Loaʻa i kāu keiki hānau hou kēia mau pilikia? E kamaʻilio kākou e pili ana i ka Neonatal Opioid Withdrawal Syndrome (NOWS)

ʻAʻole hiki ke wehewehe ʻia ka hauʻoli o ka makuahine ke lawe mai ʻo ia i kahi pēpē hānau hou i ka home. Akā i kekahi manawa, inā e uē mau ana ka pēpē, e kuha pinepine ana i ka waiū, a i ʻole e hana ana me he mea lā he ʻano ʻē, hiki ke hopohopo loa i ka makuahine. I kēia lā e kamaʻilio mākou e pili ana i kekahi ʻano weliweli akā koʻikoʻi e pono ai mākou e makaʻala. ʻO ia ka Neonatal Opioid Withdrawal Syndrome (NOWS) i nā pēpē hānau hou. Ma mua, ua kapa ʻia ʻo Neonatal Abstinence Syndrome (NAS) .

He aha ka neonatal opioid withdrawal syndrome (NOWS)?

I ka ʻōlelo maʻalahi, ʻo ia ka manawa e hoʻohana ai ka makuahine i kekahi mau lāʻau lapaʻau (ʻoi aku hoʻi nā opioids) a i ʻole nā ​​​​mea hoʻohui ʻē aʻe i ka wā hāpai, a ua hōʻike ʻia ka pēpē i kēlā mau mea i loko o ka ʻōpū, a me ka ʻoluʻolu ʻole e kū mai ana ma hope o ka wehe ʻia ʻana o nā mea mai ke kino ma hope o ka hānau ʻana. Ua ʻike anei ʻoe i ka wā e noho ana ka pēpē i loko o ka ʻōpū, loaʻa iā ia nā meaʻai a me ka oxygen mai ka makuahine ma o kahi ʻāpana i kapa ʻia ʻo ka placenta . Pēlā nō, ʻo kekahi mau lāʻau lapaʻau a me nā lāʻau lapaʻau a ka makuahine e lawe ai e hele pū ma o kēia placenta i ka pēpē. No laila, ʻoiai ke pēpē i loko o ka ʻōpū, ua maʻa ia i kēia mau mea ma ke ʻano, ʻo ia hoʻi, hoʻomaka ia e hilinaʻi iā lākou. Ke pau ka lako mai ka makuahine ma hope o ka hānau ʻana, ua paʻakikī ke kino o ka pēpē e hoʻoponopono iā ia. ʻO ia ka manawa e ʻike ʻia ai kēia mau hōʻailona haʻalele .

He aha nā lāʻau lapaʻau e hiki ai ke hana i ka NOWS?

ʻO ke kumu nui o kēia kūlana he mau lāʻau lapaʻau ia o ka papa opioid . Eia kekahi mau laʻana:

• `( Nā Amphetamine )`
• `( Buprenorphine )`
• `(Kōdeina)`
• `(Heroina)`
• ʻOkikodona
• `( Haikokodona )`
• `(Morpine)`
• `(Methadone)`

Ma waho aʻe o kēia, hiki i kekahi mau mea ʻē aʻe ke hana i kēia maʻi. ʻO lākou kēia:

• ʻAila
• Nā Barbiturates (kekahi ʻano lāʻau hiamoe)
• ʻO Benzodiazepines (kekahi mau lāʻau hoʻomaha)
• ʻO ka nikotine (aia i loko o ka paka )
• ʻO kekahi mau ʻano antidepressants, ʻoiai nā mea i loko o ka hui i kapa ʻia ʻo Selective Serotonin Reuptake Inhibitors (SSRIs).

ʻO ka mea nui loa, inā ʻoe e hāpai ana a i ʻole e hoʻolālā ana e hāpai, pono ʻoe e hoʻomaopopo i kāu kauka e pili ana i nā lāʻau lapaʻau, nā mea hoʻohui, a i ʻole nā ​​​​mea ʻē aʻe āu e lawe nei.

