Researchers believe neonatal abstinence syndrome treatment needs consistency

Researchers from the Boston University School of Medicine believe that treatment for infants dealing with neonatal abstinence syndrome should be more consistent. They believe the treatment should include standardized assessment tools and evidence that reinforces pharmacologic and nonpharmacologic treatment choices. The review was published in the journal Addiction Science and Clinical Practice.

Getting to know neonatal abstinence syndrome

Neonatal abstinence syndrome, or NAS, is a condition infants develop after being exposed to drugs or alcohol while in the womb. Though symptoms vary, infants usually experience issues with their autonomic and central nervous system or their gastrointestinal or respiratory system. The National Library of Medicine stated that some common signs include seizures, fever, vomiting, irritability, tremors and sleep problems. The birth mother may have problems during the pregnancy as well. Most infants experience this condition because of exposure to opioids and will experience withdrawals once they are born. Many mothers who are addicted to heroin, codeine, oxycodone or buprenorphine can cause their infants to have NAS. Often, development of the condition depends on the type of drug used, how it is broken down in the body, how long the mother was using for and whether the baby was born early or on schedule.

The amount of infants born with Neonatal abstinence syndrome has gone up significantly in the past decade, according to a study published in the Journal of the American Medical Association.

Determining a scoring system

The initial scoring system for NAS was developed in the 1970s. At the time, researchers believed the system was a turning point for caring for infants with the condition. Pediatricians were satisfied too, believing the system would provide consistency in diagnosing and treating infants with Neonatal abstinence syndrome. The system was known as the “Finnegan Score” and is still regularly used by clinicians looking for signs of opioid withdrawal. If infants meet a certain standard, they are started on pharmacologic therapies. However, over time the system has been modified and used in various ways in medical facilities.

“We found that the data are limited to guide physician assessment and management of these infants,” said lead author Sarah Bagley, M.D., an addiction medicine fellow at BUSM and a physician in General Internal Medicine at Boston Medical Center.

The study authors also noted that nonpharmacologic solutions could also help alleviate symptoms. They believe actions such as breastfeeding could relieve symptoms.

Looking forward

They hope that continual research will be conducted to create a consistent set of criteria for physicians and pediatricians. They believe standardizing treatment can help create solidified solutions for infants, both medically and nonmedically.

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