How does nonpharmacological care affect newborn infants with neonatal opioid withdrawal syndrome?: A Cochrane Review summary with commentary

Abstract

This paper summarizes the published Cochrane Review, “Non-pharmacological Care for Opioid Withdrawal in Newborns,” by A. Pahl, L. Young, M. E. Buus-Frank, L. Marcellus, and R. Soll (https://doi.org/10.1002/14651858.CD013217.pub2), and discusses it through a treatment policy and practice lens. The study population in the review included infants born at term (37 weeks’ gestation or greater) and late preterm (34 weeks’ gestation to 37 weeks’ gestation) who had a known or suspected prenatal exposure to opioids or who were exhibiting symptoms consistent with opioid withdrawal in the first 7 days of life. Nonpharmacological interventions included a wide range of care and were broadly categorized as: modification of environmental stimulation, feeding practices, and support of the mother-infant dyad. The review found that randomized controlled trials, identified in searches conducted in October 2019, did not provide enough evidence regarding clinically meaningful outcomes. However, recently published trial data suggest that “Eat, Sleep, Console,” an individualized, trauma-informed, family-centered nonpharmacological approach to care, can reduce the number of days an infant experiencing symptoms consistent with opioid withdrawal requires in-hospital care.