I have been working in a hospital for the last six months that uses Nubain very
frequently.  I am horrified at the behavior of some of the newborns.  I have
gone to assist mothers at delivery to find infants screaming inconsolably.
Nothing will calm them down.  Parents are astounded and worried.  When I asked
the nurses what in the world was going on with these little ones, they all say,
its the Nubain.  When I asked them why the doctors continue to give it, they
say," they don't believe it causes problems".  As I talk to the nurses in the
nursery they say that Nubain given in the hours close to delivery causes
screaming, (act like they're in pain). apnea, and what they call snubbing.
Snubbing is deep gasping every few breaths.  I asked the head nurse if we could
do a  Q/I study on this, and so we are documenting.  We are documenting
medicated and unmedicated babies behaviors, sucking abilities, etc.  So far I
have over 20 medicated and only 4 unmedicated.  Its going to take a while to get
30 of each, which Kathy A said I would need to have a good picture of whats
going on.  I am relying on the nursery nurses to obtain information because I
want to be objective in my observations of breast babies, but I will document
with bottle babies sometimes.

I am glad to see Marsha also writing an article about this and look forward to
seeing it in March. I have not talked to anyone else who has noted the
screaming, and I am going to see if there is another factor involved, such as
vaccuum extraction, forceps, phenergan, etc.  It should be interesting to
compile the data once it is all on paper.  Something needs to be done for these
babies.  It is a really awful thing to witness the babies coming into the world
this way, and just at the time when parents expect a peaceful and loving bonding
time, their infant screams and screams and screams, sometimes latching and
nursing a suck or two and then screaming more, sometimes not even going to
breast for hours.

I have been working in hospitals for 6 years now, and I haven't seen this
before.  I have seen babies who don't suck well after epidurals, especially long
drawn out ones, and very frequently with babies whose moms epidurals didn't take
and had to have more and more meds.  But the screaming behavior is new.

Thanks for any input in this, I am hoping to get to the bottom of this with the
study.

Ann Calandro,RNC, IBCLC
Waxhaw, NC