Baby Talk | What it means for babies whose moms have had illicit fentanyl exposure
Fentanyl is a potent synthetic (it can be produced in a laboratory) opioid drug. It is used for treating severe pain. It is used in epidurals to relieve the pain of labor. It helps cancer patients function when they are in pain.
Like many other opioid drugs it works by binding to specific opioid receptors in the body. Many of these receptors are in the areas of the brain that control pain and emotions.
The drug on its own can help someone relax, feel happy and relieve pain. However when it is not used appropriately it can cause sleepiness, confusion, dizziness, nausea, vomiting, and slowed breathing. That is the good news and the bad news.
Anyone who has had an epidural to relieve the pain of labor contractions generally is grateful to experience the relief from pain after the placement of an epidural. This is an appropriate use of fentanyl administered by a knowledgeable health-care provider.
We have seen lately a trend of women coming in to have babies who are exposed to illicit fentanyl. Many of these women are not aware they have ingested fentanyl. Fentanyl is used to stretch out other drugs. Heroin is commonly “laced” with fentanyl. Heroin comes from the opium poppy plant. The plant is necessary to make heroin. Fentanyl can be made in a laboratory at a much cheaper cost.
Fentanyl is a white powder that is hard to distinguish from cocaine or heroin. However, these are not the only drugs “laced” with fentanyl. Marijuana, and counterfeit prescription medications such as Xanax also commonly have fentanyl pressed into them.
There really is no way to tell whether a drug contains fentanyl just by looking at the drug. A test kit can detect the presence of fentanyl. A fentanyl test kit can reduce the risk of a life-ending overdose.
Do the babies whose mothers took fentanyl while they were pregnant suffer with withdrawal? Yes, they do. These babies tend to have the same withdrawal symptoms as all babies exposed to opioids during pregnancy. Those symptoms are seizures, blotchy skin, tremors, inability to sleep, stomach pain, loose bowels, inability to suck and swallow and temperatures.
How long do these symptoms last? It is hard to predict. Some babies have short withdrawals of just a week or two and others can be around two months.
As a nurse taking care of these babies, one of the hardest things to watch is how the stomach pain comes in waves. They will be just about asleep and then you can feel their stomach contract, their foreheads become wrinkled, they look up at you with a look pleading for help, and then the pain hits. They scream. They scream in pain, writhe in pain, and shake. We hold them tight and pray the pain will pass quickly. The waves do pass and they calm down again.
Recently I was holding a baby going through this pain when his little fingers found my finger. He wrapped his fingers around my finger and held on tightly. He held on for quite a long time. We do medicate these babies to help with the physical dependence to the opioid drug, but we cannot medicate them to the point of them not experiencing some symptoms of withdrawal.
When I looked down at his precious fingers wrapped around my finger, I was reminded how important touching another human can be. It in itself is part of healing.
Katie Powers, R.N., is a board-certified lactation consultant and perinatal educator at Manatee Memorial Hospital’s Family BirthPlace. Her column appears every other week in Healthy Living in the Bradenton Herald. Contact her at katie.powers@mmhhs.com.
This story was originally published September 14, 2021 at 10:29 AM.