So I have this friend. . .

So I really do have a friend, her initial is "A". A is a foster parent and she was just given a 19 pound 2 1/2 month old baby girl. Back story, bio-mom was arrested for meth. A doesn't know how long the bio-mom BF, but she was BF, and there is a chance that the baby is going through detox. A was given a can of formula that they got from the no-tell motel where bio-mom was arrested and it was 3/4 empty, so I'm thinking she has at least gotten 3/4 of a can of formula, somewhere down the line.

The baby has pooped at least 12 times a day since going into A's care, just a few days, maybe 5. And with that, she has amazing diaper rash and yeast rash, which she's started Nystatin for. How long can we expect the diaper rash to happen, is there any way to turn off the poo? A's really quite worried about the amount of poop this (big) 2 1/2 month old is producing. Is that just a byproduct of switching to formula? Could it be from detoxing?

 

Bex - when I did my NICU rotation we had a detox baby in there - I'm surprised she's as huge as she is (sounds like mom fed her to keep her quiet) - anyway back to the issue at hand, detoxing WILL cause multiple loose stools and an excoriated bum...if she's difficult to handle right now (inconsolable crying, hypertonicity etc) A may want to take her to the pedi - if she is detoxing hard enough they can give her methadone - also detoxing can be VERY painful for an infant and glucose water will help ease the pain...

 

You're amazing. Absolutely amazing. If there are any other questions, I'll add you to the discussion on facebook. :wub:

 

glad to help! The baby may have to be inpatient to receive meds, but in the long run it may help...and at this point she'd be on peds or PICU, rather than NICU due to her age...the high pitched, inconsolable crying is a HUGE red flag - the day I spent in the NICU was spent in the majority of that little girl's room just holding her (since the nurses had other patients, and while the ratio is low its impossible to just sit there - the nurse was so happy to have students that day!)

 

Annabelle had Nystatin for diaper rash starting Saturday and the rash is now gone. Had I applied it for every diaper change like instructed (whoops!) I think it would have cleared up maybe a day or two sooner. So 3-5 days? I also made sure she had naked time a couple times a day.

Good for your friend for taking in the baby. :hug:

 

Poor baby. I looked up the effects of various pain meds and methamphetamine to see what the lactation risk is. If your friend knows what the drug exposure likely is she can get a sense of the effect from these charts. Here's the Kellymom chart--http://kellymom.com/bf/can-i-breastfeed/meds/pain-meds/ and here's a good link on methamphetamine.. I think it would be highly unlikely that the baby was exclusively or even primarily nursed, given the very high weight. Also if the Mom was using meth, the problem would be lack of weight gain rather than excessive weight gain.

If they can figure out what if anything the baby has been exposed to that would be helpful. The good news is that most drugs don't transmit in high rates through breastmilk. Of course, who knows what the baby has been exposed to, and I'm not sure how long it takes to detox from intrauterine exposure, maybe Amy can address that?

This is so depressing, there's a big epidemic of prescription narcotic abuse, and I saw a report from a month ago indicating that the number of babies born with these drugs is their system is at an all time high.

 

detoxing from IU exposure can take a LONG time...babies can also detox from the methadone (if the mother was in treatment while pg)...the NICU baby that I spoke of earlier was only at her birth weight a month after delivery...she didn't eat well at all - had to be tube fed, and was on a LOT of glucose water (also called sweet-eze) just to get her to take 2 oz...

sounds like mom was overfeeding the baby to keep her quiet or her metabolism was in high gear...its hard to tell without seeing her, but one of the biggest issues was the multiple liquid stools and the diaper rash (and other skin excoriation) from hell...

I doubt that the level of detox is from just BM...

 

What a sad story Bex. Kudos to your friend though!

I have to say, when my kids have gotten really bad diaper rashes, I have to say Aquaphor was amazing. By the next diaper change you saw big improvements.

Just wanted to pass that along!

 

I definitely agree it sounds like withdrawal, specifically opiate withdrawal. Mom may have gotten arrested for the meth but may have also been using heroin or perscription pain meds. If the only symptoms are diarrhea, those can be handled without meds, but if baby is extra irritable, twitchy, etc she needs to see a ped. For the diaper rash, the best treatment is a thick paste made of aquaphor and maalox. The maalox neutralizes the acid in the poop so that the bottom can heal. Tell her to try to use washcloths and water instead of baby wipes until the bottom heals and let her have some no diaper open to air time a few times a day (with a nice absorbent towel underneath, of course!)

 

Using cetaphil on the wipes at each diaper change is really, really helpful. Since it's a soap/cleanser you're getting rid of all the bacteria, plus you don't rinse it off which makes things easier.

My kidd had awful reactions to pretty much everything, but the cetaphil worked wonders.

 

Just to add, babies that have been exclusively breastfed have yellow mustardy stools that are loose. until Easton was 2 months old he pooped after every feeding. He was exclusively bf.

My dh has a cousin that was putting kool aid and sweet tea in her baby's bottles because it was cheaper ( thank goodness my MIL stepped in the baby was 2 weeks old) no telling what that baby has been fed.

I cannot imagine a 19 pound 2 month old!! East will be 10 months old tomorrow and is 17 pounds!!

 

The little girl is doing so much better, they switched her to soy formula, the diarrhea is clearing up, the diaper rash is clearing up with the maalox, nystatin, and desitin mixture, and she's fat and happy. :smilie_xmas_116:

ETA: The cetaphil is a brilliant idea. I love how it feels on my face when I use it to clean my face, I can only imagine how nice it feels on a painful rash.

 

Whoo, hoo!

 

Glad to hear!