He mea maʻamau anei kēia maʻi? ʻO wai ka mea i hoʻopilikia nui ʻia?

ʻO ka mea pōʻino, ua hōʻike ʻia kēia kūlana NOWS e piʻi nei ma ka honua holoʻokoʻa. ʻO ka ʻoiaʻiʻo, e like me nā helu helu, e like me kekahi mau noiʻi, hānau ʻia kekahi pēpē me NOWS i kēlā me kēia 25 mau minuke. ʻO ia hoʻi, ma kahi o ʻehiku o kēlā me kēia ʻelua tausani pēpē e loaʻa paha kēia pilikia. Hoʻopilikia nui kēia i nā pēpē hānau hou nona nā makuahine i hoʻohana i nā opioids a i ʻole nā ​​​​mea hoʻohui ʻē aʻe i ka wā hāpai. ʻAʻole maʻalahi ka hoʻohui lāʻau lapaʻau e like me ka mea i ʻike ʻia, he pilikia paʻakikī ia.

He aha ka mea e hana ʻia i ke kino o ka pēpē ma muli o NOWS? He aha nā hōʻailona?

ʻO kēia mau hōʻailona, ​​​​i ʻike ʻia he mau hōʻailona haʻalele, hiki ke hoʻomau a hiki i ka wā e pau loa ai ka pēpē i ka lāʻau. Hiki i kēia ke hoʻoulu i ka pēpē e uē nui, lilo i mea hoʻomaha loa, a i ʻole e hana maʻi. Pehea ka paʻakikī no ka makuahine a makua kāne hou ke ʻike i kā lākou keiki liʻiliʻi e ʻeha nei e like me kēia? Hiki ke paʻakikī loa ka hōʻoluʻolu ʻana i ka pēpē i kēia manawa. Ma muli o ke koʻikoʻi o nā hōʻailona o ka pēpē, pono paha e mālama ʻia ka pēpē ma ka Neonatal Intensive Care Unit (NICU) . ʻO kēia a hiki i ka wā e pau loa ai ka pēpē i ka lāʻau a ke hana maikaʻi nei. Nā Hōʻailona Maʻamau:

• Ka luaʻi pinepine ʻana a me/a i ʻole ka maʻi pākī
• Kuni a me ka hou ʻana
• Hanu wikiwiki
• Uē nui mau
• ʻOmo pinepine
• Nā haʻalulu
• ʻUlaʻula o ka ʻili ma ka ʻaoʻao hope ma muli o ka ʻulaʻula o ka diaper)

Nā hōʻailona ʻē aʻe e hiki ke ʻike ʻia:

• ʻOʻoleʻa o nā ʻiʻo (Hypertonia) a me nā reflexes overactive
• Ka paʻakikī o ka loaʻa ʻana o ke kaumaha
• Ke paʻakikī i ka hiamoe ʻana a me ka hiamoe mau ʻana
• Nā pilikia me ka inu ʻana i ka waiū
• ʻO ke ʻano o kahi ʻano mottled, marble-like ma ka ʻili (mottling)

Hiki ke ʻokoʻa kēia mau hōʻailona mai kekahi pēpē a i kekahi, a hiki ke ʻokoʻa ke koʻikoʻi. Aia ia ma:

• Aia nō ia i ke ʻano o ka lāʻau lapaʻau i loko o ke kino o ka pēpē.
• Aia nō ia i ka nui o ka lāʻau i loko o ke kino.
• Aia nō ia i ka lōʻihi o ka lāʻau i loaʻa i ke pēpē i loko o ka ʻōpū.

He aha inā e ʻoi aku ka ʻino o nā hōʻailona?

