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 Post subject: I did this to her
PostPosted: Sun Sep 01, 2013 1:20 pm 
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My daughter was delivered by emergency c-section on Thursday and transferred to the NICU at another hospital before I even got to see her. But everytime we talked to the nurses it sounded like she was doing great. I thought she might even come home today. This morning we called to check on her and she started going into withdrawals over night. She's on methadone now. I started off on 16mg of Suboxone and got down to 6mg Subutex before I had her.
I was selfish and only thought of myself and now my sweet little baby girl is paying the price.
They released me 24 hours after the surgery with no pain meds. I've been stuck in bed ever since. I'm worthless to the people who depend on me. I thought I could change but I guess being a piece of shit is something that stays with you forever. I hope my baby knows how fucking sorry I am.


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 Post subject: Re: I did this to her
PostPosted: Sun Sep 01, 2013 2:01 pm 
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I completely understand why you are blaming yourself. I would probably feel the same way. But I want you to recognize what's really going on here in a realistic way. Yes, your baby wouldn't have withdrawals if you hadn't been on suboxone, that is true.

So what is going on with your baby right now? She was uncomfortable for a few hours and then she felt better, maybe a little bit sleepy. Of course, infants sleep a TON anyway. She won't be feeling any of that discomfort any more. She will slowly be weaned off her medication and continue being a normal infant. That's what you've done to her. Made her a little uncomfortable for a few hours. Do you think that people who circumcise their sons don't do the same thing? (I'm not making a judgement about circumcision.) If I were a baby, I'd rather go through a bit of withdrawal than have to deal with pain on my penis after the anesthetic wears off! Lol!

And what did you do during your pregnancy knowing that you were trying to spare your baby any discomfort? You tapered down by 10 mg per day! You didn't quit suboxone because that could easily have caused a miscarriage. So you protected your baby by not jumping off suboxone. You kept taking a medication that is crucial to your recovery, so that you wouldn't take street drugs that could have caused your baby much more harm. You did that to protect your baby. And yet, because you wanted to minimize the chance that your baby would deal with any discomfort, you slowly decreased your medication as much as you could before she was born. You did that to protect your baby too. Does this sound like bad parenting to you? Because to me, it sounds like you did everything you possibly could to keep your baby from any harm. The only thing you couldn't change is that you are an addict in recovery.

I also want you to think about the guilt of other parents. Some parents unintentionally pass on genetic diseases to their children. Some older parents, in their desperate bid to have a child, have babies with genetic abnormalities that are more common in older parents. Do you think that these parents should be saddled with guilt and self-recrimination? Did any of these parents including you intend for their children to go through any problems in infancy or beyond? No, of course not.

I know that you have major hormone fluctuations right now, and that is probably feeding into your feelings of guilt. That's all the more reason that you need to think about this as realistically as possible. You did everything you could to decrease the chance that your baby girl would have any problem. But, ok, she felt withdrawal symptoms for a couple of hours. Now she is receiving the medication to make her comfortable. She will feel fine throughout this process and then she will go home to a mother who will put her well-being first above everything else! There are lots of children who don't receive that much care, and who aren't that precious to their parents.

All you can do from this point on is be the best mommy you can be. I know you will be!

Amy

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 Post subject: Re: I did this to her
PostPosted: Sun Sep 01, 2013 2:50 pm 
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Thank you so much Amy. What you said really helped. I'm still feeling pretty depressed though so I'm going to wait until I'm in a better state of mind before I come back here. I don't want to scare any expectant moms who might read my post. I guess I'm just in shock from thinking she was doing fine to learning that they had to put her on methadone. Which confuses me because I thought morphine was the standard treatment for NAS.
Thanks again.


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 Post subject: Re: I did this to her
PostPosted: Sun Sep 01, 2013 3:17 pm 
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Iwtd wrote:
Thank you so much Amy. What you said really helped. I'm still feeling pretty depressed though so I'm going to wait until I'm in a better state of mind before I come back here. I don't want to scare any expectant moms who might read my post. I guess I'm just in shock from thinking she was doing fine to learning that they had to put her on methadone. Which confuses me because I thought morphine was the standard treatment for NAS.
Thanks again.


