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PostPosted: Mon Jan 16, 2017 2:12 am 
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I was just recently told that the hospitals in my area will hold babies exposed opiates (or maybe it was just to methadone or suboxone... i am not sure) for 10 days even if the baby has not been scoring/displaying NAS. The claim is the it is because it can take that long for NAS to occur. Is that true? It could take 10 days before NAS even begins?


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PostPosted: Mon Jan 16, 2017 9:45 am 
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According to various sources (Stanford, emedicine, etc), yes, it could. They say symptoms 'often' (thanks for the precision!) appear in 1-3 days, but can take 5-10 days to appear.

I would think the length of time it takes for symptoms to appear would depend on (1) mainly the half-life of the drug in neonates (even in full-grown humans, full withdrawal symptoms can take days to appear when the drug has a long half-life like methadone, buprenorphine, or LAAM); (2) how premature the baby is, i.e. how much kidney/liver function they have.

this is a good overview of NAS http://emedicine.medscape.com/article/9 ... verview#a5

For example, this is what they say about methadone: "Methadone's half-life is longer than 24 hours, and acute withdrawal may occur within the first 48 hours after birth and as long as 7-14 days later. The withdrawal may even be delayed for as long as 4 weeks after birth, with subacute signs developing as late as 6 months after birth."

I would hope that doctors would take into account the drug that the mother was using. If she was using only short-acting opiates like morphine or heroin, I would think 10 days is excessive.
But i am not a neonatologist!

If you're concerned about NAS, I'd suggest you read Dr. Junig's articles on SuboxoneTalkzone about why concerns over NAS are often based more on stigma against drug-using mothers than any real knowledge about what the baby is experiencing.


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PostPosted: Mon Jan 16, 2017 3:17 pm 
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Pregnantandlost I think every area has their own rules, but if I were concerned about it, I'd just call the hospital ur going to give birth at and ask them their procedures. I wasn't addicted when I had my children, but even then, I was able to go to the hospital and pre registered and they explained a lot of how things would go to me. So I'm assuming u can do something like that too.

The ladies that's posted on this forum, don't normally report that their baby has had to stay in the hospital that long..... but I do think it could be a possibility in different hospitals. So I'd ask, nothing in the world wrong with getting that information, even anonymously if u need to. Ur OB should be able to tell u that also.

Personally, I do not think a baby should have to stay in the hospital 10 days, especially if they baby isn't showing withdrawal symptoms during that time. But I'm sure it happens in some hospitals.

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PostPosted: Mon Jan 16, 2017 4:47 pm 
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In my opinion, the VERY best thing to do is for both you and your husband to take a tour of the hospital. Pre-register. Go to the birthing wing and actually speak with neo-natal nurses & staff.

I'm pretty sure every hospital has a different policy and standards regarding this issue. By doing this, you'll not only have some of your questions answered & get better acquainted with the place you're about to give birth at.....but, you'll also be making a very important first impression on the staff who'll soon be taking care of you and your baby. Unfortunately, there's still a stigma surrounding those whom
choose to include Sub and Methadone in their recovery. By asking questions and planning for your special day, you'll be showing how much you care for your lil one....and possibly dispel any judgment.



* I know the small amount of bupe that passes through breastmilk is supposed to be insignificant. But, I would make breastfeeding a top priority if I were you. It's wonderful for the obvious reasons. But, trace amounts of bupe could help in those early days. And, the act of breastfeeding itself should keep your bundle of joy soothed.


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PostPosted: Mon Jan 16, 2017 4:57 pm 
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I actually did the private tour in my first trimester with the purpose of asking about their procedures for monitoring infants exposed to buprenorphine. I couldnt get an answer that made since out of them...they seemed to dodge the subject. She just told me the usual stuff they do for all pregnancies. But yes...i have a call in to the nurse manager to call me back so i can demand a more thourough explanatiom


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PostPosted: Mon Jan 16, 2017 5:07 pm 
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That's right.....you mentioned that awhile back, but I completely forgot.

Definitely call and speak to the head nurse. But, I would even try to stop by and speak in person. I really believe there's something powerful about looking someone in the eye and speaking to them.

I feel like if they see how concerned you are and how much you care, the harder they'll try to be honest with you and ensure you receive the best care.

What's your due date?


