Sweet Ease for withdrawals?

[Nikki.J]

Hi all,

Is it acceptable practice to use sweet ease for, say, an infant having methadone withdrawals?

If anyone has any sound input for this I'd really love to know!!!

Thanks,

NikkiJ

[caroladybelle, BSN, RN]

Don't know about this, but.....

Given the adults in opiate withdrawal tend to crave sweets, it might make sense.

[Love_2_Learn]

If a baby is in withdrawl and being given medication for it, I'd be very, very cautious about giving sucrose pacifiers because this could cause the Neonatal Abstinence Scores to be falsely low. On the other hand, if they are really in withdrawl how much could Sweet-Ease or some other sucrose pacifier actually soothe them... probably not for long at all. I'd ask the MD or Nurse Practitioner before giving it to such a baby; maybe it could be used before drawing labs or starting an IV or something like that....but for general soothing... I don't thinks its a great idea.

[Nikki.J]

If a baby is in withdrawl and being given medication for it, I'd be very, very cautious about giving sucrose pacifiers because this could cause the Neonatal Abstinence Scores to be falsely low. On the other hand, if they are really in withdrawl how much could Sweet-Ease or some other sucrose pacifier actually soothe them... probably not for long at all. I'd ask the MD or Nurse Practitioner before giving it to such a baby; maybe it could be used before drawing labs or starting an IV or something like that....but for general soothing... I don't thinks its a great idea.

I really appreciate the response!!!!

Thanks!

[Elvish, BSN, DNP, RN, NP]

There's some difference of opinion depending on whom you ask and what facility you're at.

As a general practice at my place - mind you, I work in a mostly-well baby nursery and we withdraw all our non-seizing kids in there - no, we don't. That's not to say it never happens, because I've put a couple drops on the paci of an absolutely incorrigible kid to get them to take it, once in a great while. But it's not with every kid, and some NPs are ok with it, others get their knickers in a wad. I agree that if it's done too much the scores can be falsely lowered...but every now and then I really don't see the harm.

Let me also say that from what I can tell on this NICU forum, our NPs are better than a lot of places about these withdrawing kids. We start morphine q4 around the clock for 3 consecutive scores > 8 and wean from there. If the morphine doesn't do it they add phenobarb qday as well, which makes a HUGE difference. So most of the time, between the morphine and the phenobarb, we don't have a huge need for the Sweetease.

But if we have to transfer one of these kids to our NICU for bad withdrawals, the first thing they get is a little sweetease in their mouth....go figure. :) I wish we could do that in the 'well-baby' nursery.

[chescat58, RNC-NIC]

we use methodone for withdrawals, sweetease is for procedural pain