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Babies born addicted to drugs?

Discussion in 'General Midwifery Discussions' started by Cookie87, May 28, 2011.

  1. Cookie87

    Cookie87 New Member

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    Hi all I was just wondering if anybody has experienced caring for babies who are born addicted to drugs?

    I saw something on YouTube which was really quite sad. I just wondered how these poor babies are affected and ultimately treated for the addiction?

    In NZ a drug called P (methamthetamine) I think? is the most commonly abused so i am lead to believe anyway And I just wondered what situations can arise because of it's use in pregnancy.

    Its awful that such a tiny baby can be poisoned with such harmful drugs.

    Thanks
    :0)
     
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  2. Butterfly

    Butterfly Guest

    Maternal drug use antenatally can cause addiction, particularly with certain substances. The most common are Heroin, Cocaine, Crystal Meth (Methamphetamine like you mentioned) and some other drugs like anti-epileptic medication (so they may not always be substance misuse).

    These drugs obviously cross the placenta to the baby like any other substance, and long term my cause significant effects once the baby is born.

    Babies born addicted to substances can experience Neonatal Abstinence Syndrome (NAS) a multi-faceted syndrome that causes physical side-effects such as vomiting, diarrhoea, headaches etc, the obvious problem with this is that babies with this condition are very difficult to settle, and cry with a high-pitched wail for the majority of the time. The headaches they experience mean that rocking etc causes more discomfort so one of the only ways they can be settled is by tight swaddling and cuddling.

    In more severe addiction, babies can experience severe symptoms like seizures. This usually results in admission to a neonatal unit and treatment with oramorph (oral morphine) that is gradually reduced at a safe level until they no longer need it at all. The majority of babies however, go 'cold turkey' at birth and get through the withdrawal period with monitoring and support. These babies usually have a prolonged stay on the postnatal wards or units, with or without their parents depending on whether or not these babies are being removed from the parents.

    Pregnant women who are substance misusers, particularly with substances like Heroin, are encouraged as much as possible to go on a Methadone programme to stabilise their drug use, as the peaks and troughs of intermittent 'scoring' increase the risk of overdosing and can actually cause more harm. Despite this, the down-side of methadone is that it has a long half-life so babies can experience worse, and more prolonged, withdrawal than with heroin only, but the stabilisation of the drug use in the mother is said to be 'worth it' so to speak.

    It's very sad to watch- and the babies clearly suffer with the symptoms of withdrawing from drug addiction, but these women need support, not judgment. It's hard to imagine anyone 'doing' something like that to an innocent child, but addiction is an illness and it needs treating like anything else.

    Substance misuse is something I am interested in and it is a line of midwifery I'd consider going in to in the future.

    x
     
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  3. wannabamidwife

    wannabamidwife Active Member

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    I recently observed a situation where a young mum (previously had her two children taken away by social services) had given birth to her 3rd child and this baby was too to be taken away by social workers... she came down to the neonatal unit (as this is where we keep babys who need a safe place to stay after being born if there are social concerns) to see her baby who she was too scared to name because 'a' was going to be taken from her. She had had a c-section so was wheeled in on the bed to see her baby... the neonatal nurse handed 'a' to her to have a cuddle and the look in her eyes was painful. I wanted to cry for her. She fed 'a', which she couldnt really do too well... and 'a' was flopping all over the placew as she couldnt hold 'a' properly...the neonatal nurse took 'a' to feed properly and the mum said 'im suprised 'a' is not withdrawing'... I was so shocked at first. I handed her some photos of 'a' and I told her she could take 'a''s blanket back up to the ward with her...you should have seen her hold onto it tight, sniffing it for the baby smell, she held on that tight; crying that she fell asleep.
    I didnt think I would see her or 'a' again and the next week I was there she and 'a' were still in hospital. I think they were trying to get mum clean so that she could get her children back, which was really nice... I went to speak to mum, she had named 'a' and 'a' was to be going back up to the ward with her so that they could get to know each other and be observed by the midwives until social services could see she was well enough to go home and take 'a'...I left after they went up to the ward so I dont know what happened but I hope that she managed to turn her life around...

    to add I think that the social dealt with her situation very well. Everything was done by the book and they managed to do what they set out to do and that was to keep families together. I hope that they manage to carry on supporting her.
     
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  4. Cookie87

    Cookie87 New Member

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    Hi both,

    First of all thanks Butter Fly for all of that info! Really interesting that some prescribed medication can have these affects, I guess I'd assumed that there would be an alternative but evidently not! Must be hard for mum knowing that in order to stay healthy that baby might experience this. Lots of support needed there I'm sure!

    You make an excellent point about being supportive and treating addiction the same as you would an illness. I think initially its just a case of OMG it's awful how can they do it but the reality is that it's clearly far to late for them to just 'give up' so it's the job of the midwives to steer them in the right direction and of course be there to help and comfort baby.

    Have you found it to be particularly common? / how often would you say this sort of situation is presented?

    Also thanks wannabamidwife your story sounds very sad, I really hope bubs recovered an mum got clean and happy! Social services can get a pretty bad wrap I think it's times like this when you remember that their goal isn't to break up families as you said but to help them repair the cracks and start a fresh. It must have been awful being separated from the baby you have just birthed and awful for poor baby not having that close intimate time with mom in the same way that a 'normal' mum and baby would.

