I would want to know the levels of all narcotic pain meds in the baby from  
labor.  It would be interesting to know mother's levels as well.   Obviously, 
the blanket kept everyone from noticing the problem sooner... If  it is too 
late to get those levels checked, doses and timing could be used to  make an 
estimate.  We have all seen lethargic babies when they have gotten  too high a 
dose of med.  Also, nubain recently was studied and implicated  on respiratory 
problems in infants and if used a baby is to be monitored  frequently post-birth 
for problems.  
 
Thanks to Marsha Walker for this last Dec 7th:  "Today's Medscape  had an 
interesting piece of news on safety labeling revisions for nalbuphine  (Nubain) 
used during labor and delivery. The new  labeling will state that  nalbuphine 
injections are associated with a risk for  serious fetal and  neonatal adverse 
events. They list these as fetal bradycardia,  respiratory  depression at 
birth, apnea, cyanosis, and hypotonia. Some events  have been  reported as life 
threatening. They go on to state that severe prolonged  bradycardia has occurred 
that has resulted in permanent neurologic damage and  that infants should be 
monitored following birth for respiratory   depression, apnea, bradycardia, 
and arrhythmias.  
_www.medscape.com/viewarticle/518110_print_ 
(_http://www.medscape.com/viewarticle/518110_print_ (http://www.medscape.com/viewarticle/518110_print) )" 
 
Natalie Shenk, BS, IBCLC
Findlay Ohio
 
In a message dated 3/23/2006 12:50:49 P.M. Eastern Standard Time,  
[log in to unmask] writes:
We are concerned with this diagnosis and the implications of such. Is  this
even possible in a baby with supposed normal neurological status?   Shouldn't 
a normal infant struggle with suffocation? What factor could the  epidural or 
the blanket have played in this tragic event?





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