A- A A+

Outcome Differences in Neonates Exposed In-Utero to Opioids Managed in the NICU Versus Pediatric Floor.

Lembeck AL, Tuttle D, Locke R, Lawler L, Jimenez P, Mackley A, Paul DA.

J Addict Med. 2018 Sep 24. doi: 10.1097/ADM.0000000000000455.



Persistent feeding difficulties among infants with fetal opioid exposure: mechanisms and clinical reasoning.

Brandon J. Hart, Sreekanth Viswanathan & Sudarshan R. Jadcherla (2018) 

The Journal of Maternal-Fetal & Neonatal Medicine, DOI: 10.1080/14767058.2018.1469614 



Analysis of the factors that influence the Finnegan Neonatal Abstinence Scoring System.

Gomez-Pomar E, Christian A, Devlin L, Ibonia KT, Concina VA, Bada H, Westgate PM.

J Perinatol. 2017 Jul;37(7):814-817. doi: 10.1038/jp.2017.40.



Impact of psychiatric medication co-exposure on Neonatal Abstinence Syndrome severity.

Wachman EM, Warden AH, Thomas Z, Thomas-Lewis JA, Shrestha H, Nikita FNU, Shaw D, Saia K, Schiff DM.

Drug Alcohol Depend. 2018 Sep 1;192:45-50. doi: 10.1016/j.drugalcdep.2018.07.024. 



Outpatient pharmacologic weaning for neonatal abstinence syndrome: A systematic review.

Murphy-Oikonen, J., & McQueen, K. (2018). 

Primary Health Care Research & Development, 1-9. doi:10.1017/S1463423618000270



Screening Pregnant Women and Their Neonates for Illicit Drug Use: Consideration of the Integrated Technical, Medical, Ethical, Legal, and Social Issues.

Price HR, Collier AC, Wright TE.

Front Pharmacol. 2018 Aug 28;9:961. doi: 10.3389/fphar.2018.00961. eCollection 2018. Review.


Outpatient Pharmacotherapy for Neonatal Abstinence Syndrome.

Maalouf FI, Cooper WO, Slaughter JC, Dudley J, Patrick SW.

J Pediatr. 2018 May 7. pii: S0022-3476(18)30420-7. doi: 10.1016/j.jpeds.2018.03.048.



Morphine vs Methadone Treatment for Infants with Neonatal Abstinence Syndrome.

Tolia VN, Murthy K, Bennett MM, Greenberg RG, Benjamin DK, Smith PB, Clark RH.

J Pediatr. 2018 Sep 14. pii: S0022-3476(18)30967-3. doi: 10.1016/j.jpeds.2018.07.061.



Management of Neonatal Abstinence Syndrome: The Importance of a Multifaceted Program Spanning Inpatient and Outpatient Care.

Balakrishnan M, Suresh G.

Jt Comm J Qual Patient Saf. 2018 Jun;44(6):309-311. doi: 10.1016/j.jcjq.2018.03.004. 


As the NAS Crisis Worsens, a New Study Offers Treatment Guidelines

The incidence of neonatal abstinence syndrome (NAS) has been climbing steadily, according to a 2016 Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention (CDC). The report, published August 12, indicated that the number of NAS cases rose from 1.5 per 1,000 hospital births in 1999 to 6 per 1,000 in 2013.

Yet guidelines for treating NAS have been lacking, according to a study in JAMA Pediatrics. The study, published online June 18, found that although several different approaches are being used, “no universal evidence-based pharmacological treatment strategy exists.” The article also noted that the FDA hasn’t approved any drug for treating infants who have NAS.

The authors of the JAMA Pediatrics study said that, without clear treatment guidelines, caregivers have typically chosen either methadone or morphine to treat their young NAS patients.

New Guidelines

Which medication—methadone or morphine—is better, and how to decide on an appropriate dose? Some studies have suggested basing the dose on the infant’s weight; others, on the severity of NAS, as assessed by the Finnegan Neonatal Abstinence Scoring System.

The JAMA Pediatrics team set out to answer the medication questions. They designed a treatment plan, then carried out what they believe is the first multisite, double-blind, randomized trial comparing the safety and efficacy of methadone and morphine in NAS. They published their results online June 18. (atforum.com, USA, 04.09.2018)


Early Treatment Innovation for Opioid-Dependent Newborns: A Retrospective Comparison of Outcomes, Utilization, Quality, and Safety, 2006-2014.