I actually appreciate your blunt honesty of circumstance and emotion! I encourage you to continue to talk about it. I worry the same of my unborn child, to hear all sides, helps me out alot! Does it scare me? YES! But the unknown is even worse, we all know that.

I will pray for you. U seem stronger than I would be in this situation. Babies are so strong, they can handle it then they wont even remember, youll make it!!!

Prayers!!!!!!

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 Post subject: Re: I did this to her
PostPosted: Sun Sep 01, 2013 5:04 pm 
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I don't know much about pregnancy on Suboxone or have any advice to add, but I just wanted to commend Amy for that very thoughtful, helpful and overall awesome post. Posts like that are what make this forum so great. People come here in complete dire straits, and the support that's available is so amazing.


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 Post subject: Re: I did this to her
PostPosted: Sun Sep 01, 2013 11:11 pm 
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Ditto Surgerybound!

@OP - It's completely understandable to be upset, scared, and remorseful about what is going on with your precious little baby right now. I don't know much about the process of treating babies with this issue, but I'm absolutely sure that she will be home soon. And when she is there with you, you will feel so much better.

You did what you had to do to take care of her Mommy during pregnancy. Just remember that if you don't take care of yourself first, you won't have anything to give to those who need you. Motherhood, even in the best circumstances, is a position that comes with a ton of guilt. You will always second guess your decisions, because the decisions we make as Moms are so important! But the simple fact that you are feeling guilt about this shows just how much you love your daughter. A good Mother will worry, it's the ones who don't worry that aren't doing the job they need to do.

As Amy said, lot's of people have to deal with things like this and much worse with their children. Be gratefull that your daughter will be healthy and happy soon, and will have a healthy Mother to care for her when she comes home.

Much love to you! Let us know how she is doing soon OK?

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 Post subject: Re: I did this to her
PostPosted: Wed Sep 04, 2013 7:31 am 
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I've had two babies spend 10+ days in NICU, the latest was my daughter last year, in february of 2012. Born on 2-17, didn't come home until 2-29. So, the entire NICU thing...it cant be a bit overwhelming, especially for a parent that hasn't faced it. Right now, as I sit here and type, I'm waiting on the doctors office to open and hoping they don't decide to admit my 18-month old when I take her in this morning...part of being a parent I guess...you have to deal with the ups and downs of sickness, and on top of that, the other kids I have, which someone will have to get on to the school bus if the put my daughter in today...
But, what was the reason she was transferred to NICU? I mean, in the ideal situation, you would've been home with her before she had any withdrawals, and those would've been a minimum if you were on such a low dose before having her...so she had to be admitted for being early, probably respiratory distress? My daughter was put in for respiratory distress...but ME taking Suboxone had nothing to do with my wife having an emergency C-section, at 37 weeks...or her not being ready to breath on her own when she was born. I knew when I saw her retracting in the nursery, we were probably headed up the road about an hour (since the closest NICU-available unit is in Birmingham)...I had seen it before with my first-born son. He was retracting SO bad, and he was way worse than my daughter. He was born at 34 weeks, and they ALMOST put a chest tube in him...but he's fine now...
Aside from the sudden fever, my daughter is fine now. If she didn't have some small form of staff, which has been present for a few months, we wouldn't be going to the doc at all today...but those damn bumps come up on her from time to time..and the doctor told us if one came up, either we could "handle it"...which means, get the nasty (shit) out of the bump, or she would have to be lanced in the doctor office, which would be a LOT more painful....
But she warned us, if she EVER runs fever after you empty one of them, she needs to be in the doctor office right away to make sure it's not in her blood stream. This time, I had to get her on Saturday because the bump that came up on her was right at the top of her butt, and she was walking around just crying..she didn't wanna be held, she didn't wanna sit down..so I know it was hurting her. They feel like a golf ball under the skin...so my wife and I had to take her in the bedroom and close the door, it kills me to make her cry that way, but I know it's better than holding her while a doctor sticks a needle in her and draws it out. This one had already started coming out from the pressure, because her diaper, at the very top, had proof of it already starting to come out.
Sounds gross, but when it comes to babies, you get used to being peed on, thrown up on...etc...
I didn't know until the doctor told us that we all have some amount of staff in us, just depends on how our body fights it off...whether it ever shows up or not. Just so happens that it gives my daughter some problems, which she'll outgrow eventually...but for now, every 2-3 months, we deal with a cyst-like bump that she has come up randomly...

