A mother has a false labor three weeks before birth. For those three weeks she is on Phenobarbital. After birth the baby doesn’t suck for three weeks, doesn’t have normal thumb finger reflex and is irritable. This occurred in the early 80s.
What is the most likely background story here?
Sounds like the mom may have had/developed a seizure disorder (I think phenobarbital was a relatively common first-line epilepsy drug in those days). That late in pregnancy it’s doubtful any permanent congenital anomalies would have resulted, but it wouldn’t surprise me if there were at least some short-term behavioral changes in the baby.
Mom was a junkie, spent 3 weeks in a hospital on prescription drugs to give the baby a chance after almost losing it. Baby born premature, addicted, and most likely some brain damage.
If that’s right, then using something like phenobarb or Valium probably prevents the fetus from going through withdrawal in utero, and dying from it. Valium is given to prevent the DTs in alcoholics detoxing, albeit, under controlled conditions, since Valium can be abused as well. Phenobarb will prevent seizures in the mother and the fetus, which are a symptom of withdrawal from a lot of drugs.
I have a cousin (adopted) who was born addicted and was given phenobarb in the NICU. I can’t remember off-hand what drug or drugs it was she had in her system. FWIW, she’s fine now.
I’ll come out of hibernation to wonder whether the phenobarb may have been given in an effort to stimulate the baby’s ability to metabolize (conjugate) bilirubin. Phrased differently, phenobarbital was (? still is) used to lessen the degree of neonatal jaundice by inducing the enzymes involved in the process. If the docs thought that the baby might be born premature, then inducing its bilirubin-conjugating ability makes sense (since premies can have trouble metabolizing bilirubin).
Although the child never had a medically documented seizure, the mother somehow knew the kid probably had epilepsy. Before age 10 there were two abnormal EEGs. Mother prompted the EEGs.
Dad was on meth. Mom is unknown.
Dad’s drug issues wouldn’t matter - he delivered the sperm allright. And no more.
My suspicion is that the mom had pregnancy induced hypertension (PIH) and the phenobarb was to prevent seizure.
Back then, PIH would have been called eclampsia/preeclampsia or maybe even toxemia.
If you have access to the mom, you could ask her if those names sound familiar.
Also, as for the delayed suck, babies usually develop suck/swallow/breath coordination around 34-36 weeks.
Finally, thumb-finger? Pincher grasp is not developed until 9-12 months (think of a baby picking up a cheerio). Are you thinking of some other reflex action that was delayed?
Was the baby early? How early?
PIH and preterm labor (PTL) are very common problems in pregnancy. One can have both. In both cases, the doc would want to delay delivery as long as possible unless the mother is near term.
If born early, the baby could have had some developmental delays. The earlier a baby is born, the more at risk it is for problems. The really big problems for preemies are brain hemorrhage (could the phenobarb been given to reduce this risk?), respiratory problems and intestine issues.
What other clues do you have?
We still use those terms.
There is a lot you are not telling us so assumptions have to be made: “Dad was on meth. Mom is unknown.” If mom was intimately involved with a drug addict enough to have his child, then it may be assumed that mom also was involved in drug use. That, and the fact that doctors treated her with a powerful drug often used to treat withdrawal symptoms. The docs could have warned her about possible problems in the child’s future, hence the EEGs when mom noticed problems.
I had never heard of that being done; it sounds like it’s mostly done in certain populations with a high incidence of neonatal jaundice, specifically those with a high incidence of a genetic condition called G6PD. It interferes with the metabolism of some drugs, and foods too; ever heard of favism? It’s a symptom of G6PD; people who have it can’t eat fava beans…