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CNS Depressants: Alcohol and Nicotine01:27

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Ethanol, a clear colorless alcohol, has been consumed by humans for millennia, but its effects on the body are far from benign. At lower doses, it induces decreased inhibitions and loquaciousness, leading to its social appeal. However, it can cause severe consequences at higher doses, such as coma and respiratory depression, due to its zero-order elimination kinetics. Chronic ethanol abuse wreaks havoc on multiple organ systems, particularly the CNS and the liver. Abrupt cessation of ethanol...
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"Alcohol intoxication by proxy on a NICU" - a case report.

Ulrike Wurst1,2, Benjamin Ackermann3, Wieland Kiess4

  • 1Department for Neonatology, Hospital for Children and Adolescents, University Hospital Leipzig, Liebigstrasse 20a, 04103, Leipzig, Germany. ulrike.wurst@medizin.uni-leipzig.de.

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Summary

Breastfeeding mothers consuming alcohol can cause severe ethanol intoxication in newborns. This case highlights the need for open communication with parents in neonatal intensive care units (NICUs) to prevent such life-threatening events.

Keywords:
Child safeguardingCommunicationEthanol intoxicationPremature infantmother’s milk

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Area of Science:

  • Neonatal Medicine
  • Toxicology
  • Pediatrics

Background:

  • Ethanol intoxication in newborns is uncommon, typically resulting from formula mispreparation or maternal alcohol consumption.
  • Hospitalized neonates are rarely affected, usually due to external factors like excessive use of alcohol-based hand sanitizers.
  • This report details an unusual instance of acute ethanol poisoning in a neonatal intensive care unit (NICU) setting.

Observation:

  • An extremely premature infant experienced recurrent, life-threatening episodes of hemodynamic compromise, apnea, and lactic acidosis.
  • Treatment involved supportive care, including intravenous fluids and, when necessary, intubation and catecholamine therapy.
  • These critical events were ultimately identified as severe ethanol intoxications.

Findings:

  • The infant's ethanol intoxication stemmed from breast milk contaminated with alcohol.
  • The mother consumed alcohol, believing it would increase milk production, a practice suggested by a family member.
  • She also supplemented the breast milk with cow's milk due to concerns about insufficient nutrition for the infant.

Implications:

  • This case underscores the impact of cultural beliefs and practices on infant health outcomes in neonatal intensive care.
  • Establishing strong communication and trust with parents is crucial for effective neonatal care.
  • Neonatal intensive care units must remain vigilant for potential intoxications and child safeguarding concerns, even within the NICU environment.