Hyperphagia in neonates withdrawing from methadone

Aims-To examine whether hyperphagia is a clinically significant problem in infants born to women receiving methadone maintenance. Methods-The volume of feeds, changes in infant body weight, as well as occu rrence of adverse clinical effects in infants withdrawing from methadone we re 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 r ecords. The daily oral intake of these infants was recorded during the firs t month of life. The incidence of hyperphagia (oral intake > 190 cc/kg/day) was measured. Associations between infant oral intake and maternal methado ne dose were studied using correlation analysis as well as Anova for repeat ed measures. Adverse clinical symptoms were also recorded. A subset of prem ature infants was studied separately. Results-The 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 s ignificantly 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 inta ke of 290 cc/kg/day) did not experience increased vomiting, aspiration, dia rrhoea, or abdominal distention. Conclusions-Hyperphagia is commonly found in infants withdrawing from metha done and can be persistent in a significant number. Hyperphagia was not ass ociated with either increased neonatal weight gain or with adverse gastroin testinal consequences. Hyperphagia may occur in infants withdrawing from me thadone who have high metabolic demands due to clinical signs not controlle d by opiate treatment.