By Edmund Hey
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Additional info for Neonatal Formulary: Drug Use in Pregnancy and the First Year of Life
9 Beware giving a small newborn baby excess sodium unintentionally. The use of flush solutions of Hep-lok®, Hepsal® or 0·9% sodium chloride can expose a baby to an unintended excess of intravenous sodium. The steady infusion of 1 ml/hour of heparinised 0·9% sodium chloride (normal saline) to maintain catheter patency is sometimes enough to double a very small baby’s total daily sodium intake. So can intratracheal sodium chloride administration during tracheal ‘toilet’. ) with special care. There are relatively few situations where it is really necessary to use such potentially dangerous drugs.
Continuous use for even a few days can produce tolerance (the need for a progressively larger dose) and dependency (addiction). Management is the same as for addiction acquired in utero – a slow, tapered withdrawal of treatment. Perhaps we should do what we tell mothers to do, and avoid sustained use all together. INSTITUTE FOR THE STUDY OF DRUG DEPENDENCE This charitable organisation, founded in 1968, provides an information service for professionals and for researchers. It has produced a useful series of informative booklets called Drug Notes, and a series of five short leaflets called Drug Information for Women.
Subscribers also, for a fee, enjoy online access to over 400 regularly updated standard reading lists, and to over 100,000 articles on pregnancy, midwifery and childbirth issues. org Motherisk Program The Motherisk Program, backed by the expertise of the Department of Clinical Pharmacology and Toxicology at the Hospital for Sick Children in Toronto, maintains a very authoritative website dealing with the safety of drug use during pregnancy and lactation. org National Association of Neonatal Nurses NANN is the main neonatal nursing organisation in the USA.