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A few months ago we were placed with a baby who was exposed to heroin and methadone in utero. The baby was kept in the hospital to withdraw for 2 months and then DC'd to another foster home for a few days, at which point they disrupted the placement because the baby was so irritable, not sleeping, crying for hours, etc.
When we got the baby, these behaviors continued, plus we saw sweating, gassiness, explosive, irritating loose stools, severe diaper rash, as well as poor sucking, frantic feeding behaviors and muscle stiffness. I brought the baby to our pediatrician, who immediately consulted w/an MD from the Pain and Palliative Care Service at the children's hospital. This palliative care MD determined that the baby was experiencing withdrawal symptoms and prescribed a small dose of morphine 4x/day, plus a smaller dose every hour as needed to manage symptoms. After 2 weeks -- during which we began to see a completely different baby! -- we started the gradual weaning process of a 10% reduction in dose each week (under the direction of the palliative care service). It has taken over 2 months. Apparently, this 3-4 months-long process of weaning from methadone is not unusual.
The baby has done well with this slow weaning, is on track developmentally, smiles and interacts, and sleeping is much improved. The only symptoms we are seeing as we get near the end is continued muscle tension/stiffness resulting in reflux of feedings quite often. I have reported this to pediatrician and palliative care service, and plan is to get a weight check in a few weeks.
I am so pleased with the care provided by the palliative care staff that have managed the baby's care. They are very experienced with this sort of thing and it has made such a difference for this little baby.