Hyperphagia in neonates withdrawing from methadone
a Department of
Pediatrics, University of California, San Francisco, USA, b Department of
Pediatrics, Boston Medical Center, Boston, Massachusetts, USA
Correspondence to: Dr Alma Martinez University of California, San Francisco, San Francisco General Hospital, Department of Pediatrics - 6E9, 1001 Potrero Avenue, San Francisco, CA 94110, USA. Email: amartinez{at}sfghpeds.ucsf.edu
Accepted 29 October
1998
AIMS
To examine
whether hyperphagia is a clinically significant problem in infants born
to women receiving methadone maintenance.
METHODSThe volume of
feeds, changes in infant body weight, as well as occurrence of adverse
clinical effects in infants withdrawing from methadone were studied
during the first month of life. A retrospective chart review was
conducted for all infants at San Francisco General between 1992 and
1995, born to women receiving methadone maintenance during their
pregnancy. Forty four infants were identified and the data obtained
from hospital medical records. The daily oral intake of these infants
was recorded during the first month of life. The incidence of
hyperphagia (oral intake > 190 cc/kg/day) was measured. Associations
between infant oral intake and maternal methadone dose were studied
using correlation analysis as well as Anova for repeated measures.
Adverse clinical symptoms were also recorded. A subset of premature
infants was studied separately.
RESULTSThe incidence
of hyperphagia was 26% by day 8 and 56% by day 16 of life in the
infants. Hyperphagia was not associated with maternal methadone dose or
with infant withdrawal scores. Infants who were hyperphagic lost
significantly more weight during the first week of life than those who
were not. Despite significantly greater intake, the hyperphagic infants
did not gain weight more rapidly during the first month of life
compared with those infants with lower oral intake. Infants who were
hyperphagic (maximum intake of 290 cc/kg/day) did not experience
increased vomiting, aspiration, diarrhoea, or abdominal distention.
CONCLUSIONSHyperphagia
is commonly found in infants withdrawing from methadone and can be
persistent in a significant number. Hyperphagia was not associated with
either increased neonatal weight gain or with adverse gastrointestinal
consequences. Hyperphagia may occur in infants withdrawing from
methadone who have high metabolic demands due to clinical signs not
controlled by opiate treatment.
Keywords: methadone withdrawal; hyperphagia; metabolism
© 1999 by Archives of Disease in Childhood
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