Ngaba usana lwakho olusandul’ ukuzalwa lunazo ezi ngxaki? Masithethe nge-Neonatal Opioid Withdrawal Syndrome (NOWS)

Uvuyo oluviwa ngumama xa ezisa umntwana osandul’ ukuzalwa ekhaya alunakuchazwa. Kodwa ngamanye amaxesha, ukuba umntwana uhlala ekhala, ekhupha ubisi rhoqo, okanye ebonakala ngathi wenza izinto ngendlela engaqhelekanga, kunokuba yinto eyoyikisayo kumama. Namhlanje siza kuthetha ngemeko eyoyikisayo kodwa ebalulekileyo ekufuneka siyiqaphele. Le yiNeonatal Opioid Withdrawal Syndrome (NOWS) kwiintsana ezisandul’ ukuzalwa. Ngaphambili, yayikwabizwa ngokuba yiNeonatal Abstinence Syndrome (NAS) .

Yintoni isifo sokurhoxiswa kwe-opioid yeentsana ezisandul’ ukuzalwa (i-NOWS)?

Ngamafutshane, oku kwenzeka xa umama esebenzisa iziyobisi ezithile (ingakumbi ii-opioids) okanye ezinye izinto ezibangela umlutha ngexesha lokukhulelwa, kwaye umntwana uvelelwa kwezo zinto ngelixa esesibelekweni, kunye nokungonwabi okwenzeka emva kokuba izinto zisusiwe emzimbeni emva kokuzalwa. Ubusazi ukuba xa umntwana esesibelekweni, ufumana izondlo kunye neoksijini kumama ngesitho esibizwa ngokuba yi-placenta . Ngokufanayo, amanye amayeza kunye namayeza athathwa ngumama nawo adlula kule placenta aye kumntwana. Ngoko ke, ngelixa umntwana esesibelekweni, uqhelana nezi zinto ngandlela thile, oko kukuthi, uqala ukuxhomekeka kuzo. Xa unikezelo oluvela kumama luyeka emva kokuzalwa, umzimba womntwana uba nzima ukumelana nazo. Kulapho ezi mpawu zokurhoxa zivela khona.

Ngawaphi amayeza anokubangela i-NOWS?

Le meko ibangelwa kakhulu ziziyobisi ezikudidi lwe-opioid . Nazi imizekelo embalwa:

• `( Amphetamines )`
• `( Buprenorphine )`
• `(I-Codeine)`
• `(Iqhawekazi)`
• `( I- Oxycodone )`
• `( I -Hydrocodone )`
• `(I-Morphine)`
• `(I-Methadone)`

Ukongeza koku, ezinye izinto nazo zinokubangela le meko. Nazi:

• Utywala
• IiBarbiturates (ezinye iintlobo zeepilisi zokulala)
• IiBenzodiazepines (ezinye izithomalalisi)
• I-Nicotine (equlethwe kwicuba )
• Ezinye iintlobo zemithi yokudakumba, ingakumbi ezo zikwiqela elibizwa ngokuba yiSelective Serotonin Reuptake Inhibitors (SSRIs).

Okubaluleke kakhulu, ukuba ukhulelwe okanye uceba ukukhulelwa, ngokuqinisekileyo kufuneka wazise ugqirha wakho malunga namayeza, izongezo, okanye ezinye izinto ozithathayo.

Ingaba le meko ixhaphakile? Ngubani ochaphazeleka kakhulu?

Ngelishwa le meko ye-NOWS ixelwa ukuba iyanda kwihlabathi liphela. Enyanisweni, ngokwezibalo, ngokwezinye izifundo, umntwana omnye uzalwa ene-NOWS rhoqo ngemizuzu engama-25. Oko kuthetha ukuba malunga nesixhenxe kwiintsana ezingamawaka amabini zinokuba nale ngozi. Oku kuchaphazela kakhulu iintsana ezisandul’ ukuzalwa ezinoomama abasebenzisa ii-opioid okanye ezinye izinto ezibangela umlutha ngexesha lokukhulelwa. Ukulutha iziyobisi akulula njengoko kubonakala, yingxaki enzima.