Summey J, Chen L, Mayo R, Charron E, Hudson JA, Sherrill WW, Dickes L.

Jt Comm J Qual Patient Saf. 2018 Jun;44(6):312-320. doi: 10.1016/j.jcjq.2017.12.004.


Stabilizing the Mother-Infant Dyad for Better Outcomes from OB to FM: Caring for Patients with Perinatal Opioid Use Disorder through the 4th Trimester.

Ramage M, Ostrach B, Fagan B, Coulson CC.

N C Med J. 2018 May-Jun;79(3):164-165. doi: 10.18043/ncm.79.3.164. 


Gender Differences in Withdrawing Infants.

Stevens S, Flaugher T, Hughes K, Terwilliger C, Copley J, Mohan S.

Glob Pediatr Health. 2018 May 18;5:2333794X18775886. doi: 10.1177/2333794X18775886.


Heroin - Drugs and Lactation Database 

Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-.

Last Revision: May 1, 2018.


Quality improvement initiative to improve inpatient outcomes for Neonatal Abstinence Syndrome.

Wachman EM, Grossman M, Schiff DM, Philipp BL, Minear S, Hutton E, Saia K, Nikita F, Khattab A, Nolin A, Alvarez C, Barry K, Combs G, Stickney D, Driscoll J, Humphreys R, Burke J, Farrell C, Shrestha H, Whalen BL.

J Perinatol. 2018 May 8. doi: 10.1038/s41372-018-0109-8.



Methadone - Drugs and Lactation Database.

Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-.

Last Revision: June 4, 2018.


Breastfeeding Intention Compared With Breastfeeding Postpartum Among Women Receiving Medication-Assisted Treatment.

Yonke N, Maston R, Weitzen S, Leeman L.

J Hum Lact. 2018 Apr 1:890334418769637. doi: 10.1177/0890334418769637.



Buprenorphine - Drugs and Lactation Database

Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Last Revision: June 4, 2018.


Neonatal Abstinence Syndrome: Advances in Diagnosis and Treatment.

Wachman EM, Schiff DM, Silverstein M.

JAMA. 2018 Apr 3;319(13):1362-1374. doi: 10.1001/jama.2018.2640. Review.



Comparison of outcomes between morphine and concomitant morphine and clonidine treatments for neonatal abstinence syndrome.

Gullickson C, Kuhle S, Campbell-Yeo M.

Acta Paediatr. 2018 Jul 4. doi: 10.1111/apa.14491.



An Initiative to Improve the Quality of Care of Infants With Neonatal Abstinence Syndrome.

Grossman MR, Berkwitt AK, Osborn RR, Xu Y, Esserman DA, Shapiro ED, Bizzarro MJ.

Pediatrics. 2017 Jun;139(6). pii: e20163360. doi: 10.1542/peds.2016-3360. Epub 2017 May 18.



Drogenentzugssyndrom bei Babys nicht abrechnungsfähig

Celle – Tabak ist nach einem Urteil des Landessozialgerichts Niedersachsen-Bremen keine Droge, zumindest hinsichtlich des Krankenhausvergütungsrechts. Unabhängig davon, ob Tabak und Nikotin im allgemeinen Sprachgebrauch als Drogen aufgefasst werden oder nicht, werde Tabak im Gesundheitssystem nicht mit Opiaten, Methadon oder Heroin gleichgesetzt, urteilten die Celler Richter in einem heute veröffentlichten Urteil (Az.: L 16 KR 43/16). (aerzteblatt.de, 09.07.2018)


Retrospective review of neurodevelopmental outcomes in infants treated for neonatal abstinence syndrome.

Merhar SL, McAllister JM, Wedig-Stevie KE, Klein AC, Meinzen-Derr J, Poindexter BB.

J Perinatol. 2018 Mar 7. doi: 10.1038/s41372-018-0088-9.



Active Ear Acupuncture Points in Neonates: Initial Results in a New Research Field.

Stadler J, Raith W.

Med Acupunct. 2018 Jun 1;30(3):155-158. doi: 10.1089/acu.2018.1277.


Maternal opioid use disorder and neonatal abstinence syndrome in northwest Ontario: a 7-year retrospective analysis.

