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Daughter on Midazolam now Ativan in NICU


[AR...]

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Hello,

 

My daughter who was born premature at 33 weeks has been in the NICU for close to two months now. She has been on a ventilator to help her small lungs develop. During this time, she has been given continuous IV infusions of Midazolam. Now they are tapering with Ativan.

 

I want to find out as much as possible with what the best route to help my daughter is as it seems the physicians tasked with her care have no idea what they're doing and are just experimenting to see what happens.

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Hi ARPKDToes,

 

Welcome to BenzoBuddies - we're glad you found us! 

 

First, congratulations on the birth of your daughter!  I'm sorry you've been dealing with such a stressful time.  I think you're wise to be proactive about tapering her off of Midazolam and now Ativan.  I very glad they are starting to taper her off. 

 

We generally support a very slow and careful taper off benzos.  I don't know what the protocol would be for a small infant.  I think you would certainly want to discuss  a slow taper with small gradual cuts in dose with her physicians and nurses, and perhaps the pharmacologist at the hospital, and make sure they communicate their rationales to you for the treatment plan they recommend. 

 

Please explore the site and post your questions.  A good place to start is Planning Your Withdrawal (Taper Plans)

 

I hope you find information that's helpful to you - bearing in mind the forum is oriented toward supporting adults trying to quit benzos.

 

Wishing health, happiness and a smooth taper for your daughter,

Brighterday

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Hello,

 

My daughter who was born premature at 33 weeks has been in the NICU for close to two months now. She has been on a ventilator to help her small lungs develop. During this time, she has been given continuous IV infusions of Midazolam. Now they are tapering with Ativan.

 

I want to find out as much as possible with what the best route to help my daughter is as it seems the physicians tasked with her care have no idea what they're doing and are just experimenting to see what happens.

Welcome to BenzoBuddies!

Congratulations on your baby! Sorry you guys are experiencing such a difficult time and that the doctors are not much help to reassure you about having an appropriate withdrawal schedule and understanding what your baby is going through. I have researched an article on Neonatal Drug Wtihdrawal https://pediatrics.aappublications.org/content/pediatrics/129/2/e540.full.pdf

It might have some useful information for you regarding what can be done to help, see the quote below

Treatment of infants who develop early signs of withdrawal is directed at minimizing environmental stimuli (both light and sound) by placing the infant in a dark, quiet environment; avoiding autostimulation by careful swaddling; responding early to an infant’s signals;  adopting appropriate infant positioning and comforting techniques (swaying, rocking); and providing frequent small volumes of hypercaloric formula or human milk to minimize hunger and allow for adequate growth. Caloric needs may be as high as 150 to 250 cal/kg per day because of increased energy expenditure and loss of calories from regurgitation.../or loose stools. The infant needs to be carefully observed to recognize fever, dehydration, or weight loss promptly. The goals of therapy are to ensure that the infant achieves adequate sleep and nutrition to establish a consistent pattern of weight gain and begins to integrate into a social environment."

Please see another article below titled: Oral lorazepam can be substituted for intravenous midazolam when weaning paediatric intensive care patients off sedation

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6120549/

I hope this helps a little.

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Oh my, God bless you and your baby. At least she doesn't have any of the mental part to process. I know that skin to skin rocking and cuddling are good and I am sure you are doing all things possible for her and your benefit. Check her irritability and comfort level. I am sure you will be able to tell if it seems like she is being tapered appropriately. And, of course, ASK.  Please keep us informed.
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