Kwenzeka ntoni emzimbeni womntwana ngenxa ye-NOWS? Zithini iimpawu?

Ezi mpawu, ezaziwa ngokuba ziimpawu zokurhoxa, zinokuhlala zikho de umntwana ayeke ngokupheleleyo ukusebenzisa iyeza. Oku kunokubangela ukuba umntwana akhale kakhulu, angazinzi, okanye azenze onesiphene. Kunzima kangakanani kumama okanye utata omtsha ukubona umntwana wakhe ehlupheka ngolu hlobo? Kunokuba nzima kakhulu nokuthuthuzela umntwana ngeli xesha. Ngokuxhomekeke kubukhali beempawu zomntwana, umntwana unokufuna unyango kwiYunithi yoKhathalelo oluNzulu lweZifo eziSandulelayo (i-NICU) . Oku kwenzeka de umntwana ayeke ngokupheleleyo ukusebenzisa iyeza kwaye aphile kakuhle. Iimpawu eziqhelekileyo:

• Ukuhlanza rhoqo kunye/okanye urhudo
• Umkhuhlane kunye nokubila
• Ukuphefumla ngokukhawuleza
• Ukukhala ngokuqhubekayo, okukhulu
• Ukuncanca rhoqo
• Iingxolo
• Ukurhawuzelela kwe-diaper (ububomvu besikhumba kwindawo yeempundu ngenxa yokurhawuzelela kwe-diaper)

Ezinye iimpawu ezinokubonakala:

• Ukuqina kwemisipha (iHypertonia) kunye nokusabela okugqithisileyo
• Ubunzima bokufumana ubunzima
• Ubunzima bokulala nokuhlala ulele
• Iingxaki zokusela ubisi
• Imbonakalo yepateni enamabala, efana nemarble eluswini (enamabala)

Ezi mpawu zinokwahluka ukusuka kumntwana ukuya komnye, kwaye ubukhali bungahluka. Kuxhomekeke koku:

• Kuxhomekeke ekubeni loluphi uhlobo lweyeza olusemzimbeni womntwana.
• Kuxhomekeke ekubeni ingakanani na iyeza elisemzimbeni.
• Kuxhomekeke ekubeni umntwana uchithe ixesha elingakanani efumana eli yeza esesibelekweni.

Kuthekani ukuba iimpawu ziya zisiba mandundu?

Ukuba umntwana uneziyobisi ezininzi emzimbeni wakhe xa ezalwa, unokuba neempawu ezinzima nezisongela ubomi. Ezi ziquka:

• Ukuzalwa ngaphambi kwexesha
• Iingxaki zophuhliso kunye neziphene zokuzalwa
• Ukuxhuzula
• Isifo Sokufa Kweentsana Ngesiquphe (SIDS)

Iimpawu zibonakala nini?

Ezi mpawu ziqala ukubonakala kungekapheli usuku okanye ezintathu emva kokuba umntwana ezelwe. Ngamanye amaxesha, iimpawu zisenokungabonakali ukuya kuthi ga kwiveki. Ngeli xesha, umntwana uhlala egcinwe kwi "NICU" yesibhedlele de into iphume ngokupheleleyo emzimbeni kwaye umntwana uphilile ngokwaneleyo ukuba abuyele ekhaya.

Ngaba i-NOWS inokubangela iziphumo zexesha elide?

Le yingxaki ebucayi kakhulu. Iziphumo zexesha elide ze-NOWS zinokwahluka ngokuxhomekeke kubukhali bemeko. Njengoko umntwana ekhula, unokufumana oku kulandelayo:

• Ukulibaziseka kophuhliso : Ukulibaziseka kophuhliso lwezakhono zokuqonda, zentlalo, kunye nezakhono zokunyakaza.
• Iingxaki zokuziphatha esikolweni.
• Iingxaki ngenkumbulo yexesha elifutshane.
• Iingxaki zokukhula (ubude, ukwehla kobunzima).
• Iingxaki zokuva nokubona.