Dooley J, Ryan G, Gerber Finn L, Bollinger M, Matsumoto CL, Hopman WM, Kelly L.

Can J Rural Med. 2018 Spring;23(2):39-44.


Auricular Medicine in Neonatal Care.

Raith W.

Med Acupunct. 2018 Jun 1;30(3):138-140. doi: 10.1089/acu.2018.1299.


The Use of Serum Methadone/Metabolite Ratios to Monitor Changing Perinatal Pharmacokinetics.

McCarthy JJ, Vasti EJ, Leamon MH, Graas J, Ward C, Fassbender C.

J Addict Med. 2018 Mar 7. doi: 10.1097/ADM.0000000000000398.



Comparison of Safety and Efficacy of Methadone vs Morphine for Treatment of Neonatal Abstinence SyndromeA Randomized Clinical Trial. 

Davis JM, Shenberger J, Terrin N, et al. 

JAMA Pediatr.Published online June 18, 2018. doi:10.1001/jamapediatrics.2018.1307



Neonatal Abstinence Syndrome: Twins Case Series.

Pandey R, Pandey Sapkota N, Kumar D.

Front Pediatr. 2017 Dec 22;5:242. doi: 10.3389/fped.2017.00242.


USA. There's No Such Thing as a Baby Opioid Addict

“They can be born dependent on a substance, but there is a difference between dependence and addiction.”

(...) The distinction matters for opioid-exposed babies for a number of reasons. One reason is that addiction can be managed, but it doesn't have a cure, says Robert Newman, president emeritus of Beth Israel Medical Center. That can lead some people to think that once babies are "addicted," they're addicted for life. The label can impact them from their earliest experiences. 

"It has enormous potential harm to the babies, as the baby grows up, and to the family because of the stigma of the term 'addict,'" Newman says. "If the baby applies to kindergarten and the parent is asked about health issues and the parent says, 'the baby was born addicted,' that's the kiss of death. A lot of parents don't want their child sitting next to an addict." (vice.com, USA, 08.11.2017)


The Epidemic of Neonatal Abstinence Syndrome, Historical References of Its' Origins, Assessment, and Management.

Gomez-Pomar E, Finnegan LP.

Front Pediatr. 2018 Feb 22;6:33. doi: 10.3389/fped.2018.00033. eCollection 2018. Review.


Does Maternal Buprenorphine Dose Affect Severity or Incidence of Neonatal Abstinence Syndrome?

Wong J, Saver B, Scanlan JM, Gianutsos LP, Bhakta Y, Walsh J, Plawman A, Sapienza D, Rudolf V.

J Addict Med. 2018 Jun 13. doi: 10.1097/ADM.0000000000000427.



Plasma Brain-Derived Neurotrophic Factor Levels in Newborn Infants with Neonatal Abstinence Syndrome.

Subedi L, Huang H, Pant A, Westgate PM, Bada HS, Bauer JA, Giannone PJ, Sithisarn T.

Front Pediatr. 2017 Nov 3;5:238. doi: 10.3389/fped.2017.00238.


USA. Non-pharmacologic approaches improve outcomes for infants with neonatal abstinence syndrome 

BOSTON--A quality improvement (QI) initiative at Boston Medical Center that focused on using non-pharmacologic approaches to care for infants with neonatal abstinence syndrome (NAS) yielded positive short-term outcomes for both the mothers and infants. The results, published in the Journal of Perinatology, showed a decrease in medication use, length of stay, and health care costs. (Boston Medical Center, 04.06.2018)


Neonatal abstinence syndrome due to prenatally citalopram exposure: A case report.

Erol S, Ozcan B, Celik IH, Bas AY, Demirel N.

Arch Argent Pediatr. 2017 Dec 1;115(6):e424-e427. doi: 10.5546/aap.2017.eng.e424.


USA. Stop labeling babies as 'born addicted' — it stigmatizes them and is inaccurate

(...) Saying that babies are born with addiction stigmatizes the very babies that Brown seeks to help. As Robert Newman, president emeritus of Beth Israel Medical Center, tells Tonic, the label can harm the babies and their families because of the stigma associated with the word "addict." Newman points out that, as a child grows, this label is “the kiss of death. A lot of parents don’t want their child sitting next to an addict.” (The Hill, USA, 19.06.2018)