Got off topic, sorry..but at any rate, if your baby was admitted for respiratory distress, then don't blame yourself...perfectly normal pregnancies sometimes go early and have the same thing happen. The only thing different, your daughter was under a physician's care and was seen having withdrawal symptoms....
whether they made the right call or not on the methadone, I can't say...
I would say this...if you had a normal delivery, or even a normal c-section, and came home 3-days after ....you would've been seeing it, probably would've been a little more fussy than a normal, non-withdrawal infant,unless you took really high doses of Suboxone before delivering. She would've likely had a couple of days where she didn't sleep well, and almost acted like a baby with infantile colic..but after a 3-4 day period, would've probably started to normalize and be more like an infant. They are already up every 2 hours for feeding...unless she was having some awful side effects from the withdrawals, I don't see what would've been so bad about minimizing the current withdrawals and letting her fight through that without adding another medicine to her IV...but I'm not a doctor..so please don't take anything I've said as medical advice. Just had a LOT of practice, with four kids...3 of them spending time in hospitals at birth. Only one was perfectly healthy and came home, actually a day early after delivery. Two spent time in NICU, and one spent time in the hospital nursery (about a week, 5 days)...
So as a parent, I'm here to tell you that babies are VERY resilient...they are tougher than we think..but I know you can't help but worry and think you could've done something different..and that would've helped...
That MIGHT be true, but you can't know for sure. You could've caused even more problem than what you're currently seeing had you chosen other paths...so don't beat yourself up. Best thing to do now is prepare yourself, and rest, because soon enough you'll have a newborn at home, demanding all that mommy-time, and I know very well how much they require especially coming home from NICU. You spend all that time just WISHING you could hold your own baby, and they spend all the time telling you why you CAN'T hold them...so when you get home, you don't wanna put them down.
It drove us NUTS that we had a baby we couldn't hold for FOUR DAMN DAYS after she was born.
My son, we couldn't hold him for 8 days ...that's TORTURE!!!
With my daughter, I was an emotional roller coaster last year (sub prob didn't help this)...
I remember crying like a baby the first time we came home and slept ....I felt SO bad for leaving my baby an hour away...
but then again...don't beat yourself up...she's in good hands, and hopefully you won't deal with it much longer before you bring the bundle of joy home.

Keep us posted. If you feel so inclined, once you get home...post pics!! I miss my baby being that tiny infant that I used to sleep with on my chest..
She still sleeps on daddy's chest..but isn't so tiny anymore. Sucks that the grow up so quick!

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 Post subject: Re: I did this to her
PostPosted: Wed Sep 04, 2013 2:06 pm 
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I don't want to unnecessarily confuse things--- and I always recommend that people take the recommendations of their OWN physician. But some doctors are confident enough to withstand questions from patients who are educated.... and I hope that you are lucky enough to have that with your doc.

I unfortunately see many examples of medicine getting it wrong. I could go through history and name a few big examples-- I've done that on the blog at times-- and I just watched a documentary about early space exploration that mentioned that 98% of doctors 'knew' that the human body would cease to function in a zero-gravity environment. They KNEW that. They were wrong, of course.

I know, beyond a doubt, that bias affects the scoring of infants in 'withdrawal'. I know that many babies would go through the nursery without any hold-up-- unless the nursing staff heard that the mom took a substance, in which case all sorts of 'symptoms' are identified. We had the 'crack baby' fake epidemic in the 1980's; most doctors who work with neonates now acknowledge that there was no such thing as a 'crack baby'-- that the news shows pulled in tight on normal newborn spasticity (the nerves are not fully myelinated at birth in normal babies) and got people to believe it was different from normal. People love a story about poor babies and guilty mothers; it allows people to say to themselves, 'I'm SO much better than THAT mother.' Crazy---- but human.

