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Expert Q&A

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How can I help my pregnant, addicted daughter?

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Because of the complexity of this viewer question, three of CNNHealth's expert doctors are offering advice. Last week, Diet and Fitness expert Dr. Melina Jampolis had ideas for gaining weight in a healthy way. Today, Dr. Jennifer Shu offers information about concerns for a baby born to an addicted woman. Watch for insights Tuesday from Mental Health expert Dr. Charles Raison.

My daughter is a heroin addict -- the "new face" of the heroin addict. My question concerns her weight. She is 5 feet 3 and is probably somewhere in the 85-90 pound range (I hope). She has always eaten a large amount of food just to maintain her before-addict weight of 108-110 pounds. I realize most of the population does not have this problem, but how can we add weight gain to her? Is GNC OK? The one supplement I found has over 2,000 calories and I told her to halve that amount and eat regularly. She still is not gaining weight. Are there any weight-gain "diets" out there for this small minority of people who have trouble gaining weight? I would like to have her eating something healthy to gain and maintain the weight. Is there a daily drink she could have? I'm afraid her little body will just give out one day.

We have a history of heart disease in our family. I can't always control the "addict" in her, but I do try and make sure she has food, etc. She's supposed to be taking Suboxone, which works great for her when we/she can afford it. It's such an awful addiction. Any help would be appreciated.

She is an identical twin and her twin sister is also an addict on Suboxone, and pregnant. She's due September 6 and has great prenatal care and a good job. I worry about the effects of the Suboxone on the baby, but it has to be better than the alternative. She is doing wonderful, though, on Suboxone and I hope that she can just continue to take it after the baby gets here. Thanks in advance.

Expert Bio Picture

Living Well Expert Dr. Jennifer Shu Pediatrician,
Children's Medical Group

Expert answer

Thank you for your question. Suboxone is made up of an opioid drug called buprenorphine and naloxone, a medication that counteracts the effects of opioids (also called narcotics). As you mentioned, this medication is used to treat addiction to opioids (such as heroin, morphine, methadone and codeine). Exposure to narcotics may cause complications with pregnancy, such as bleeding, premature birth, low birth weight and other problems.

During pregnancy, Suboxone passes through the placenta to the baby, but after delivery, the exposure to the medication suddenly stops. This situation is called neonatal abstinence syndrome and there may be withdrawal symptoms from stopping the buprenorphine, including agitation, tremors, rigid muscles, high-pitched crying, fever, sweating, diarrhea, feeding problems or difficulty sleeping. Withdrawal symptoms typically occur within the first 48 hours of life and may last a week or more.

Neonatal abstinence syndrome tends to be less common when buprenorphine is involved compared with other opioids but still occurs. Babies exposed to opioids of any type during pregnancy are monitored closely after birth and given supportive care for any withdrawal symptoms that appear. Some infants will need to take small amounts of an opioid medication, which is weaned gradually to help ease the withdrawal process.

Possible future problems include poor growth, learning problems, behavior disorders and an increased risk for sudden infant death syndrome. Infants should therefore be monitored for their growth and development in the first few months to years of life, if not longer. It is also important that both mother and baby receive optimal social, psychological and medical support in order to increase their chances of having good long-term health and other outcomes.

I wish you and your family the best of luck.

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