Re: neonatal methadone withdrawal
From: Charlie Chambers (ricechaz@me.com)
Wed Jan 28 20:21:44 2009
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Patient is on 40mg methadone per day. Was a heroin user, last use
about one month ago. hep c carrier.
******************************************************************************
Charlie Chambers
Hood River, OR USA
--
cchamber@alumni.rice.edu
"All good things...come by grace,
and grace comes by art,
and art does not come easy."
Norman Maclean
*******************************************************************************
On Jan 28, 2009, at 6:46 PM, DoctorJoe@aol.com wrote:
>
> In a message dated 1/28/09 8:19:55 PM, ricechaz@me.com writes:
>
>> We have a patient who delivered about 3 years ago at our level
>> facility who remained on methadone. Baby was cared for by a local
>> FP, and did remarkably well though eventually taken by child
>> protective services. Patient is now back in our practice at 35
>> weeks again on methadone. We discussed with local peds MD who is
>> agreeable to care for the baby. However, behind the scenes, nursing
>> supervisors were concerned with caring for this patient at our
>> facility. Without prompting from ob or peds, they contact neonatal
>> doc at tertiary care center regarding appropriateness of this plan.
>> Opinion was given that there are new guidelines which mandate in
>> patient management of these kids for 3-6 weeks. The local peds
>> doesn't want to go against these "guidelines" and I can't seem to
>> find the source. Are other aware of this ? Would you agree that
>> delivery at level one facility is inappropriate? Opinions please.
>
> Depends on the dose of Methadone, any other medications, and
> underlying pathology.
>
> I've seen a number of babies whose mothers were on modestly small
> Methadone doses who didn't even withdraw in the neonatal period.
>
> Joe P.
>
> ?scf8072%26hmpgIDb%26bcdÞcemailfooterNO62)
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Patient is on 40mg methadone per day. Was a heroin user, last use about one month ago. hep c carrier.
******************************************************************************
Charlie Chambers
Hood River, OR USA
cchamber@alumni.rice.edu
"All good things...come by grace,
and grace comes by art,
and art does not come easy."
Norman Maclean
*******************************************************************************
In a message dated 1/28/09 8:19:55 PM, ricechaz@me.com writes:
We have a patient who delivered about 3 years ago at our level facility who remained on methadone. Baby was cared for by a local FP, and did remarkably well though eventually taken by child protective services. Patient is now back in our practice at 35 weeks again on methadone. We discussed with local peds MD who is agreeable to care for the baby. However, behind the scenes, nursing supervisors were concerned with caring for this patient at our facility. Without prompting from ob or peds, they contact neonatal doc at tertiary care center regarding appropriateness of this plan. Opinion was given that there are new guidelines which mandate in patient management of these kids for 3-6 weeks. The local peds doesn't want to go against these "guidelines" and I can't seem to find the source. Are other aware of this ? Would you agree that delivery at level one facility is inappropriate? Opinions please.
Depends on the dose of Methadone, any other medications, and underlying pathology.
I've seen a number of babies whose mothers were on modestly small Methadone doses who didn't even withdraw in the neonatal period.
Joe P.
**************
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