I think I have stumbled onto a disturbing trend related to the timing of
nubain (nalbuphine) administration in labor and sleepy babies with
disfunctional sucks in the first 5-7 days.
I have spoken to a couple of LC's in my area who are seeing the same thing.
What we are seeing is that if the mother receives nubain 1.5 to 2 hours
before the birth the baby is exceptionally sleepy for up to 7 days post
partum. They have either a disorganized or non-existent suckle. They do not
even bottle feed well. They also exhibit low muscle tone- almost floppy.
If the nubain was given 20 minutes to 1 hour before delivery or 3 hours
before delivery there doesn't seem to be a problem.
There is one confounder--many doctors mix phenergan with the nubain. Can this
increase the effect?

I'd like to survey lactnet to see if others are also seeing a relationship.
What are you seeing (symptoms, behaviors)?
When was the dose given in relation to the time of birth?
How much of the medication was used (if known)?
Was it given with phenergan?
Were there other confounders (other meds, pitocin, epidural , mag sulfate,
long second phase, forcepts etc)?
How long (days-hours) did it take for the baby to *recover*?
Did the baby begin to feed well when the effects wore off?

Email me privately and I will compile the data and post it to the list.
I would like Dr. Hale's input on this as well.

If there is enough anectodal evidence--there may be someone out there willing
to do a paper.