8+Postnatal+Development+of+Methadone+Babies

Postnatal Development of Methadone Babies will cover the withdrawal symptoms of an infant born to a mother in methadone treatment, concerns regarding breast feeding and the long term effects on child development. = Withdrawal Symtoms of a Infant Born to a Mother in Methadone Treatment = Not all infants born to mothers on methadone will go through withdrawal after birth. This usually begins a few days after birth (48 to 72 hours after), but symptoms could arise two to four weeks after birth and may last several weeks or months. The onset of withdrawal and severity of symptoms vary: during the birth serum and tissue levels begin to fall; the newborn continues to metabolize the drug(s) and abstinence symptoms occur when critically low tissue levels are reached. Less sever withdrawal symptoms can persist until six months of age.

Methadone exposed infants generally are reported to have a higher frequency and more lengthy period of abstinence than those whose mothers used heroin. Withdrawal may be mild and short-lived delayed in onset or characterized by a step by step increase in severity. Symptoms may be present irregularly, or have a two stage course that includes severe withdrawal followed by improvement and then become worse again. More severe symptoms seem to occur in infants whose mothers have taken large amounts of drugs for a long time. The development of the infant’s metabolic and excretory systems also plays an important role, since preterm infants generally eliminate the prenatal drug(s) more slowly and seem to show a less active onset of withdrawal.

'Infants born to mothers using methadone need pharmacological treatment for Neonatal Abstinence Syndrome (NAS)  or baby withdrawals. For women who had continued to use other drugs, there was a significantly increased chance of the infant requiring treatment for NAS. The most important factor determining the possibility of the infant requiring treatment was the prescribed maternal dose of methadone.' (Medical News Today. 2009).

Hospitals allow the infants to be treated for Neonatal Abstinence Syndrome in the postnatal ward; infants are admitted to the neonatal unit after birth for treatment of prematurity, low birth weight, respiratory distress and a range of social reasons. Infants in withdrawal need to be monitored closely and may become irritable, cranky; do not eat or sleep well; have a fever and sweating; mottling (blotchy skin colouring); hiccups and vomiting; trembling; muscle spasms and seizures. If the symptoms are severe, the infant may be medicated to ease the withdrawal. Never give methadone to a infant. Only a doctor should manage an infant’s withdrawal, because even a small amount of methadone can be enough to kill them.

‘Narcotic Neonatal Abstinence Syndrome is a generalized disorder characterized by signs of hyperirritability of the central nervous system, gastrointestinal dysfunction, respiratory distress and vague autonomic nervous system symptoms that include yawning, sneezing, mottling and increased temperature. Initially infants develop mild, high frequency, low amplitude tremors that progress in severity. A high-pitched cry, increased muscle tone, irritability, increased deep tendon reflexes and an exaggerated Moro reflex are all characteristics of the syndrome at this stage. The rooting reflex is increased and sucking of fists or thumbs is common, yet infants show great difficulty with feeding regurgitates frequently. The feeding difficulty results from an uncoordinated and ineffective sucking reflex. Infants may also develop loose stools and therefore more likely to become dehydrated and have an electrolyte imbalance.’ (Loretta P.Finnegan, MD. 2000)

Treatment options for babies born with Neonatal Abstinence Syndrome  depends on serveral things, including the infants overall health, whether the child was born premature or full term. Infants with NAS may need medicine similar to an adult who is having withdrawal symtoms. The medicines used to treat an infant may include: a benzodiazepine (like valium for alcohol withdrawal); methadone for heroine and other opiate withdrawal;the same drug(s) that the mother was taking and then reduce the amount of the drug until the infant has withdrawn.

The odds of Sudden Infant Death Syndrome is about three to four times higher tha in the general population. (University of Nevada, Reno. 2001)

== =﻿Breast Feeding = <span style="font-family: Arial,Helvetica,sans-serif;">    <span style="color: #0000ff; font-family: Arial,Helvetica,sans-serif;">﻿ ﻿ ﻿ ﻿ ﻿ ﻿ “A significant advantage of treating the pregnant heroin addict with methadone is that breastfeeding can be encouraged if the mother is not abusing other drugs. Such small amounts of methadone appear in the breast milk that it is not even adequate treatment for the newborn showing signs of abstinence.” (Loretta P.Finnegan, MD. 2000)

<span style="font-family: Arial,Helvetica,sans-serif;">Mothers are encouraged to breast feed when they are motivated and in a supervised methadone treatment program, provided several conditions are in place. The mother is: on a well-controlled, stable dose; in good health with adequate nutrition; is not infected with HIV, tuberculosis or hepatitis; not using alcohol or other drugs. Women who are hepatitis C positive are usually able to breastfeed, but should check with their doctor.

<span style="font-family: Arial,Helvetica,sans-serif;">The benefits of breastfeeding are felt to outweigh the effect of the tiny amount of methadone that enters the breast milk. Once the baby is three to six months old, and is drinking large amounts of breast milk, he or she is also getting larger amounts of methadone. For this reason the baby should be weaned at this time, or the mother should stop taking methadone. (Mothers should only stop methadone if they are sure this will not lead to a return to drug use.) If you feel that you want to wean your baby because of methadone exposure, talk to your doctor. Your doctor should be able to give you advice about when you should begin weaning and the risks and benefits of continuing to breastfeed. (Centre for Addictions and Mental Health. 2008).