Inā loaʻa i kahi pēpē ka nui o ka lāʻau lapaʻau i loko o ko lākou kino i ka wā hānau, hiki iā lākou ke loaʻa nā hōʻailona koʻikoʻi, a hiki ke hoʻoweliweli i ke ola. ʻO kēia mau mea:

• Ka hānau mua ʻana
• Nā pilikia hānau a me nā hemahema o ka ulu ʻana
• Nā hopu ʻana
• ʻO ka maʻi make koke o nā pēpē (SIDS)

Āhea e ʻike ʻia ai nā hōʻailona?

Hiki i kēia mau hōʻailona ke hoʻomaka e ʻike ʻia i loko o hoʻokahi a ʻekolu paha lā ma hope o ka hānau ʻana o ka pēpē. I kekahi manawa, ʻaʻole paha e ʻike ʻia nā hōʻailona a hiki i hoʻokahi pule. I loko o kēia manawa, mālama pinepine ʻia ka pēpē i loko o ka "NICU" o ka haukapila a hiki i ka wā e hoʻomaʻemaʻe loa ʻia ai ka mea mai ke kino a ua lawa ka maikaʻi o ka pēpē e hoʻi i ka home.

Hiki iā NOWS ke hoʻoulu i nā hopena lōʻihi?

He pilikia koʻikoʻi loa kēia. Hiki ke ʻokoʻa nā hopena lōʻihi o NOWS ma muli o ke koʻikoʻi o ke kūlana. I ka ulu ʻana o ke keiki, hiki iā lākou ke ʻike i:

• Nā lohi o ka ulu ʻana : Nā lohi i ka ulu ʻana o nā mākau ʻike, pilikanaka, a me nā mākau neʻe.
• Nā pilikia pili i ke ʻano ma ke kula.
• Nā pilikia me ka hoʻomanaʻo pōkole.
• Nā pilikia ulu (ke kiʻekiʻe, ka pohō kaumaha).
• Nā pilikia lohe a me ka ʻike.

No laila, he mea nui loa ka lawe ʻana i kāu pēpē no nā nānā olakino maʻamau e hōʻoia i kona hoʻokō ʻana i nā pae hoʻomohala no kona mau makahiki. Ua hōʻike ʻia nā noiʻi e ʻoi aku ka nui o ka loaʻa ʻana o nā keiki i hānau ʻia me NOWS i nā kūlana aʻe i ko lākou ulu ʻana:

• Ka maʻi hoʻolohe-nele/hyperactivity (ADHD)
• Hopohopo
• Kaumaha

Pehea e ʻike ai i ke kūlana NOWS?

Ma muli o ka like ʻana o nā hōʻailona o NOWS me nā kūlana ʻē aʻe i nā pēpē hānau hou, hiki i nā kauka ke ʻike i ke kūlana ma hope o ka ʻike ʻana e pili ana i nā lāʻau lapaʻau a ka makuahine i lawe ai i ka wā hāpai a ma hope o ka hana ʻana i kahi pale lāʻau . Hiki i kēia pale lāʻau ke ʻike i ke ʻano o ka lāʻau i loko o ke kino o ka pēpē a me ka nui. Hiki ke hana ʻia kēia ma ka hoʻāʻo ʻana i kahi laʻana o ke kaula umbilical o ka pēpē, ka mimi, ke koko, a i ʻole ka ʻōpala mua o ka pēpē (meconium). I kekahi manawa hiki ke hoʻāʻo ʻia ka makuahine no nā lāʻau lapaʻau e hōʻoia i ka hōʻailona. Eia kekahi, hoʻohana nā kauka i kahi ʻōnaehana helu NAS . Hoʻohana ʻia kēia e hāʻawi i kahi helu ma muli o ke koʻikoʻi o nā hōʻailona o ka pēpē a hoʻolālā i ka mālama ʻana e like me ia.

He aha nā lāʻau lapaʻau no NOWS?