Ngoko ke, kubaluleke kakhulu ukusa umntwana wakho rhoqo ukuze ahlolwe impilo yakhe ukuqinisekisa ukuba uhlangabezana nemigangatho yokukhula ehambelana nobudala bakhe. Izifundo zibonise ukuba abantwana abazelwe bene-NOWS banamathuba amaninzi okuphuhlisa ezi meko zilandelayo njengoko bekhula:

• Ingxaki Yokunqongophala Kwengqalelo/Ukuphazamiseka Kokusebenza Kakhulu (ADHD)
• Ixhala
• Uxinzelelo

Ungayichonga njani imeko ye-NOWS?

Ngenxa yokuba iimpawu ze-NOWS zinokufana nezezinye izifo kwiintsana ezisandul’ ukuzalwa, oogqirha banokufumanisa imeko kuphela emva kokufunda ngamayeza athathwe ngumama ngexesha lokukhulelwa nasemva kokwenza uvavanyo lwamayeza . Olu vavanyo lwamayeza lunokufumanisa ukuba loluphi uhlobo lwamayeza olusemzimbeni womntwana kwaye lungakanani. Oku kungenziwa ngokuvavanya isampuli yentambo yomntwana, umchamo, igazi, okanye indle yokuqala yomntwana (i-meconium). Ngamanye amaxesha umama unokuvavanywa ngamayeza ukuqinisekisa ukuxilongwa. Ukongeza, oogqirha basebenzisa inkqubo yokuvavanya i-NAS . Oku kusetyenziselwa ukunika amanqaku ngokusekelwe kubukhali beempawu zomntwana kwaye bacwangcise unyango ngokufanelekileyo.

Zithini iindlela zonyango ze-NOWS?

Unyango olunikwa umntwana luxhomekeke kuhlobo lweyeza emzimbeni, ubungakanani balo, impilo yomntwana iyonke, kunye nobunzima beempawu. Unyango lungabandakanya:

• Ukunika amayeza okunciphisa kancinci kancinci iimpawu.
• Ukuba umntwana uphelelwe ngamanzi emzimbeni, mnike i-saline ngemithambo yegazi (ii-IV fluids).
• Ukufaka iikhrimu okanye amafutha okugcoba ukurhawuzelela iinapukeni kunye nokurhawuzelelwa lulusu.
• Ukutshintsha amaxesha kunye nobungakanani bokuncancisa: Ukuze uncede umntwana wakho atyebe, mnike ifomula eneekhalori eziphezulu ngomlinganiselo omncinci nophindaphindayo.

Unyango lunokuthatha iintsuku ezintlanu ukuya kwiinyanga ezintandathu, de umntwana aphile kwaye kungasekho machiza aseleyo emzimbeni wakhe. Unyango lwexesha elide lokunciphisa iimpawu, olufana nonyango lokuziphatha kwengqondo (CBT) , lunokufuneka ubomi bomntwana bonke.

Zeziphi iintlobo zamayeza ezinikwa i-NOWS?

Ukuba umntwana wakho uneempawu eziqatha, oogqirha banokusebenzisa amayeza athile ukunceda ukulawula ezi mpawu zokurhoxa kwaye bancede umntwana wakho atye aze alale ngcono. Oku kuquka ukunika umntwana wakho idosi ephantsi kakhulu yeyeza efana nelo balifumene esibelekweni, ukunciphisa idosi kancinci kancinci, kunye nokumkhupha umntwana kulo. Oku kungenxa yokuba ukuyeka iyeza ngequbuliso (i-cold turkey) kunokwenza iimpawu zibe mandundu. Amanye amayeza asetyenziselwa le njongo aquka:

• `(I-Methadone)`
• `(I-Morphine)`
• `(I-Buprenorphine)`
• `(I-Phenobarbital)`
• `(I-Clonidine)`

Ukuba umntwana wakho udinga unyango ngale ndlela, ungadinga ukuhlala esibhedlele iiveki okanye iinyanga ezimbalwa. Oku kwenzelwa ukuqinisekisa ukuba oogqirha basempilweni ngokwaneleyo ukuba bayeke ngokupheleleyo amayeza baze bamthumele ekhaya umntwana.