If you go in any nursery, you will see babies that cry all the time, and babies that sleep all the time. If no moms take buprenorphine, it is a normal nursery. But if one mom takes buprenorphine, if her baby cries, it is part of the withdrawal scoring system. If the baby is sleeping, THAT is part of the scoring system. Trouble feeding? Another 'symptom'. Diarrhea and constipation? more symptoms. The jerking movements of the arms and legs--- something all babies do as a result of immature nervous systems? 'symptoms' if mom takes buprenorphine.

My own first child never figure out breast feeding-- something that is not all that abnormal. After 3 days of screaming, we said the heck with it-- and used a bottle. If my wife (or maybe even if I) used opioids (we didn't), it would have been attributed to opioid discontinuation.

My experience, after following several dozen women through their pregnancies: the women who delivered at a hospital where people were low-key, where the approach was to do as much as possible 'naturally', had very uneventful deliveries and discharges. Babies were allowed to breast feed; the thought was that in that way, if the baby DID have any need for opioids, they would be delivered in breast milk--- and the fetal circulation would assure that most of any buprenorphine in the milk would be destroyed by the liver, leaving traces to help wean off buprenorphine.

In the big medical centers, where they have neonatologists, high risk nurseries, pediatric fellows, etc, babies are placed in incubators (rather than in bassinets in the room with mom all day), where they lie in bright light, crying. Their lack of sleep is attributed to withdrawal, and they are given IV's-- i.e. they have an extra source of discomfort. They are, of course, agitated-- any baby who was poked several times in the search for an IV WILL be agitated-- and that is seen as more 'withdrawal'. Babies are put on morphine or methadone-- drugs harder to stop than the original buprenorphine-- and go through an exercise of pushing tolerance higher, than tapering it lower again. The result is extra days in the NICU, unnecessary needle sticks and IVs, less bonding time...

Don't worry-- because it doesn't matter to the baby; they used to allow babies to go through much worse discomfort, knowing that babies don't remember these things. But the bill can be pretty painful!

Some people on this forum know that my father died earlier this year. I arrived at the hospital early enough to intervene, and to prevent the craniectomy that the neurosurgery residents were getting all set to perform on my 89-y-o dad. I've since read articles about the controversy over craniectomies-- procedures to remove parts of the skull so that the brain can swell, allowing the patient to survive.... even after devastating injuries. The result is a lower death rate for cerebral hemorrhages, what my dad had----- but a higher number of people with severe neurological deficits in nursing homes, unable to walk, talk, or feed themselves, or in some cases in vegetative states. Modern medicine (like some other things) needs to be reined in by patients--- because doctors will never rein it in. Why? The money, of course.. but also because the big med centers are training institutions, and the residents are there in order to DO the big procedures, and make the big interventions. I can hear the conversation between the med student and resident on the way to the NICU: Resident: 'we have a mom coming in addicted to Suboxone..... we'll need to place lines, set up a morphine drip....' Med student: 'cool-- can I try getting the line in?' Resident: 'mom's neurotic so if she's there, I'll just do it-- but if she isn't you can take a couple tries at it'.

For moms feeling guilty---- don't. You will have plenty of time, going through life as a mom, to feel guilty! Use this time to recover from the delivery... and when you see them increase the dose of methadone or morphine, don't be afraid to speak up and say 'I want to get him home; do you really need to push his tolerance higher?'

A last, horrible anecdote.... I had a patient deliver a baby while on buprenorphine. The baby did poorly, and everyone assumed it was withdrawal. Took an extra 2 days to realize that the baby had a rare genetic defect, unrelated to buprenorphine. My point-- just like people in this forum are quick to blame buprenorphine for every ache or pain, doctors and nurses are quick to blame buprenorphine for every abnormality in a newborn. There are babies who were not born to moms on buprenorphine, who experience aspiration pneumonia, shoulder dystocia, poor tone, respiratory failure, etc.