ʻO ka lāʻau lapaʻau i hāʻawi ʻia i ka pēpē e pili ana i ke ʻano o ka lāʻau i loko o ke kino, ka nui o ia mea, ke olakino holoʻokoʻa o ka pēpē, a me ke koʻikoʻi o nā hōʻailona. Hiki i ka lāʻau lapaʻau ke komo pū me:

• Ke hāʻawi ʻana i ka lāʻau lapaʻau e hōʻemi mālie i nā hōʻailona.
• Inā maloʻo ka pēpē, e hāʻawi i ka saline ma ke ʻano intravenous (nā wai IV).
• Ke hoʻopili nei i nā kirīmi a i ʻole nā ​​​​​​mea ʻaila no ka ʻili ʻulaʻula a me nā ʻeha.
• Ke hoʻololi nei i ke alapine (pinepine) a me ka nui o ka hānai ʻana i ka waiū umauma: No ke kōkua ʻana i kāu pēpē e hoʻonui i ke kaumaha, e hāʻawi i kahi waiū momona kiʻekiʻe-calorie i nā liʻiliʻi a pinepine.

Hiki ke lōʻihi ka lāʻau lapaʻau mai ʻelima mau lā a i ʻeono mahina paha, a hiki i ka wā e ola maikaʻi ai ke pēpē a ʻaʻohe lāʻau lapaʻau i koe i loko o ko lākou kino. Pono paha nā lāʻau lapaʻau lōʻihi e hōʻemi i nā hōʻailona, ​​​​e like me ka cognitive behavioral therapy (CBT) , i ke ola holoʻokoʻa o ke keiki.

He aha nā ʻano lāʻau lapaʻau i hāʻawi ʻia no NOWS?

Inā loaʻa i kāu pēpē nā hōʻailona koʻikoʻi, hiki i nā kauka ke hoʻohana i kekahi mau lāʻau lapaʻau e kōkua i ka kaohi ʻana i kēia mau hōʻailona haʻalele a kōkua i kāu pēpē e ʻai a hiamoe maikaʻi. ʻO kēia ka hāʻawi ʻana i kāu pēpē i kahi lāʻau lapaʻau haʻahaʻa loa e like me ka mea i loaʻa iā lākou i loko o ka ʻōpū, e hoʻemi mālie i ka nui, a me ka wehe ʻana i ka pēpē mai ia mea. ʻO kēia no ka mea ʻo ka hoʻōki koke ʻana i ka lāʻau lapaʻau (cold turkey) hiki ke hoʻonui i nā hōʻailona. ʻO kekahi o nā lāʻau lapaʻau i hoʻohana ʻia no kēia kumu:

• `(Methadone)`
• `(Morpine)`
• `(Buprenorphine)`
• `(Phenobarbital)`
• ʻO ke Clonidine

Inā pono e hāʻawi ʻia kāu pēpē i ka lāʻau lapaʻau ma kēia ʻano, pono paha ʻoe e noho i ka haukapila no kekahi mau pule a i ʻole mau mahina. ʻO kēia ke hōʻoia i ke olakino o nā kauka e hoʻōki loa i ka lāʻau lapaʻau a hoʻouna i ka pēpē i ka home.

Pehea e hiki ai i ka makuahine ke kōkua i ka mālama ʻana i nā hōʻailona o kāna pēpē?

Ke ʻeha nei kāu pēpē i nā hōʻailona haʻalele, hiki ke kaumaha loa a paʻakikī hoʻi ke hōʻoluʻolu iā lākou. Akā, ma ke ʻano he makuahine, hiki iā ʻoe ke kōkua ma o:

• E noho kokoke i ka pēpē i ka hiki.
• E hōʻemi i ka nui o ke kukui ʻālohilohi a me ka walaʻau nui i loko o ke kaiapuni o ka pēpē.
• E hoʻoluliluli mālie i ke pēpē.
• E hoʻopaʻa i kāu pēpē a kokoke i kou umauma ( pili ʻili-a-ʻili ). He mea hōʻoluʻolu loa kēia no kāu pēpē.
• E ʻōwili maikaʻi i ka pēpē i loko o kahi lole palupalu (swadding).