Umama anokunceda njani ukulawula iimpawu zomntwana wakhe?

Xa umntwana wakho enengxaki yokurhoxa, kunokuba nzima kakhulu ukumthuthuzela. Kodwa njengomama, unokunceda ngokuthi:

• Hlala usondele kakhulu kumntwana kangangoko unako.
• Nciphisa ubungakanani bokukhanya okukhanyayo kunye nengxolo enkulu kwindawo yomntwana.
• Mshukumise umntwana kancinci.
• Bamba umntwana wakho kufutshane nesifuba sakho ( ukudibana kwesikhumba nolusu ). Oku kuyamthuthuzela kakhulu umntwana wakho.
• Msonge kakuhle umntwana ngelaphu elithambileyo (i-swaddling).

Ngaba ndingamncancisa umntwana wam ngelixa ndisebenzisa iziyobisi?

Le yingxaki ebaluleke kakhulu. Ewe, iziyobisi ezifana nee-opioids zinokungena kubisi lwebele lomntwana wakho. Oku kunokuba nemiphumo emibi eyingozi kumntwana wakho. Ngoko ke, ukuba usebenzisa iziyobisi ezingavunywanga ngugqirha wakho, musa ukuncancisa umntwana wakho nangasiphi na isizathu . Endaweni yoko, mnike ubisi lwakho lwebele okanye unike ubisi lwebele olunikelweyo. Nangona kunjalo, ukuba ukwinkqubo yonyango lweziyobisi, oko kukuthi, ukuba uthatha i-opioid emiselweyo (efana ne-methadone) ngexesha lokukhulelwa okanye emva kokubeleka ukuthintela iimpawu zokurhoxa, unokukwazi ukuncancisa. Kodwa kuphela ngemvume kagqirha wakho kwaye ukuba bagqiba kwelokuba ikhuselekile kumntwana wakho. Ukuba unengxaki yeziyobisi okanye umlutha, thetha nogqirha wakho malunga neendlela zokufumana unyango lwayo. Ukuhlala usempilweni kuya kukunika amandla okuba khona kumntwana wakho xa ekudinga kakhulu.

Ungayithintela njani i-NOWS?

Ungathatha la manyathelo ukuthintela umntwana wakho ukuba angabi neempawu eziqatha ze-NOWS:

• Ukuba ukhulelwe, qiniseka ukuba uxelela ugqirha wakho ngazo naziphi na iziyobisi okanye izinto ozisebenzisayo. Ukuba ngequbuliso uyeka ukusebenzisa iyeza obulisebenzisa ixesha elide, unokuba neempawu ezibi zokurhoxa, ezinokuba yingozi kumntwana wakho ongekazalwa. Ugqirha wakho uya kucebisa iindlela zonyango ezikhuselekileyo kuwe nakumntwana wakho.
• Xelela ugqirha wakho ngayo nayiphi na imithi kagqirha kunye nezongezo ozithathayo. Qinisekisa ukuba zikhuselekile kuwe nakumntwana wakho. Musa ukuyeka ukuthatha naliphi na iyeza de ugqirha wakho akuxelele ukuba wenze njalo.
• Sebenzisa indlela yokuthintela ukukhulelwa ude ulungele ukuba nomntwana. Ukuba usabela ngokwesondo kwaye unengxaki yokusebenzisa iziyobisi okanye unyangwa ngenxa yoko, yenza ucansi olukhuselekileyo ude ube sempilweni ngokwaneleyo ukuba ukhulelwe.

