Managing your baby's withdrawal symptoms

Before your baby is born and during your time in hospital, the nursing staff will discuss how you can help your baby if he or she is withdrawing.

In the hospital

Admission to a special care nursery

If your baby has severe withdrawal symptoms, he or she may need to be cared for in a special care nursery. The nurses will closely supervise your baby to make him or her as comfortable as possible and reduce the risk of complications such as convulsions (fits).

You can help by staying in the nursery as much as possible to feed, settle and hold your baby. Many parents find their baby settles easier when held gently and close.

Medication

Your baby may be given medication such as morphine or phenobarbitone to decrease his or her withdrawal symptoms and reduce the risk of convulsions. Ideally this medication will help settle your baby without him or her becoming drowsy (sleepy).

How much medication will my baby need?

Your baby’s dose will depend on the clinical assessments done by your midwives and doctors and your baby’s weight.

Stopping the medication

Your midwives and doctors will keep checking your baby’s symptoms and reducing the medication continues until your baby’s withdrawal symptoms have stopped. Each baby is different in how they respond to the medication being reduced.

Will my baby need to stay in hospital?

If your baby is on medication he or she will need to stay in hospital for at least a week and sometimes longer, but you will go home earlier. Some babies are sent home with medication and require follow up by the home visiting nurse and at a clinic. It is very important to keep any follow-up appointments.

Having a baby in hospital for a long time and being away from your partner or other children is not easy. This can be a stressful and emotional time. Remember that you and your health carers share the same goal - to help you and your baby through the withdrawal and go home as soon as possible.

How you might feel

Many parents describe their baby’s withdrawal as an emotional roller-coaster.

Your health carers understand that this is a very stressful and emotional time. Please let staff know if you require further support.

At home

Your baby’s withdrawal symptoms may continue for longer than a week and possibly up to 6 months, but over time they will gradually decrease. Once at home, your baby may continue to experience:

• difficulty with attachment during breastfeeding
• colic (unexplained regular crying fits where it seems like the baby is in pain)
• poor sleeping patterns
• slow weight gain.

What can I do to help my baby?

If you baby is experiencing withdrawal he or she may be more unsettled when you take them home and may need more care and comforting.

The following advice on how to manage some of the behaviours your baby may display may help you both at this time:

• Prolonged crying (may be high pitched)
  • Hold your baby close to your body, perhaps wrapped in a sheet
  • Decrease loud noises, bright lights, and don’t handle your baby too much.
  • Humming and gentle rocking may help.
• Sleeplessness
  • Reduce noise, bright lights, patting or touching your baby too much.
  • Soft, gentle music and rocking may help.
  • Make sure your baby has a clean nappy and a dry bottom.
  • Check for nappy rash or skin irritation and use nappy rash or zinc cream as needed.
  • Feed your baby on demand.
• Excessive sucking of fists
  • Cover your baby’s hands with gloves or mittens if his or her skin becomes damaged. Avoid lotions or creams as the baby may suck them.
  • Keep areas of damaged skin clean.
• Difficult or poor feeding
  • Feed small amounts often.
  • Feed in quiet, calm surroundings with minimal noise and disturbance.
  • Allow time for resting between sucking.
• Sneezing, stuffy nose or breathing troubles
  • Keep your baby’s nose and mouth clean.
  • Avoid overdressing or wrapping your baby too tightly.
  • Feed the baby slowly, allowing for rest periods between feeds.
  • Smaller feeds more often may help.
  • Keep your baby in a semi-sitting position, well supported and supervised.
  • Don’t place your baby to sleep on their tummy.
  • If breathing difficulties continue or worsen, contact your doctor or Princess Margaret Hospital on 9340 8222, 24 hours a day and you will be put through to the Emergency Department.
• Vomiting
  • Burp your baby each time he or she stops sucking and after the feed.
  • Support your baby’s cheeks and lower jaw to enhance sucking and swallowing efforts.
  • Keep your baby clean and his or her bedding free of vomit. The smell may increase the problem and the vomit may irritate your baby’s skin.
• Hyperactivity
  • Use soft flannel blankets or a short haired sheep skin covered by a cotton sheet for baby’s comfort.
• Trembling
  • Keep your baby in a warm, quiet room.
  • Avoid excessive handling of baby.
• Fever (temperature over 37 °C)
  • Keep clothing to a minimum.
  • Avoid using too many bedclothes.
  • Seek medical help if your baby’s temperature stays high for more than 4 hours or if other symptoms develop.

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This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.