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Methadone Treatment for Infants

Methadone treatment for pregnant women addicted to heroin or other opiates is essential for improving the health of the mother and protecting the health of her unborn child. Mothers receive regulated, monitored doses instead of the sporadic opiate levels of the user. Infant outcomes are improved and hopefully, the mother will eventually be relieved of addiction. For the newborn baby who suddenly (at birth) has his methadone supply cut off, however, the road to comfort is sometimes long.

  1. Definition

    • Treatment is dependent upon the degree of methadone withdrawal. The infant is observed in the hospital for specific signs which are then rated on a scale for severity. Symptoms usually appear within 24-48 hours. Less often, symptoms of methadone withdrawal are noted in babies as late as 5 days of life. Nurses document the baby's behavior at least every 4 hours. If the infant receives a high Neonatal Abstinence Syndrome (NAS) score, he may be prescribed Morphine to relieve symptoms, which include profound irritability, gastrointestinal issues and skin breakdown. Feeding for the baby in withdrawal is often difficult and the infant may also have fevers. Ideally, the dose of morphine is tapered as the symptoms lessen. Morphine is usually given every 4 hours at the time of the nursing assessment and NAS scoring.

    Why Do Infants Need Morphine?

    • Methadone is a synthetic opiate that is easily regulated and controlled. That is why it works so well to help heroin addicts wean off heroin. When the baby of a women using methadone is born, her supply of methadone which has been crossing the placenta and letting her "use" drugs for all those months, is suddenly cut off. Opiates need to be weaned slowly so that the body can adjust to being without them. If the methadone (or heroin or morphine) exposure was small and for a short period of time, the baby may not experience any noticeable symptoms of withdrawal. She might also have mild symptoms that respond to comfort measures like swaddling and extra sucking. If the in-utero exposure to opiates was great and for a longer period of time, morphine helps to wean her from her own dependence on the drugs.

    Length of Treatment

    • Infants born addicted to methadone or other opiates may have mild or severe symptoms. If an infant requires morphine to treat withdrawal, he may need only a few days of treatment and wean quickly as determined by his NAS score, or may take a couple of weeks. The length of time he was exposed to opiates and the amount of drug he was exposed to usually dictate the course of treatment. In some severe cases of withdrawal, Phenobarbital is also added to treatment to further soothe the irritable central nervous system.

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