<span style="font-family: Arial,Helvetica,sans-serif;">“Doctors have found that when women breastfed their babies for more than 72 hours there was a significantly reduced odds of the infant receiving treatment for NAS. Apart from the benefits of breast milk and the way breastfeeding soothes agitated babies, researchers note that small traces of the drugs taken by the mother may find their way into the breast milk, thus lessening the baby’s withdrawal symptoms.Breast feeding seems to protect against the risk of developing Neonatal Abstinence Syndrome, with the likelihood of receiving treatment halved in those infants who breastfed for more than three days. The advice is for pregnant drug misusing women to be maintained on the lowest dose of methadone compatible with the stability and for them to be encouraged and supported to breastfeed. Research has revealed that higher methadone dose is associated with an increased chance of NAS in infants.” (Medical News Today. 2009).

= Long Term Effects on Child Development = Research on the developmental outcome of a child exposed to methadone during pregnancy has been inconclusive. Some leading researchers suggest if there are long term effects of methadone, they may be quite subtle or may take years to appear.

<span style="font-family: Arial,Helvetica,sans-serif;">'In one recent study on children born to mothers given methadone while pregnant, 95 percent of the children had vision problems. Out of these twenty children, involuntary eye movement was found in eleven out of twelve children who were treated for withdrawal symptoms versus three out of eight children whose withdrawal symptoms did not warrant treatment. One in three children had a squint and a similar proportion had blurred vision or farsightedness or near-sightedness problems and one in four had impaired brain function relating to sight. The causes of the eye problems were unclear, but it was noted the developing visual system is particularly sensitive to unexpected stressors before birth.' (United Press International, Inc. 2010).

<span style="font-family: Arial,Helvetica,sans-serif;">'A study on physical development following birth covered fourteen children from four and a half to forty-two months of age. Each child was found to be developing physically within normal limits without exception; a below average test, as far as development of intelligence was concerned, in one baby; and high normal or high average intelligence in one baby. One normal baby, who is average in all other respects, showed poor language development at ages 23 and 33 months. Overall, the impression is that this group compares favourably with other children of a similar age.' (Edward M. Brecher, Editors of Consumer Reports Magazine, 1972).

<span style="font-family: Arial,Helvetica,sans-serif;">'A review of the data in five current long term studies, on the developmental outcome of children born to drug dependent women maintained on methadone evaluated methadone exposed infants throughout the first two years of life. The results of these studies suggest that no long term developmental effects are directly associated with methadone exposure in-utero. Although differences were often found between methadone exposed infants and comparison infants on the Bayley Scales of Infant Development, scores for the methadone exposed infants were well within the normal range of development. Existing data on methadone exposed children at 4 years of age are reviewed. No differences in cognitive performance were found between methadone exposed and comparison children although scores for both groups were low. Problems with confounding variables and the inappropriate use of a main effects model of development in this area of research are addressed and the need to investigate socio-environmental risk factors in order to fully understand the development of children exposed to methadone in-utero is discussed.' (L.P. Finnegan. & K. Kaltenbach, 1984).

<span style="font-family: Arial,Helvetica,sans-serif;">'Development depends on environmental factors as well as on the child’s own constitutional makeup. It is best to focus on a child’s current abilities and environmental situation when making an assessment or determining interventions.' (Alberta Health Services, 2004).

<span style="font-family: Arial,Helvetica,sans-serif;">Becoming a new mother is overwhelming for most women in the beginning, but the characteristics of a child experiencing withdrawal can make parenting less rewarding and more difficult to deal with. There are concerns regarding the parenting skills of the mother and the ability to provide appropriate care for the child. 'Negative lifestyle factors can compound the physical and psychosocial heath problems of a methadone dependent mother and child. <span style="font-family: Arial,Helvetica,sans-serif;">These factors include: <span style="font-family: Arial,Helvetica,sans-serif;">(Alberta Health Services, 2004).
 * <span style="font-family: Arial,Helvetica,sans-serif;">poor living conditions, poverty, lackof education, and homelessness
 * <span style="font-family: Arial,Helvetica,sans-serif;">erratic lifestyle with poor nutrition and exercise habits, and high stress
 * <span style="font-family: Arial,Helvetica,sans-serif;">concurrent medical problems such as sexually transmitted diseases an HIV/AIDS
 * <span style="font-family: Arial,Helvetica,sans-serif;">multiple druge use
 * <span style="font-family: Arial,Helvetica,sans-serif;">the mother being under 15 years of age
 * <span style="font-family: Arial,Helvetica,sans-serif;">inadequate parental care'

<span style="font-family: Arial,Helvetica,sans-serif;">'There are ten factors used to quantify in each individual's assessment of environmental risk: depression, domestic violence, nondomestic violence, family size, homelessness, and incarceration, absence of significant other in home, negative life events, psychiatric symptomatology, and severity of drug use. These are considered as risk factors for parenting problems and negative child outcomes and are relatively common among drug abusing women.' (Prasanna Nair, Maureen E. Schuler, Maureen M. Black, Laurie Kettinger, Donna Harrington, 2003).

<span style="font-family: Arial,Helvetica,sans-serif;">Other factors considered are: Maternal Parenting Attitudes, which include child abuse potential and stress associated with parenting. Also considered is an assessment of infant characteristics which include the neonatal outcome, infant development and language development.

<span style="font-family: Arial,Helvetica,sans-serif;">Overall most research suggests that if a child is raised in a caring and supportive family environment, they will do as well at school as any other child in similar circumstances. And it is believed, with the proper support network in place a mother in methadone treatment will be able to raise their child.

Below is an awesome link to a brief outline of child development in pdf form. healthy child development <span style="font-family: Arial,Helvetica,sans-serif;">media type="youtube" key="x_igbsBl14M?fs=1" height="385" width="640" <span style="color: #333333; font-family: 'Arial','sans-serif'; font-size: 12pt; letter-spacing: -0.4pt; line-height: 115%;">Methadone Effects: Long-Term Effects of Methadone Addiction in Children. (<span style="color: black; font-family: 'Arial','sans-serif'; font-size: 12pt; line-height: 115%;">E How Health. 2009).