIFE TO FUNCTION AS A "NORMAN"PERSON IM OKAY WITH THAT. MY BOYS ARE 5 AND 9 NOW. THEY HAVE DEVELOPED COMPLETELY NORMALLY, IF NOT EXCEEDED EXPECATIONS. SO PLEASE QUIT DOWNING THE MOTHERS THAT HAVE TAKEN RESPONSIBILITY FOR THEIR ACTIONS, GOTTEN MEDICALLY APPROVED HELP FOR THEIR ADDICTIONS AND, AS HARD AS IT MAY BE FOR SOME OF YOU, SUPPORT US! WE CARE AS MUCH FOR OUR CHILDREN AS ANYONE ELSE!
Specializes in NICU, PICU, PACU.

To the moms who responded on here....you are the minority of what we typically see, a small minority. The majority of withdrawl kids we see are the product of a mom who is not only on methadone, but is still doing whatever else she did before. This is a nurse's forum and we are telling what we see and experience, which is different from your side. We don't mean to disrespect the moms who have come around and straightened out, but like I said, you are the vast minority. And to say we are uneducated on this is not a fair statement, we base our care on evidence based research and experience.

I recently went to a drug rehab with one of our fellows to see what the docs/counselors were telling these moms. They were telling all the moms, regardless of doses of med, what illicit drugs they did, etc that the babies won't withdrawl up to 14 days after delivery, they shouldn't need any meds and if they do they will only be in the hospital for "a week at the most". Needless to say, this has prompted many of our neos and peds to form a clinic just for drug dependent moms so that we can educate them prior to delivery on what truly is to be expected, how we score,etc.

My baby is 6 days old. I was using 6-8 MG of subutex through my pregnancy. I was mislead by my doctor that my baby would not suffer withdrawl. They started him on a methadone treatment a few days ago. I go there everyday for 7-8 hours and lay "skin to skin" with him and breast feed. I want my baby home. I dont think his withdrawl symptoms were as bad as the doc made them out to be. I think he over reacted. It seems like since they started tapering him from the methadone his withdrawl syp. are worse now then they were before he started treatment. I think the nurses are unexperienced in the NAS scoring and every nurse is scoring him different then the next shift- they all arent on the same page. I want a second opinion on this whole methadone treatment. How long are they going to keep my baby? It seems like a big game, but in this case its the doc thats money hungry-not the methadone clinic. I bet if i didnt have insurance my baby would be home right home. :confused::crying2:

Specializes in NICU, Infection Control.

Again, we need to remind posters that this is a nursing forum, and we are discussing what we see in clinical settings, and how various hospitals handle this sensitive issue. We cannot comment on an individual situation, nor give advice. You must communicate w/the team caring for your baby.

We wish you and your baby the best.

knowledge.png IAM SICKENED AND QUITE SADDENED BY MOST OF THE RESPONSES IVE READ ABOUT YOUR OPINIONS OF METHADONE BABIES. IM A MOTHER OF 2 METHADONE BABIES MYSELF SO I CAN TELL YOU THE HONEST TRUTH, AS I HAVE LIVED IT. MY FIRST CHILD WAS FULL TERM AND I DOSED AT 30MG. HE WAS IN THE HOSPITAL FOR ALMOST 2 MONTHS AND SENT HOME TO COMPLETE HIS DETOX FROM .1OMG DOWN. WITHIN 2 WEEKS HE'D OUTGROWN HIS DOSE AND HAD NO SYMPTOMS WHATSOEVER. EVEN AT THE HOSPITAL HE DIDNT "SUFFER." THE DR. WEENED HIM WITH METHADONE, DECREASING AS HE GREW. MY SECOND SON WAS BORN 4 YEARS LATER. I WAS ON 100MG THIS TIME. MY SON CAME HOME IN 2 WEEKS AND AGAIN I CONTINUED THE DETOX WITH METHADONE AT MY HOME. WHILE I'LL AGREE WITH MET BABIES BECOMING EASILY OVERSTIMULATED MY SON EXPERIENCED NOTHING BUT SOME REFLUX, AND SWITCHING TO SOY FORMULA CLEARED THT RIGHT UP. IM NOT PROUD TO SAY IM AN ADDICT, BUT IM IN RECOVERY AND CAN SAY IM AS GOOD A MOM AS ANYONE ELSE.:heartbeat INSTEAD OF JUDGING THESE WOMEN WH DONT YOU EDUCATE YOURSELF ON ADDICTION. ANYONE IN THE MEDICAL FIELD SHOULD BE WELL AWARE ITS AN INCURABL DISEASE. NO ONE WAKES UP ONE MORNING AND SAYS "GEE, I THINK I WANT TO RUIN MY LIFE BY BECOMING A DRUG ADDICT TODAY." METHADONE HAS SAVED MY LIFE AND IF I NEED TO TAKE IT FOR THE REST OF MY LIFE TO FUNCTION AS A "NORMAN"PERSON IM OKAY WITH THAT. MY BOYS ARE 5 AND 9 NOW. THEY HAVE DEVELOPED COMPLETELY NORMALLY, IF NOT EXCEEDED EXPECATIONS. SO PLEASE QUIT DOWNING THE MOTHERS THAT HAVE TAKEN RESPONSIBILITY FOR THEIR ACTIONS, GOTTEN MEDICALLY APPROVED HELP FOR THEIR ADDICTIONS AND, AS HARD AS IT MAY BE FOR SOME OF YOU, SUPPORT US! WE CARE AS MUCH FOR OUR CHILDREN AS ANYONE ELSE!

thank you ................ i two have wrote the same on here i am a methadone mother and the things i have read on here made me sad more then anything some of these people are ment to be caring for us and our children and this is what thay are saying.

im up every morining at 6am with my 4 kids and my 6mnth old wakes 2 times a night at the mo is teething and im up walking around singing talking cuddling her one of the post on here said US WE drug mums dont do that for our babys BUT WE DO glad more mums like me are reading this and dstanding up

+ Add a Comment