Hiki iaʻu ke hānai i kaʻu pēpē i ka waiū umauma i ka wā e lawe ana i nā lāʻau lapaʻau?

He mea nui loa kēia. ʻAe, hiki i nā lāʻau lapaʻau e like me nā opioids ke komo i loko o ka waiū umauma o kāu pēpē. Hiki i kēia ke loaʻa nā hopena ʻino no kāu pēpē. No laila, inā ʻoe e hoʻohana ana i nā lāʻau lapaʻau i ʻae ʻole ʻia e kāu kauka, mai hānai i kāu pēpē no kekahi kumu . Akā, e hāʻawi i kāu pēpē i ka waiū waiū a i ʻole ka waiū umauma i hāʻawi ʻia. Eia nō naʻe, inā ʻoe i loko o kahi papahana mālama lāʻau lapaʻau, ʻo ia hoʻi, inā ʻoe e lawe ana i kahi opioid i kuhikuhi ʻia (e like me ka methadone) i ka wā hāpai a ma hope o ka hānau ʻana e pale aku i nā hōʻailona haʻalele, hiki paha iā ʻoe ke hānai i ka waiū. Akā me ka ʻae ʻana o kāu kauka a inā hoʻoholo lākou he palekana ia no kāu pēpē. Inā he pilikia lāʻau lapaʻau a i ʻole ka maʻi ʻona, e kamaʻilio me kāu kauka e pili ana i nā ala e loaʻa ai ka lāʻau lapaʻau no ia mea. ʻO ka noho olakino e hāʻawi iā ʻoe i ka ikaika e noho ma laila no kāu keiki i ka wā e pono nui ai lākou iā ʻoe.

Pehea e pale aku ai i ka NOWS?

Hiki iā ʻoe ke hana i kēia mau hana e pale aku ai i kāu pēpē mai ka loaʻa ʻana o nā hōʻailona koʻikoʻi o NOWS:

• Inā hāpai ʻoe, e hōʻoia e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau a mea paha āu e hoʻohana nei. Inā hoʻōki koke ʻoe i ka hoʻohana ʻana i kahi lāʻau lapaʻau āu i hoʻohana ai no ka manawa lōʻihi, loaʻa paha iā ʻoe nā hōʻailona haʻalele koʻikoʻi, hiki ke hoʻopōʻino i kāu pēpē i hānau ʻole ʻia. E paipai kāu kauka i nā koho lapaʻau palekana no ʻoe a me kāu pēpē.
• E haʻi i kāu kauka e pili ana i kekahi lāʻau lapaʻau a me nā mea hoʻohui āu e lawe nei. E hōʻoia i ka palekana no ʻoe a me kāu pēpē. Mai hoʻōki i ka lawe ʻana i kekahi lāʻau lapaʻau a hiki i ka wā e ʻōlelo aku ai kāu kauka iā ʻoe.
• E hoʻohana i ka pale ʻana i ka maʻi a hiki i kou mākaukau e hānau keiki. Inā he wahine ʻoe e hana ana i ka moekolohe a he pilikia kou no ka hoʻohana ʻana i ka lāʻau lapaʻau a i ʻole ke mālama ʻia nei no ia mea, e hoʻomaʻamaʻa i ka moekolohe palekana a hiki i kou olakino e hāpai ai.

Inā loaʻa i kaʻu pēpē ʻo NOWS, he aha kaʻu e manaʻo ai?