Ukuba umntwana wam une-NOWS, ndimele ndilindele ntoni?

Usana olufunyenwe lune-NOWS luhlala esibhedlele kangangeentsuku ezingama-20 ukuqinisekisa ukuba luphilile ngokwaneleyo ukuba lubuyele ekhaya. Ngamanye amaxesha unyango lwe-NOWS lunokuthatha ukuya kuthi ga kwiinyanga ezintandathu. Oogqirha baya kujonga iimpawu zomntwana wakho ngokusondeleyo baze bazithumele ekhaya kuphela emva kokuba amayeza ephelile ngokupheleleyo emzimbeni wakhe. Ugqirha wakho uya kukunika iingcebiso malunga nendlela yokuncancisa umntwana wakho kunye nendlela yokumnyamekela. Khumbula, ukuba usebenzisa iziyobisi, musa ukuncancisa, njengoko amayeza anokudluliselwa kumntwana wakho ngobisi lwebele kwaye abangele iimpawu ezinokuchaphazela impilo yakhe. Emva kokuba umzise umntwana wakho ekhaya evela esibhedlele, umntwana wakho uya kufuna uthando lwakho olongezelelweyo kunye nenkxaso kangangeeveki okanye iinyanga ezimbalwa, mhlawumbi kulo lonke ixesha lobuntwana. Nika ingqalelo ekukhuleni nasekuphuhliseni komntwana wakho. Ukuba umntwana wakho akahlangabezani nemigangatho yophuhliso yobudala bakhe, xelela ugqirha wakho ngoko nangoko.

Ufanele ufune nini unyango olungxamisekileyo?

Ukuba umntwana wakho unezi mpawu zinzima, yiya kwiSebe leeNgxamiseko (ETU) ngoko nangoko okanye utsalele umnxeba ku-1990:

• Umkhuhlane ophezulu ohlala ixesha elingaphezulu kweeyure ezingama-24.
• Ukuba awuseli ubisi, okanye ukuba uyahlanza emva kokusela ubisi.
• Ukuba kukho ukuxhuzula.
• Ukuba ukubetha kwentliziyo akuqhelekanga.
• Ukuba unengxaki yokuphefumla.

Yeyiphi imibuzo ebalulekileyo ekufuneka uyibuze ugqirha?

• Ngawaphi amayeza akhuselekileyo ukuwasebenzisa ngexesha lokukhulelwa?
• Ungayiyeka njani ukusebenzisa isiyobisi esibangela umlutha?
• Ngaba iimpawu zomntwana wam ziya kumchaphazela ixesha elide?
• Ndingamthuthuzela njani umntwana wam ngexesha lonyango?

Okokugqibela, yintoni ekufuneka uyikhumbule (Umyalezo Wokuya Ekhaya)

Ukulutha iziyobisi yinto enzima kakhulu kwaye inzima kakhulu. Xa ukhulelwe, ezi mvakalelo zinokuba nzima nangakumbi, kwaye ungaziva ngathi awazi ukuba wenze ntoni. Kodwa khumbula, awuwedwa.

Kukho unyango olufumanekayo olunokukunceda wena nomntwana wakho niphile ubomi obonwabisayo nobunempilo. Eyona nto ibalulekileyo kukunyaniseka kugqirha wakho malunga nawo onke amayeza kunye namayeza owasebenzisayo ngexesha lokukhulelwa kwakho. Oku kuya kunceda ugqirha wakho ukuba amisele unyango olulungele wena nomntwana wakho. Akukho nto imbi ngokucela uncedo, kuyakunika amandla.

Isifo sokurhoxiswa kwe-Opioid yeNtsana, iSifo sokuzila ukutya kweNtsana, i-NOWS, i-NAS, ukurhoxiswa kosana olusandula ukuzalwa, ukuvezwa kweziyobisi zosana, ukukhulelwa komlutha we-opioid, ukukhulelwa kweziyobisi, iintsana ezisandula ukuzalwa, imiphumo yeziyobisi kusana