Opiate drugs can affect the function of the gastrointestinal tract of premature babies, as confirmed by Menon et al. A new development in palliative care medicine may someday help us with this problem.

Methylnaltrexone is an opiate antagonist that does not cross the blood-brain barrier. In theory, giving methylnaltrexone along with opiates would allow the opiates to give the desired analgesia while maintaining normal gastrointestinal motility. Research done in adults is encouraging thus far, (NEJM 358:2332-2343, 2008).

Methylnaltrexone may also be be useful in the treatment of premature babies, but much more research is clearly needed.