Whole body massage for newborns: A report on non-invasive methodology for neonatal opioid withdrawal syndrome

Abstract

BACKGROUND: Infants with in-utero exposure to opioids are at risk Neonatal Opioid Withdrawal Syndrome (NOWS) and non-pharmacological methods of care, like swaddling, quiet ambient environment are routinely recommended but are not systematically studied. We hypothesized that opioid exposed infants can tolerate whole body massage while hospitalized. METHODS: This is a prospective observational study (August 2017 to January 2019) and infants of mothers having a history of opioids use (OUD) were included. Infants received whole body massage for 30 minutes from birth till discharge home. Infants heart rate (HR), respiratory rate (RR), systolic (sBP) and diastolic blood pressure (dBP) were recorded prior to and at the end of massage session. RESULTS: The pilot study enrolled 30 infants. The mean birth weight and gestational age were 38±1 weeks and 2868±523 grams, respectively. All massage sessions were well tolerated. There was marked decrease in HR, systolic and diastolic BP and RR, (p < 0.01) in all study infants post massage, more profound among infants with NOWS (p < 0.01) than without NOWS. CONCLUSIONS: Whole body massage is very well tolerated by infants with in-utero opioid exposure. Infants with NOWS had marked decrease in their HR and BP from their baseline after massage.

Treatment for Neonatal Abstinence Syndrome using Nonpharmacological Interventions

“…Its ability to adjust the intensity of rocking to the infant's intensity of agitation was assumed would have a beneficial effect on sensory stimulation and behavioral responses analogous to other studies involving reactions to sensory input by infants with intrauterine drug exposure. [17][18][19][20][21][22] Instead, the basinet was found to be associated with an increased length of hospitalization and exposure to pharmacological treatment of NAS.…”

Pharmacologic Treatment and Length of Hospitalization for Neonatal Abstinence Syndrome (NAS) in an Open Bay Neonatal Intensive Care Unit (NICU) Using Novel Non-Pharmacologic Interventions

“…It was presumed the unique features of the novel bassinet would collectively act as an effective NPI for NAS, especially in an open-bay NICU. Its ability to adjust the intensity of rocking to the infant's intensity of agitation was a characteristic presumed to bene t vestibular sensory stimulation that has increasingly been suggested to improve behavioral responses of infants with intrauterine drug exposure (15)(16)(17)(18)(19).…”

Efficacy of a Vibrating Crib Mattress to Reduce Pharmacologic Treatment in Opioid-Exposed Newborns

“…A growing amount of research suggests the importance of tactile sensory stimulation for promoting physiologic maturation and brain development, and for improving behaviors implicated in intrauterine drug exposure . Evidence supports that stochastic (ie, random, noisy) mechanostimulation can promote stability in destabilized biological systems .…”

“…A growing amount of research suggests the importance of tactile sensory stimulation for promoting physiologic maturation and brain development, and for improving behaviors implicated in intrauterine drug exposure. [21][22][23][24][25][26][27][28][29][30][31][32][33][34] Evidence supports that stochastic (ie, random, noisy) mechanostimulation can promote stability in destabilized biological systems. [35][36][37][38][39] In preliminary studies by some of the authors of the present study, low-level stochastic vibrotactile stimulation (SVS) delivered through a uniquely constructed crib mattress improved physiologic function in newborns with neonatal abstinence syndrome.…”