    Must be sooo frustrating not knowing the endings to some of the stories, I'm a sucker for a story and a happy ending Il have to try hard not to chase after people! Ha ha
     
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  5. Butterfly

    Butterfly Guest

    I would say it depends on the are you work in- I both trained and now work in an affluent area so drug addiction is not a sight I see very often.

    However, if you worked in an inner city area or areas where there were high levels of social deprivation cases of substance misuse would be more prevalent.

    I only experienced it twice as a student and am yet to as a qualified midwife, although I have cared for people with a history of drug abuse.

    It's interesting caring for these women because there is some evidence to suggest that they feel pain more acutely- having been addicted to drugs with pain relieving properties for so long this school of thought suggests that this effects the way in which the brain interprets pain information.

    These women also tend to metabolise drugs like pethidine and meptid quicker as well.

    x
     
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  6. Mkunga

    Mkunga Guest

    I've had the priviledge of caring for drug-using women postnatally.

    It's hard to watch a baby withdraw, the high pitched cry and the baby being so unsettled is heartbreaking, but no-one feels it so much as the mums themselves.

    I also trained in an area where drug use was less prevalent than the area I work now, and when I qualified, I was a bit taken aback at how upfront most women are about their drug use, about their treatment (if they're on treatment programmes) and the fact that they know when their baby is withdrawing.

    I (stupidly) felt quite scared the first time I looked after a woman who had been using IV drugs when I was a student (get me, small town bumpkin!), but I soon realised that they're no different to anyone else - they still expect and deserve to be treated with respect.
    The majority of women in any situation prefer to be told what's what, and I admit, to tell a woman who has used a drug during pregnancy, that her baby is withdrawing is very very hard, but it's also very rewarding when the information that you give to her can go on to help her settle the baby and bond with it.

    Addiction is a horrible thing. Truly horrible. People get addicted to drugs for many, varied reasons - we're the lucky ones who haven't fallen into that trap and it's a priviledge that we get to help those who have, in any way we can.
     
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  7. Cookie87

    Cookie87 New Member

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    Thanks for your info Mkunga, I'm sure what you said about it being the most heart breaking for the mums themselves is very very true.

    Do babies receive pain relief so to speak? Or is this part of the relief that oramorph would give as they are weaned?

    In situations where social services are involved and it is decided that a child will be removed from it's mother how does this happen? Are they given time to bond or is it quite a 'clean' cut? I can't imagine anything much worse than that :0( my son was separated from me so I could be taken to theatre and it broke my heart, only god knows how it would feel if it were a permanent situation!
     
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  8. Butterfly

    Butterfly Guest

    The Oramorph would be given to settle the baby too- the one experience I had of carng for a severely withdrawing baby was on a high dose of Oramorph (as she was only 4 days old).

    Each case is taken individually- the few women I've looked after have all been on established methadone programmes and had been assessed by social services as capable of taking care of their newborns- they all had good family support and places to live too, although this is not the case for many women.

    I believe the women are allowed a few days with their babies in some cases (just enough time to bond IMO :() but I think it depends on why the babies are being removed (ie. for child sex offences I should imagine the baby would be removed immediately).

    It's not something I've had a lot of experience with so hopefully someone more knowledgeable will come along and explain in better words!

    x
     
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  9. Cookie87

    Cookie87 New Member

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    You have been loads of help butterfly, I think as a student waiting to apply you have lots of time to muse over the aspects of the job, it's great to be able to ask and have questions answered by people who have been there done/ seen that so to speak.

    This site and nice ppl like yourself and those above really provide a great service to us wanna be's and students etc.

    It's a
    Little crazy when you think about it I couldn't realistically just pop up to the local labour ward and ask these questions etc so the fact you guys give your time to the sight is fab and priceless.

    Out of interest in the days that a mum would have to bond with a baby before removal by social Services would her time parenting be independent or supervised?
     
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  10. Guest5957

    Guest5957 -

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    ^ Its been my experience that is supervised, I remember not long after I started I had to sit in with a mother whose baby was being removed from her care due to sex offences and drug abuse. She could hold baby and fed her, but was never left alone with her. I just had to observe, and call the midwife if anything seemed inappropriate. It was very sad, but this mother was a danger to child and hopefully the baby was adopted into a loving family.

    A baby my parents fostered was born addicted to cocaine, and it is the most heartbreaking thing to witness. He came to us at about 5/6 weeks old, and flinched when he was touched, didnt respond well (at first) to touch and screamed and screamed for hours. He wasnt used to being held as he had been on SCBU for weeks, and had missed that human contact. I can remember swaddling him tightly, holding him and singing and him scratching and screaming for at least 2 hours before he settled - he did that for about 3 weeks every night, until the neonatal nurse said we could give him paracetamol as he was in pain, and it did help a little. It took till he was about a year I think for him to recover, he was still twitchy until then and was difficult to settle for months. His mum tried to get clean, but couldnt, and his dad was her pimp (!) so he was adopted, and we saw him recently and he's so happy and cheerful.

    No baby deserves the pain he suffered, I cant describe the anger and hurt you feel for this little person who is in agony. </3
     
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