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 Post subject: Re: I did this to her
PostPosted: Wed Sep 04, 2013 5:00 pm 
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I'm glad Dr. J chimed in and put it so much more eloquently than I ever could've dreamed of, mostly because of his experience and wisdom in the field....I said what I did from a parent's point of view, who's been down that road with babies in NICU...babies, as I said before, are VERY resilient.
And like I posted earlier, I don't understand what would've been so bad about letting the baby continue withdrawals...IF they even knew about it to begin with (DID they?)

without reading my previous post, I know I said something about the baby shouldn't have had any discomfort until discharged from the hospital, unless there was another problem that came up causing the infant to be sent to NICU, like respiratory distress...I think that's the most common thing these days.

what they should focus on (the Neo docs) is WHY are so many pregnancies ending early, with SOOOO many infants going to NICU's? I mean, when my first daughter (now 12 years old) was born, it was RARE to have a baby go into NICU. Now...every Bob, Dick and Harry I talk to about their kids mentions their baby had to stay in the NICU before coming home. Something is wrong with either 1)prenatal care, and in a sickening, greedy point of view, are OB/GYN's purposely doing something to expecting mothers (certain "prenatal VITAMINS") to cause early labor, which in-turn generates more revenue for hospital, staff, and on-call? or 2) genetic problems to begin with becoming more common in people that cause the mother to not be able to go full term.
I mean, how many people do you know that actually have a 40 week baby? I can't name but one of a bunch of people I know with kids who had normal, 2-day stays, then sent home in the past 5 years or so.

And now, for some strange reason, my infant has staff that comes and goes. Lots of people who come from Brookwood in Birmingham complain about that, but this was a BRAND NEW multi-million dollar NICU unit, and supposedly Brookwood is one of the best hospitals in Bham area....I know a friend who lost his wife after she delivered at Brookwood, because of staff....lucky for us, we delivered locally, and were just sent to Brookwood after that.

Anyway..thanks Doc for your knowledgeable input on the matter...helps to have that professional opinion on the matter.

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 Post subject: Re: I did this to her
PostPosted: Thu Sep 05, 2013 4:09 pm 
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Thank you all so much for sharing your stories and intellect with me. I'm feeling a bit better now that it's sunk in. She was delivered by emergency c-section after her heart rate dropped to 60. Ot stabilized pretty quickly but the doctor wanted to get her out of me as soon as possible. During the delivery she swallowed some meconium(sp?) and had trouble breathing so they immediately transferred her by ambulance to a hospital with a NICU. Her breathing improved over the next couple days and she was completely off the oxygen in three days but they wanted to observe her for a few more days to watch for signs of NAS. We called to check on her before bed and she was doing great. Called back the next morning and she was on methadone. I don't know how much they are giving her but they said it's her "full dose". And when her Finnegan scores have been low for a few consecutive days they'll start weaning her off by 0.02mg a day. When I ask for an idea of how long she's going to be in there, they can only say that every baby is different and it's possible that she might not be home for 3 months.
If she is truly suffering from NAS then I am thankful she's being kept comfortable. But I am scared that the nurses are being overly cautious. We don't have health insurance so the bill is going to be a nightmare and it's a 130 mile roundtrip to the hospital. I just want her to be home where she belongs :(


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 Post subject: Re: I did this to her
PostPosted: Fri Sep 06, 2013 10:00 am 
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I just have to say that Dr. J's post touched me so. It is my hope that more expectant mothers find THIS forum instead of "other" forums when doing research. Usually, mothers really want to do what's best for their babies. Scare tactics only push someone to shut down. Expectant mothers need to know the FACTS. Weigh the risks v. benefits and make an informed decision. And be SUPPORTED throughout the entire process.

We can worry about "morality" later. Like Dr. J says, you have the rest of your lives to feel guilt. THAT, my dear is the definition of motherhood!