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PostPosted: Mon Jan 16, 2017 5:10 pm 
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I do intend to go in again..but would like answers asap. Due date is feb 28th... but don't think i will make it that long.
Had highblood pressure today at my appointment and the are now doing testing for pre-eclampsia. If i have that he said i will deliver early, at 37 weeks.


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PostPosted: Mon Jan 16, 2017 7:03 pm 
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Hi Pregnant&Lost.


I'm extremely new to Suboxone (on Day 6) but I've had all three of my girls while taking something prescribed and I thank God to this day that they were (& still r) absolutely fine. My first one, I was still on hydros and had no problems. The last two I was going to the Methadone Clinic. I was completely upfront and honest about everything with my OB and the hospitals. They all explained their procedures regarding pregnancies like mine so I knew what to expect on that front. It all depended on my babies and how they scored. I still thank God that there was no withdrawal symptoms worth noting. I say it like that because everytime one of them even sneezed, my husband would freak out. They slept so good that that even worried my husband. I even explained to the Dr and nurses that nobody in my circle of family and friends (other than said husband) even knew I was on Methadone and I didn't want it mentioned unless it was absolutely necessary around others. They were very good about that. There were a couple of nurses that always had to make some kind of comment about thanking God my babies were healthy now and that u could tell wanted to let their opinions known but couldn't. I ignored them. Trust me, i felt guilty enough and thankful enough all on my own. I had to have C-Sections everytime due to an emergency C-Section (not related to addiction) the first time so I had to stay in the hospital 2-3 days but my babies were always ready to go when I was. I would go ahead with your plan of talking to the hospital again and this time demand answers from somebody that knows. I wish u all the luck in the world!!


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PostPosted: Mon Jan 16, 2017 11:23 pm 
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Marie, i most definitely plan to breast feed!
I really hope i get some straight answers...my OB claims to not know what will be done exactly, but today when i asked him about having to stay for 10 days even if the baby is doing fine he scoffed at that and said he has not seen that happen. It just really freaks me out that I can't get clear answers from anybody except my counselor. But her claim that they are held 10 days regardless seems to be incorrect,so now I am questioning what made her come to that conclusion. And my OB said maybe the nurse who gave me the tour the first time was just trying to not draw attention to the subject as she doesn't want me to worry. Well... sorry, but i would like to know what is what. Obviously i understand everything depends on how she is doing, but it should be fairly standard procedure in how they determine how she is doing and how long they monitor for, etc. Drive me nuts people...just tell me what the hell you do! Lol


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PostPosted: Tue Jan 17, 2017 1:26 am 
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Hey P&L,

Hopefully you'll hear back soon and know for sure. In the meantime just some thoughts...You are amazing. Am proud of you. You are asking the critical questions. Don't have the time to research but I recall a 2008-2010ish study where moms on bup or methadone, for study design reasons, were required to leave the newborn for a 10 day stay for evaluation. Later, some folks misread this study to mean all babies from Mom's on methadone and buprenorphine HAD to stay 10 days. Maybe this is what your counselor references? IF your hospital requires babies w or wo NAS to stay 10 days, your OB would know Truly! And he scoffed at the idea. He knows what goes on in the hospital he delivers in. No way would your OB not know... He hears everything...

Also, you are maybe super focused about bup issues but want you to keep in mind that nurses see newborns w other issues - Mom's hiding they're on full opiates, benzos, higher dose antidepressants, Mom's who smoke pks of cigarettes, drink a gallon of iced tea, mountain dew a day and their newborns might withdraw...

Separate yourself from this. I really like Marie's post somewhere - she went in w info, and bc of it and her attitude -- earned respect and helpfulness while there. Mom 3 82 was open too and it worked out.

Inform them: You're fully disclosing you're on bup. You work. You are married. Your OB knows. You have great prenatal care. You are in prescribed treatment. Your OB called your Bup Dr. Your pediatrician knows. I assume its your GP/bup doc that you took your son to w the eye issue. You've turned over every stone for the best delivery possible. This shows them you've worked hard -- which in turn will minimize or avoid the nurses overreacting to your newborn.

Inform them of who you are, the accomplished, successful, in-recovery Mom who is doing all you can to make things well for her baby girl. One day maybe none of this will be necessary, but until then, proud of you and for you, Pelican

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Stopping went well -- its the staying stopped -- where the real work begins.
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