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Neurology
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Baclofen Pump Implants (Intrathecal): Home Care
Division of Pediatric Neurology
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Why is my child on IBT (Intrathecal Baclofen Therapy)?
Baclofen therapy helps reduce spasticity (muscle tightness). This helps make movement
easier for your child. It does not cure your child’s problem. Follow-up care with your
doctor is very important. Be sure to keep all of your child’s doctor appointments.
How does the pump work?
The pump sends Baclofen through a tube to the area of muscle tightness.
Your child’s neurosurgeon will choose the right size pump for your child. There are 3 sizes:
Milliliters (ml) are the volume of liquid the pump can hold. One teaspoon is about 5 ml.
There are also 3 strengths of medicine (Baclofen):
- 500 mcg/ml
- 1000 mcg/ml
- 2000 mcg/ml
Micrograms (mcg) are the amount of Baclofen in each milliliter.
Your child’s dose can be increased about 10% each week. The dose depends on how your child responds
to the medicine, not by his size or weight.
Post Operative Guidelines:
- Pump Refill Appointment:Contact the Neurology office as soon as your child is discharged
from the hospital to make an appointment to have the pump refilled. The appointment will be scheduled
with Charlotte Swint, FNP on a Thursday morning at404-778-2400.
- Surgical Follow-up Appointment:Contact Dr. Timothy Mapstone’s office as soon as you are
discharged at 404-778-5700.
- Medical Follow-Up:Contact Spasticity Clinic directly at 404-785-8188 or Dr. Barbara Weissman’s
office to schedule an appointment to see her at 404-778-2400.
Activity:
- Try to encourage your child not to twist at the waist, reach high overhead, stretch, or bend
forward or backward a lot for 4 weeks.
- Avoid frequent positional changes that can cause stress on the incision for 4 weeks.
- Your child should not sleep on her stomach for 4 weeks.
- Your child can resume normal activity once the incisions have healed.
Wound Care:
- Check your child’s incisions daily for:
- Redness
- Swelling
- Drainage
- Temperature greater then 101.5 degrees
- If your child has these signs or persistent incision pain, call Dr. Timothy Mapstone's office right away.
- Do not give your child a tub bath or place them in water up to the incision for 2 weeks. Give your
child a sponge bath until the incisions are healed. Your child may shower ONLY if you cover the incisions with
gauze and plastic wrap.
- Wear loose clothing over the incision site for comfort and to prevent skin problems.
- Keep skin area around and over the pump clean and dry.
- Keep seatbelts off pump.
- Carry these items with you at all times:
- Implanted Device Identification Card
- Emergency Information card
When Should I Call My Child’s Doctor?
- Call your child’s doctor as soon as possible if your child:
- Is more sleepy than usual
- Is weak
- Is lightheaded
- Is dizzy
- Has headaches
- Has nausea
- Has seizures
- If your child is very drowsy, it can be a sign of too much of the medicine or a problem with the pump.
This needs immediate attention. Go the nearest emergency room and have your emergency card ready.
Pump Alarm:
- The pump is programmed to beep when it is time for you to return for a refill. You will hear a
very quiet “beep” every 5-15 seconds. You should make your refill appointment before leaving the hospital.
Do not let the pump become empty.
- Call Dr. Weissman’s office at 404-778-2400 if you hear the beep at any other time. Two beeps together
every 5-15 seconds could indicate a problem with the pump.
Other Medicines:
- Tell your child’s other doctors, dentists, and health care professionals about the pump so that
they can adjust other medicines and therapies as needed.
- Talk with your child’s doctor about any prescribed and over-the-counter medicines such as cough
syrup and cold or sinus medicines. This will help to prevent side effects.
- Never stop taking oral anti-spasticity medicines suddenly. Your doctor will give you a schedule to
gradually stop them.
- Urinary tract infections, skin irritation, severe constipation or other medical conditions can cause
the spasticity to increase. Increasing the baclofen dose will not reduce the spasticity in these
situations. The medical condition must be resolved first. Let your child’s doctor know if your child
is having any other medical problems.
Travel and Other Questions:
- Avoid activities that can cause extreme pressure changes such as scuba diving or flying in
unpressurized planes (commercial planes are not a problem). These things could increase the pressure
in the pump and change flow rates.
- Present your child’s ID card at airport security to help with security clearance. The pump may
set off the metal detector.
- Tell Dr. Weissman in advance of travel plans so plans can be made for refills as necessary.
- Call Dr. Weissman’s office if you have any other questions.
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