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 Post subject: Re: I did this to her
PostPosted: Sun Sep 08, 2013 11:53 pm 
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Hello,
I know exactly what you are going through and it is very hard. I was on 8mg of subutex and the last few months i have only been taking 1/2 of an 8mg tablet a day. I gave birth to a baby boy on 9/3 he was 8lb 5oz and very healthy. The first day in the hospital he was fine he would twitch his arms here and there when he was sleeping. Then the second night he started getting real cranky but as soon as i fed him he was fine. They brought him in the next morning when we where going to be discharged and all he wanted to do was cry it was like he couldn't get comfortable he would twitch and then started crying. Then they came and got him so the doctor could check him over and then the doctor came in and said he needed to get treatment. After that they brought him back to me and i fed him and he was completely fine. He got sent to another hospital 2hrs away from where i live so its very hard for me to get out there to see him. I haven't seen him since Friday and its been very hard on me all i want to do is cry all day but i know i have to be strong for him. When i called and checked on him today they said he is still getting morphine every 4hrs and they had to up his dose. I really don't understand why it seems totally crazy to me! I mean i took 1/4 of a subutex tablet last night at about 11pm and i didn't even take another dose until about 4pm tonight and i hadnt even started getting any withdrawal. So if i can go over 12hrs without any meds i don't understand why my son is going through such bad withdrawal in only 4hrs! They said they give him a dose of morphine every 4hrs before he eats and they said when he wakes up to eat he wakes up with tremors and excessive crying. I just don't understand how he is getting worst and not better!

I am kind of pissed off at my suboxone doctor because he encouraged my husband and i to have a baby he said that having a baby would help us get off the program. He said that if anything our baby may have to stay in the hospital and extra day or 2! If i would have known this was going to happen i would have waited but instead i trusted my doctor and didn't even research this before i got pregnant. I do know he was right about 1 thing i am 100% dead set on getting off the suboxone i hate for what it has done to my child and i have more to worry about right now.

I do understand everything you are going through and i know its really hard! But you have to be strong for your baby and just think positive. Every time you start to get upset just think your baby will be fine and will be home soon! People think babies go through some agonizing pain but the doctors keep them comfortable (seems like they are keeping him a little to comfortable) and babies don't have the mentality of an addict. They go through withdrawal but they don't crave they don't sit there and think "Oh if i take a pill ill feel so much better" which makes withdrawal 100 times worst. I really hope your baby gets better and gets to come home soon!


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 Post subject: Re: I did this to her
PostPosted: Mon Sep 09, 2013 6:45 am 
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Seems to me like they are prolonging the withdrawals instead of helping matters..I mean, instead of allowing the infant to come down from an obviously easier withdrawals, introducing a full agonist to them, which causes a more abrupt withdrawal, just sounds absurd. When you factor in 37 hour half-life, and the rate at which suboxone (or buprenorphine) breaks down in the body, the infant should have an easier time coming away from buprenorphine, rather than slowly weaning off morphine, which all traces would be gone in what, 24 hours ...maybe 36?

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 Post subject: Re: I did this to her
PostPosted: Mon Sep 09, 2013 10:31 am 
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Has it ever been studied or documented that breastfeeding could help in weaning a baby? As if the mother's milk still carries enough chemical to comfort baby? I know different meds have different barrier crossing ability, but I don't know what bup or methadone's is. The first couple of days is not really enough milk (just colostrum) anyway, so my question is probably mute.

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 Post subject: Re: I did this to her
PostPosted: Mon Sep 09, 2013 2:04 pm 
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I think a study should be done to see if babies that are breastfed have a better chance of not going through withdrawal after the mother had been on subutex while being pregnant. From what i have read it seems like the mothers who breastfed there babies had more of a chance that there baby did not go through withdrawal. I think it is something that doctors should check in to because what they do now is ridiculous i don't feel that my child should be given a ton of morphine and he should not be going through withdrawal as bad as they are making it out to be.

I mean my baby acts like any other baby it seems like every time he does something they say Oh that's from withdrawal like sucks on his hands or cry's when he wakes up and shakes his arms at times. Its like all babies do those things so i don't understand how just because i was on subutex they automatically assume he is going through withdrawal. I mean i am not going to say he did not go through some sort of withdrawal because i have gone through some bad withdrawals at times and i know how it feels. He would try to sleep and then his legs and arms would tense up and he would start crying which i know that feeling iv gone through bad withdrawal that made my legs real restless. But that only lasted maybe a half hour then i fed him and he was fine he stopped tensing up and slept for about 3hrs until they came and took him to another hospital. I don't think doctors understand the full effect of withdrawal how could they unless they have went through withdrawals themselves?


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 Post subject: Re: I did this to her
PostPosted: Mon Sep 09, 2013 4:07 pm 
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Oh my goodness, reading these posts just breaks my heart for all of you Mommies and the babies.

I certainly hope they can come home soon...praying exactly that!

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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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