Nonpharmacological management of neonatal abstinence syndrome: a review of the literature

Background: Infants with neonatal abstinence syndrome (NAS) experience withdrawal that occurs as a result of termination of placental opioid supply following delivery. Common symptoms include restlessness, tremors, agitation and gastrointestinal disturbances. Severe NAS is often treated using opioid...

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Bibliographic Details
Published in:The journal of maternal-fetal & neonatal medicine 2019-05, Vol.32 (10), p.1735-1740
Main Authors: Ryan, Gareth, Dooley, Joe, Gerber Finn, Lianne, Kelly, Len
Format: Article
Language:English
Subjects:
Analgesics, Opioid - administration & dosage
Analgesics, Opioid - adverse effects
Conservative Treatment
Female
Humans
Infant, Newborn
Neonatal abstinence syndrome
Neonatal Abstinence Syndrome - physiopathology
Neonatal Abstinence Syndrome - therapy
nonpharmacological
opioid-related disorders
Opioid-Related Disorders - complications
Pregnancy
Severity of Illness Index
therapeutics
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Description
Summary:Background: Infants with neonatal abstinence syndrome (NAS) experience withdrawal that occurs as a result of termination of placental opioid supply following delivery. Common symptoms include restlessness, tremors, agitation and gastrointestinal disturbances. Severe NAS is often treated using opioids and/or sedatives. Although commonly employed effectively in neonatal care, there is a lack of published information regarding nonpharmacological management of the NAS infant. Objective: The purpose of this review was to summarize the current literature on nonpharmacological management of NAS. Methods: A literature search of Medline and EMBASE was performed for articles published between 2000 and June 2107. Results: Nonpharmacological management encompasses "environmental control", "feeding methods", "social integration", "soothing techniques" and "therapeutic modalities". Several interventions, including: breastfeeding, swaddling, rooming-in, environmental control and skin to skin contact have proven to be effective in managing NAS and should be incorporated into standard of care for this population (Level I-III Evidence). These interventions can be effective when offered in combination with pharmacological therapy, or as stand-alone therapy for less severe cases of NAS (Finnegan score
ISSN:1476-7058
1476-4954
DOI:10.1080/14767058.2017.1414180