Does a baby born on methadone or subutex require a higher dose of OTC meds due to tolerance isssues?

My daughter was born on Methadone and my best friends daughter on subutex. They are the same weight, but her mom says that the baby's pediatrician told her to give her daughter more ibuprophen and tylenol because they have a tolerance to pain meds, ie:being born on methadone and subutex (both are pain meds). My doctor has never said this to me and has never brought anything like this to my attention. My friend, gives her daughter double the recommended dosage and also goes up one line more on the dropper. As a nurse myself, it makes me very nervous because i know what overmedicating an infant can do, but when i say something i feel like she thinks I am questioning her mothering skills. Any feedback would be greatly appreciated. Oh and I am a LPN ( Licensed Practical Nurse)and work with mostly elderly, so my infant and toddler nursing skills arent the greatest. I would have to research something like this, although it doesnt seem AT ALL right to me.
thanks,
bostonmommy

I am in recovery, and know several women whose babies were born on both Suboxone and methadone. The babies were monitored in NICU for a few days as a precautionary measure, and one had a bit of a breathing problem (breathing too fast), but it subsided right away and baby was released in two days.

I doubt that babies born on these meds would need a higher dose of Tylenol etc. They may have a greater tolerance to opiate-based painkillers, but babies generally don't need those anyhow (at least, I hope not...). Acitominophen and ibuprofen should be tolerated the same as any infant, and given in regular doses only when necessary. These aren't ingredients in Subs or methadone, so the baby shouldn't be tolerant to them at all. Also, OTC pain meds are tough on a new babies' liver, so I wouldn't think it would be safe to up the dose for any reason without a doctors' close supervision.

The main problem I am aware of, as far as babies born on these meds, is vision problems. Your friend may want to get regular eye checks at an early age, prescription glasses could easily remedy any vision problems and it is best to get baby used to glasses at a young age.

Your friend does not need to overmedicate her infant. Her baby has no tolerance to OTC drugs and the little liver can't handle it. Sorry to repeat myself, but it's important that she stop doing this.

I don't think giving the kiddos extra is a good idea, regardless of what they were addicted to at birth. If you are treating fever you don't need extra pain meds you need a correct dose of fever reducer.

Since you are a nurse, then you should know that Tylenol can be extremely dangerous and overdose can cause kidney failure and death.

It sounds like your friend is transposing her 'need' for more pains meds because of her 'high' tolerance on the baby (typical addict thinking). I would talk to your pedi and ask if there is a reason this should ever be done, probably not. If she still won't listen to you, maybe you should call child protective services so you friend doesn't end up hurting her baby.

Good luck.

no no NO!
Regardless of the maternal dosing, NO.

first of all, methadone for pain use in dosages of 40 mg/ day and below has *No* effect on the developing fetus so clearly there is no need to overdose the young child.
Up to 120 mg/ day (such as for drug abusers) is out of the newborns system within days of birth and only in a minute fraction of babies needs any further follow up most likely, since that dosage is for the drug using population, other substances contribute to that need for further care. Methadone is all in all, a very harmless yet effective pain med for neurogenic pain. Your friend needs counsel from HER physician, her babies physician, and possibly social services, simply because she is taking such a risk so lightly as to do it on her own. Tylenol and ibuprofen can be far more harmful than rugs such as methadone precisely because large quantities are so liver-toxic.
Just a thought, I probably wouldn't have asked this on here, people tend to be very judgmental combined with little knowledge of medical issues.

My twins were born on Methadone also never had any withdrawals and do not require a higher dose of medicine that is not true not at all.I'm sure you are on methadone for maintenance just as well as I am although am detoxing now, but you can ask the clinic you go to and they'll tell you there is no side effects for the baby may bye minor withdrawals when born but otherwise the same as a regular baby that Dr. does not know what he's talking about.what a coincidence I'm an LPN @ a nursing home to.Do you have a heavy work load to like 50 patients a day?I'm from Long Island and this is the norm for LPNs @ N/h.That Dr. is very ignorant don't ya think?Tell your friend not to give more than the recommended dose she is gonna cause more problems for the baby they can'y breakdown meds like we can.i'm sure she doesnt want to kill the babies liver does she.tell her to stop doing that and to get a new Dr.

Put a call into your pediatrician and ask him/her. And, when you girl friend thinks you are questioning her, let her know that you aren't, you're just wondering about your own child's needs. And then explain that your doctor has never mentioned this. Could it be that your pediatrician was once aware (at your child's birth) but has since forgotten (as it is buried in the back of the chart)?

tylenol goes through the liver
motrin through the kidneys
She really doesn't want her child to have problems with either of those. My doctor said to try to avoid using either prior to 6 months of age and give with a feeding. Even when I was pregnant my doctor recomended trying to take one pill (half the dose) see if it helped before taking the full dose.
I am not a nurse but just a mom. I can't imagine any doctor recommending over medicating an infant. And she can quote any doctor as saying what she wants to do and it not be truthfull.