Subutex born baby given methadone. How long will baby be on for?

[free4life]

I stayed on subutex whole pregnant cause I didn't want to lose the baby as I read so many lost from w/d.  After she was born, she had withdrawals from the subutex, but was told by my doctor it would last just a few days.  The hospital having no knowledge of subutex, decided to treat with methadone at .5 mg twice a day for 5 days; .3 twice a day for two day, now at .3 once a day.  When will I be able to bring my baby home, and how long will the methadone last in her system?

[Julia M Aharonov, DO]

I feel for you. It seems that you really did not have good guidance from the very beginning. Is there a large children's hospital or university medical center around in your area? Could you get to talk to chief baby doctor (neonantologist)?  Maybe he/she can get your baby transferred to another hospital where they actually know what they are doing.
Yes then can and should put the baby on a very small dose of morphine and titrate it down. It should have been done already and not have taken weeks. However, please keep in mind, I am not there and I am not a NICU doctor.
Now, I want to ask you something. What are you doing about your Subutex? Are you tapering it off? Are you getting clean. I am an expert in adult addiction and I know that if you need any help, that I can do. Just let me know. Click on my name in blue, them my clinic name, You can get my help anytime. Good luck. You precious baby needs you. Please let me know if I can be of any further assistance.

[free4life]

Thank you Jaharonov for your response.  Althought, I feel like I'm about to have a panic attack as I knew this was not right to treat her with the methadone.  She has been on it for a total of 12 days now.  They just lowered her dosage to .2 twice a day.  Yes, a social worker was involved and tried to get me to say, at a meeting with the doctors, that I agreed with the treatment.  I did not agree and we never gave then consent to administer  the first dose to begin with.  As I know, you can't mix subutex with methadone.  At this meeting I pointed out that the doctors did NOT know anything about subutex.  I explained I had a plan after finding out I was pregnant on subutex to stay on it as I did not want my baby born a methadone baby.  I don't know why they didn't listen to me when I said to treat her with a tranquilizer as there is a 50% chance she could be born with withdrawals. As far as overreacting, Yes, it's this computerized test with scores determined by the nurses if she coughs, sneezes, eats, if she cries or sleeps.  But every time I'm there, she is near perfect as she just wants her mother.  I've had my subutex doctor speak with the NICU doctors, but he feels they are not familiar what to do so they are doing what they know.  This concerns me, and the father and I are frustrated.  We have spoke to the pediatrician, but he is also clueless.  No one at this hospital has had any experience with subutex. What can we do?  I want my baby home.  She's been in the hospital since the 6th.  Yes, they plan on keeping her the duration of the detox.  Can they take her off the methadone and treat her with the morphine?  Please help us....

[Julia M Aharonov, DO]

I am somewhat surprised that they chose methadone to detox your baby. The usual way for infants to detox is morphine because it is so short acting, allowing a relatively fast taper. Methadone is a long acting opiate with half life of anywhere of 13 to more then 40 hours (meaning that it is in the body about 5 times that long). Given that infants' metabolism is usually faster than adults', it will probably be closer to 13 to 20, but it is still very long half-life. Are they going keep her in the hospital until she is totally weaned off of it? It may take a while. Methadone is not easy to withdraw from, that is why I am surprised at their choice. I wonder if they got social services involved.  I have a funky feeling about this.  Did you talk to a pediatrician about your situation before the baby was born, so they were ready to manage her or was this a surprise to them? Did you ask them if they have had dependent moms give birth there before and if they have experience with babies in withdrawals?  These babies need special expertise. Very often very mild withdrawal symptoms are over-treated in exaggerated way actually leading to  addiction and long term hospital stay, when all the baby did was sneezed a couple of times.
I am not saying that is what happened here I am just saying you need neonantologist with experience who will not overreact in this situation and cause more harm then good. Please ask them about their experience in treating this problem before - you have a right to know. Talk to your own pediatrician who may want to get involved and change the course of treatment. And let me know what happens, please.