Non-pharmacological care for opioid withdrawal in newborns

Pahl, Adrienne; Young, Leslie; Buus‐Frank, Madge E.; Marcellus, Lenora; Soll, Roger F.

doi:10.1002/14651858.cd013217.pub2

Cited by 11 publications

(9 citation statements)

References 134 publications

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“…4 5 In the United States, length of hospital stay is up to 42% shorter for breastfed NAS infants compared with nonbreastfed NAS infants. 6 Shorter hospitalizations could have major public health implications given that hospital charges for NAS are approximately 1.4 billion dollars, more than 81% of NAS newborns are billed to state Medicaid programs, and overall treatment costs for newborns with NAS are substantially higher than for infants without NAS ($53,400 vs. 9,500), primarily due to longer hospital stays. 7 8 9 10 Among infants with NAS, breast milk intake is also associated with reduced NAS severity, delayed onset of NAS, and decreased need for pharmacologic treatment.…”

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confidence: 99%

Breastfeeding Intention, Knowledge, and Attitude of Pregnant Women in Treatment for Opioid Use Disorder

2021

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Objective The objective of this study was to describe breastfeeding intention, knowledge, and attitude, and sources of infant feeding information during the prenatal period among a cohort of pregnant women in treatment for opioid use disorder (OUD). Study Design Pregnant women who were receiving treatment for OUD and in the third trimester completed a questionnaire that measured demographic characteristics, infant feeding intentions, breastfeeding beliefs and attitudes, and sources of breastfeeding information. Frequency counts and percentages and means and standard deviations were used to describe data. Results Sixty-five women completed the survey. Three-fourths reported some intention to breastfeeding. While attitudes around breastfeeding were generally positive, less than half of respondents knew the recommendations and infant health benefits of breastfeeding. Conclusion Prenatal programs for women in treatment for OUD should consider addressing patient-reported concerns and gaps in knowledge regarding the benefits of and recommendation for breastfeeding. Key Points

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confidence: 99%

Breastfeeding Intention, Knowledge, and Attitude of Pregnant Women in Treatment for Opioid Use Disorder

2021

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“…Interventions minimize newborn dysregulation, reduce overstimulation, encourage rest, and improve overall functioning. Specifically, skin-to-skin contact and nonnutritive sucking reduce the pain response, whereas developmental swaddling and gentle maternal care improves regulation by lowering stress (Pahl et al, 2020). According to Graves et al (2016), breastfeeding is associated with reduced NOWS severity in as little as 72 hours.…”

Section: Signs Of Neonatal Opioid Withdrawal Syndromementioning

confidence: 99%

Strategies to Successfully Implement an Eat, Sleep, Console Protocol

Wortham

Bianchi

2022

McN: The American Journal of Maternal/Child Nursing

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Neonatal opioid withdrawal syndrome is pervasive, reflected in a case rate increase among most demographics in the United States from 4.0 newborns per 1,000 hospitalized births in 2010 to 7.3 newborns per 1,000 hospitalized births in 2017. Historically, assessments have been based on present symptomatology, excluding the mother's input, and increasing the likelihood of pharmacotherapy. The Eat, Sleep, Console approach provides an opportunity for the mother to act as the treatment for her newborn as she performs nonpharmacologic interventions that reduce withdrawal severity. Maternal confidence to help her newborn grows with this level of involvement and mother/infant dyad care improves, as do nurse and mother interactions. Assessments are less subjective and less time-consuming for nurses to conduct than those of the often-used Finnegan tool, and are conducted in collaboration with the mother. Facilities implementing this approach have seen a reduction in newborn hospital length of stay, pharmacotherapy, associated medical costs, and improved breastfeeding rates. Implementing an Eat, Sleep, Console protocol involves a stepwise approach to ensure all stakeholders are effectively prepared for the transition. We present strategies to implement an Eat, Sleep, and Console clinical protocol. A stepwise approach to implementation along with a clinical nursing maternal education protocol exemplar is included. Methods to overcome barriers to implementation and recommendations for further development are discussed.

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“…9 Nonpharmacological treatment is the first line of treatment for infants with prenatal opioid exposure (POE) and may include breastfeeding, rooming-in, and decreasing stimulation in the environment. 11 Typically, if an infant receives 2 consecutive FNAST scores of 10 or more or 3 consecutive FNAST scores of 8 or more, then pharmacological treatment (eg, morphine) for withdrawal is started. 9 Regardless of the clinical diagnosis (eg, POE, neonatal abstinence syndrome [NAS], or neonatal opioid withdrawal syndrome [NOWS]), infants with POE are "at risk" for developmental delays such as increased referral for special education services and both cognitive and motor delays.…”

Section: Introductionmentioning

confidence: 99%

“…The Finnegan Neonatal Abstinence Scoring Tool (FNAST) is commonly used in the hospital setting to monitor severity of withdrawal in infants 9. Nonpharmacological treatment is the first line of treatment for infants with prenatal opioid exposure (POE) and may include breastfeeding, rooming-in, and decreasing stimulation in the environment 11. Typically, if an infant receives 2 consecutive FNAST scores of 10 or more or 3 consecutive FNAST scores of 8 or more, then pharmacological treatment (eg, morphine) for withdrawal is started 9…”

Section: Introductionmentioning

confidence: 99%

Early Identification of Atypical Motor Performance of Infants With Prenatal Opioid Exposure

Boynewicz

Campbell

Chroust

2023

Pediatric Physical Therapy

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Purpose: To investigate the association between prenatal opioid exposure (POE) and newborn infants' motor performance to aid in the early identification of developmental delays. Methods: Nineteen infants with POE requiring pharmacological treatment, 27 infants with POE without pharmacological treatment, and 25 infants without POE were assessed via the Test of Infant Motor Performance (TIMP). Results: Infants in both groups with POE had lower TIMP scores than infants without POE. There was no difference between the TIMP scores of infants with POE who required pharmacological treatment and infants with POE who did not require pharmacological treatment. Conclusions: The TIMP can detect differences in motor performance of infants with POE. Regardless of whether infants required pharmacological treatment, POE was associated with lower motor performance. Those working in hospital or early intervention settings can use the TIMP to identify early delays in infants with POE and refer for intervention.

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Non-pharmacological care for opioid withdrawal in newborns

Cited by 11 publications

References 134 publications

Breastfeeding Intention, Knowledge, and Attitude of Pregnant Women in Treatment for Opioid Use Disorder

Breastfeeding Intention, Knowledge, and Attitude of Pregnant Women in Treatment for Opioid Use Disorder

Strategies to Successfully Implement an Eat, Sleep, Console Protocol

Early Identification of Atypical Motor Performance of Infants With Prenatal Opioid Exposure

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