"Babies are cute but are not little adults. Their body proportions are quite different with their head much larger proportionately and with relatively sparse hair, which can cause them to lose a lot of body heat easily through their scalp. Parents often ask me what temperature they should set their baby’s room—I suggest keeping it the same as before, but then dressing baby appropriately. Unless the baby is especially small, this means putting on about one light layer of clothing more than what the adult is wearing. However, because of the large head surface area, it is often helpful to put a hat on your baby, especially if they get cold hands or feet."
Dr. Gaunt's Corner
It would be a wonderful thing if every baby who comes to PICC could go home to a mother who had overcome the addiction that led to the baby’s prenatal drug exposure. The reality is, though, that addiction is such a powerful force that even a mother’s love can’t always overcome it. When a mother can’t be there for her baby, it’s heartwarming to see other family members step up and make a commitment to love and care for the child.
Let me tell you the story of how that happened for one of our babies. Whitney came to us with a prenatal exposure to opiates. Withdrawal from the drugs made her extremely irritable and jittery. To help her through the painful process, we stabilized her on small doses of morphine. Even so, she was very challenging to feed and calm.
Although Whitney was with us at PICC nearly six weeks, her mother only visited briefly a couple of times. Her Dad was another story. He came in every day to hold and rock his little daughter. This was his first child, and he was one proud papa. Dad also worked hard with PICC’s staff to learn how manage his daughter’s challenging feeding and calming difficulties. At first he could barely get her take more than half an ounce at a feeding, but day by day both he and Whitney got better. By the time Whitney was ready to go home, Dad was able to demonstrate that he could feed the baby an adequate amount for her to grow and thrive.
Whitney’s Grandma also came once or twice a week to visit her granddaughter and learn her care. We felt good about the state’s decision to place Whitney with her Dad and Grandma. We know that her care will be challenging, but we also know that they have a real, loving commitment to her. We wish their family all the best.
During the past two months we have seen a resurgence of cocaine exposure among our babies. In recent years, cocaine had been overtaken, first by opiates, and then by methamphetamine. Our friends in the law enforcement community say they are also seeing a resurgence of cocaine on the streets. They say this is because the crackdown on meth labs has made cocaine more competitive in price and availability.
For us at PICC, the upswing in cocaine means that we are seeing more tiny premature neonates. Most are 34 to 36-week gestation, weighing 4-5 pounds. Some of these babies have been starved in utero and have no subcutaneous fat on their tiny bodies, many times looking like little birds with no feathers. Most, though, are pink and cuddly, and look perfectly healthy. The biggest problem with these babies is that they have a lot of feeding difficulties. Even with years of expertise, our staff here at PICC has to work very hard to get these babies to take enough formula to thrive.
It’s also very hard to fight for the safety of cocaine-exposed babies. Because they don’t have obvious symptoms, their needs can be discounted. We believe it’s absolutely imperative that we teach the caregiver how to feed the baby before it goes home. We can’t do that unless we have a caregiver who is willing to spend the time and make the commitment to focusing on the baby’s care. Too often, that just doesn’t happen. When we can’t train the caregiver, it means that the baby will probably have to stay at PICC longer and that the chance of success at home is less. We know that these babies are at risk for failure to thrive, dehydration, and malnutrition. We are happy for babies who come home with trained and committed caregivers. We worry about those who don’t.
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