ʻO ka maʻamau, noho ka pēpē i loaʻa i ka NOWS i ka haukapila no kahi o 20 mau lā e hōʻoia i ko lākou olakino e hoʻi i ka home. I kekahi manawa hiki i ka lāʻau NOWS ke mau a hiki i ʻeono mahina. E nānā pono nā kauka i nā hōʻailona o kāu pēpē a hoʻouna iā lākou i ka home ma hope o ka pau ʻana o nā lāʻau lapaʻau mai ko lākou ʻōnaehana. E hāʻawi kāu kauka iā ʻoe i ka ʻōlelo aʻoaʻo no ka hānai ʻana i kāu pēpē a pehea e mālama ai i kāu pēpē. E hoʻomanaʻo, inā ʻoe e hoʻohana ana i nā lāʻau lapaʻau, mai hānai i ka waiū, no ka mea hiki i nā lāʻau lapaʻau ke hele i kāu pēpē ma o kou waiū umauma a hana i nā hōʻailona e hiki ke hoʻopilikia i kona olakino. Ma hope o kou lawe ʻana mai i kāu pēpē i ka home mai ka haukapila, pono kāu pēpē i kou aloha a me ke kākoʻo hou aku no kekahi mau pule a i ʻole mau mahina, a malia paha i ka wā kamaliʻi. E makaʻala pono i ka ulu ʻana a me ka ulu ʻana o kāu pēpē. Inā ʻaʻole i hoʻokō kāu pēpē i nā pae hoʻomohala no kona mau makahiki, e haʻi koke i kāu kauka.

Āhea ʻoe e ʻimi ai i ka mālama ulia pōpilikia?

Inā loaʻa i kāu pēpē kēia mau hōʻailona koʻikoʻi, e hele koke i ka Emergency Department (ETU) a i ʻole e kelepona iā 1990:

• Ke kuni nui e mau ana ma mua o 24 mau hola.
• Inā ʻaʻole ʻoe e inu waiū, a inā paha e luaʻi ʻoe ma hope o ka inu ʻana i ka waiū.
• Inā loaʻa kahi hopu ʻana.
• Inā ʻaʻole kūpono ka puʻuwai.
• Inā pilikia ʻoe i ka hanu ʻana.

He aha nā nīnau koʻikoʻi e nīnau aku ai i ke kauka?

• He aha nā lāʻau lapaʻau e palekana ai ke lawe i ka wā hāpai?
• Pehea ʻoe e hoʻōki ai i ka hoʻohana ʻana i kahi lāʻau lapaʻau addictive?
• E hoʻopilikia anei nā hōʻailona o kaʻu pēpē iā ia i ka wā lōʻihi?
• Pehea e hiki ai iaʻu ke hōʻoluʻolu i kaʻu pēpē i ka wā o ka mālama ʻana?

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)

He mea paʻakikī a hoʻokaumaha loa ka hoʻohana ʻana i nā lāʻau lapaʻau. Ke hāpai ʻoe, hiki i kēia mau manaʻo ke ʻoi aku ka ikaika, a manaʻo paha ʻoe ʻaʻole ʻoe i ʻike i ka mea e hana ai. Akā e hoʻomanaʻo, ʻaʻole ʻoe hoʻokahi.

Aia nā lāʻau lapaʻau e kōkua iā ʻoe a me kāu pēpē e ola i kahi ola hauʻoli a olakino. ʻO ka mea nui loa, ʻo ia ke haʻi pololei i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe ai i kou wā hāpai. E kōkua kēia i kāu kauka e hoʻoholo i ka lāʻau lapaʻau maikaʻi loa nou a me kāu pēpē. ʻAʻohe hewa o ke noi ʻana i ke kōkua, he mea hoʻoikaika ia.

ʻO ka Neonatal Opioid Withdrawal Syndrome, Neonatal Abstinence Syndrome, NOWS, NAS, ka haʻalele ʻana i ka pēpē hānau hou, ka ʻike ʻana i ka lāʻau lapaʻau pēpē, ka hāpai ʻana i ka maʻi opioid, ka hāpai ʻana i ka lāʻau lapaʻau, nā pēpē hānau hou, nā hopena o ka lāʻau lapaʻau ma ka pēpē