Of coorifice I can not be specific...but I have not seen many babys going through withdrawal....how long does this usually take? I have understood that it is painful for the baby in that they are hypersensitive to Everything.
My little client had recieved phenobarb and I think is wakening from it. But is also getting a clonidine patch as well as morphine weaned to .1mg. I've had to increase the amounts more tonight.
I've tried sweeties too but don't want to get too much in the stomach. Swaddleing - he gets too warm, holding doesn't do it either...HELP!
Just talk me through it and any suggestions from your experiences that you can share would be helpful. I work again Sunday night.
We use methadone on the hard to wean kids....we try them on morphine and if their score cont to be high we put them on methadone. We have had kids withdraw so hard we had to intubate them and knock them out for a few days, just to be humane. I'd rather have a heroin baby then a methadone kid hands down. Long term, some of them have ADD or ADHD, no surprise there.
We are also not allowed to send the kids home on methadone if they are going with any family. The county will not let us, so they either stay with us or go to a foster family. We have had one too many moms/SO's steal the kid's methadone to use or sell. How pitiful is that?
Tincture of Opium is what we use and they seem to do fine with it. Then, we slowly wean the dose down. We also encourage the mothers/fathers to stay for or visit for a long time to hold them. That way, they will realize what damage drugs are causing to their babies. Swaddling, low light, swing, baths and pacifiers also helps a lot. Sometimes, you have to change your routine 'cause, one measure may not be effective today but will work the next day.
We use Oromorph, sometimes alongside Phenobarb. Always with these babies, there seems to be hyper motility of the gut, with frequent loose stools, leading to raw backsides! It's a common problem, and we use Cavalon spray, exposing the buttocks to air and more recently Intra site gel...this has been a god send! Cleared up one of the most excoriated and broken down wee bottoms I had ever seen!
Poor wee babies, they have such a hard deal, usually swaddling in just a sheet, a cool cotton one, only in their diaper, and rocking to sleep helps. The quiet place, in a rocking pram helps too. We have a rocker thing, the pram sits on it, and the baby is rocked to sleep with the constant motion. Great invention!
Have used swaddling in a sheet in the bath too, usually calms the wee one, helps them organise themselves a wee bit.
I want to thank you all for your replies and suggestions. I had been off for a week...the little one is somewhat better - we were able to free up a sepparate room and he's liking that I guess.
Bathing: swaddle in a thinner blanket before putting in the tub. A tub bath is more calming than sponge, but if baby is hot and sweaty, sponge him w/a tepid cloth helps.
Sometimes Tylenol and simethicone (sp?) can provide some symptomatic relief. If the baby wants to suck and eat almost constantly, 1/2 -1 tsp of rice cereal to 2 oz of formula slows stomach emptying and can decrease diarrhea, which causes a sore butt.
I don't see a problem w/the swing--most of them adjust so they are fairly flat; use slower speed. Whether or not they've passed corificeat, they're on monitors. Harder to do crib death on a monitor.
Nothing beats being held and rocked in a darkened room.
When I did nursery, we got a lot of cocaine and heroin babies. We did absolutely nothing to help them wean, unless they seized, at which point we would put them on phenobarb. The only thing we could do was feed them A LOT, and give sweet-ease. It was horrible, so I feel for you.
Those little guys were so miserable. Our docs just wouldn't listen to us concerning the "new" techniques of weaning drug addicted babies using morphine, clonidine, or anything else. Why should they, they didn't have to stay with them for hours and watch them suffer.
We also did the bouncy seat and swing, as we didn't have a policy on passing the car seat before this. And we snuggled a lot. I also would do a "tub" bath for them, it seemed to wear them out enough to let them sleep a few hours.
At least our kids weren't constipated, the poor things had so much diarrhea that their poor bottoms would bleed.
When I did nursery, we got a lot of cocaine and heroin babies. We did absolutely nothing to help them wean, unless they seized, at which point we would put them on phenobarb. The only thing we could do was feed them A LOT, and give sweet-ease. It was horrible, so I feel for you.
Those little guys were so miserable. Our docs just wouldn't listen to us concerning the "new" techniques of weaning drug addicted babies using morphine, clonidine, or anything else. Why should they, they didn't have to stay with them for hours and watch them suffer.
We also did the bouncy seat and swing, as we didn't have a policy on passing the car seat before this. And we snuggled a lot. I also would do a "tub" bath for them, it seemed to wear them out enough to let them sleep a few hours.
At least our kids weren't constipated, the poor things had so much diarrhea that their poor bottoms would bleed.
The little pt is doing much better now what about 3 weeks since I first wrote?! I haven't gotten to care for him tho...What you say regarding some of the doctors...I so agree!!! Sometimes I think we should put these babys in their room with them for the night! Plus it frustrates the other familes...you of course can't tell them what's going on!
BittyBabyGrower, MSN, RN
1,823 Posts
We use methadone on the hard to wean kids....we try them on morphine and if their score cont to be high we put them on methadone. We have had kids withdraw so hard we had to intubate them and knock them out for a few days, just to be humane. I'd rather have a heroin baby then a methadone kid hands down. Long term, some of them have ADD or ADHD, no surprise there.
We are also not allowed to send the kids home on methadone if they are going with any family. The county will not let us, so they either stay with us or go to a foster family. We have had one too many moms/SO's steal the kid's methadone to use or sell. How pitiful is that?