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Evaluation of the Cardiovascular Effects of Clonidine in Neonates Treated for Neonatal Abstinence Syndrome.

Meddock RP, Bloemer D.

J Pediatr Pharmacol Ther. 2018 Nov-Dec;23(6):473-478. doi: 10.5863/1551-6776-23.6.473.


[Increasing Consumption of Crystal Meth in Saxony and its Risks for Mother and Child - Experiences at a Level I Perinatal Center from a Pediatric Viewpoint].

Dinger J, Näther N, Wimberger P, Zimmermann US, Schmitt J, Reichert J, Rüdiger M.

Z Geburtshilfe Neonatol. 2017 Apr;221(2):73-80. doi: 10.1055/s-0043-102953. Epub 2017 May 23. German. 



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.



Survey of Neonatal Intensive Care Unit Nurses' Use of a Motion/Sound Infant Seat.

Holmes M, Wright ME.

Adv Neonatal Care. 2019 Jan 11. doi: 10.1097/ANC.0000000000000579. 



Impact of timing of methadone initiation on perinatal outcomes following delivery among pregnant women on methadone maintenance therapy in Ontario.

Guan, Q., Sproule, B. A., Vigod, S. N., Cadarette, S. M., Greaves, S., Martins, D., and Gomes, T. (2018) 

Addiction, doi.org/10.1111/add.14453.



NIDA. Higher rates of NAS linked with economic conditions

A NIDA-funded analysis of eight states showed a significant association between rates of neonatal abstinence syndrome (NAS) and poor economic conditions. (NIDA News, USA, 29.01.2019)


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 



Pharmacological Treatments for Neonatal Abstinence Syndrome: A Systematic Review and Network Meta-analysis.

Disher T, Gullickson C, Singh B, Cameron C, Boulos L, Beaubien L, Campbell-Yeo M.

JAMA Pediatr. 2019 Jan 22. doi: 10.1001/jamapediatrics.2018.5044.


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. 



Neonatal Head Circumference in Newborns With Neonatal Abstinence Syndrome.

Towers CV, Hyatt BW, Visconti KC, Chernicky L, Chattin K, Fortner KB.

Pediatrics. 2019 Jan;143(1). pii: e20180541. doi: 10.1542/peds.2018-0541. 


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.


Morphine and Methadone for Neonatal Abstinence Syndrome: A Systematic Review.

Slowiczek L, Hein DJ, Risoldi Cochrane Z, Gregory PJ.

Neonatal Netw. 2018 Nov;37(6):365-371. doi: 10.1891/0730-0832.37.6.365.



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.



Opioid tapering and weaning protocols in pediatric critical care units: a systematic review.

Bichaff P, Setani KT, Motta EHG, Delgado AF, Carvalho WB, Luglio M.

Rev Assoc Med Bras (1992). 2018 Oct;64(10):909-915. doi: 10.1590/1806-9282.64.10.909.


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)


Impact of In-utero Exposure to Selective Serotonin Reuptake Inhibitors and Opioids on Neonatal Opioid Withdrawal Syndrome.

Bhatt-Mehta V, Richards J, Sturza J, Schumacher RE.

J Addict Med. 2018 Nov 21. doi: 10.1097/ADM.0000000000000484. 



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. 


USA. MATER Center Director, on the Importance of Dr. Finnegan’s Work—Which Continues—and the Need to Treat Mothers for Trauma

Loretta Finnegan, MD, a champion of medication-assisted treatment with methadone, developed her scoring system for newborns more than 40 years ago. The Finnegan Neonatal Abstinence Scoring System (FNASS) assigns a numerical score to 21 clinical signs, and babies are treated accordingly. Developing the test was an important step in making sure that these babies were treated with morphine, if necessary, to manage the symptoms of withdrawal.

But the work of Dr. Finnegan goes far beyond the Finnegan score. When she first started an opioid treatment program (OTP) at Thomas Jefferson University in Philadelphia, 44 years ago, Dr. Finnegan opened a landmark program for pregnant women addicted to opioids. Since then, the program, called Maternal Addiction Treatment Education & Research (MATER), has included intensive outpatient treatment as well as residential treatment.

Diane Abatemarco, PhD, MSW, director of MATER and associate professor of OB/GYN and Pediatrics at the Sidney Kimmel Medical College at Jefferson, talked with AT Forum about the scope and importance of Dr. Finnegan’s work. (ATForum, USA, 17.12.2019)


Heroin - Drugs and Lactation Database 

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

Last Revision: May 1, 2018.


USA. Healthy Pregnancy Healthy Baby Fact Sheets

This series of four fact sheets emphasizes the importance of continuing a mother's treatment for opioid use disorder (OUD) throughout pregnancy. The series includes information on OUD and pregnancy, OUD treatment, neonatal abstinence syndrome, and considerations to address before hospital discharge. (SAMSHA - Substance Abuse and Mental Health Services Administration, USA, August 2018)


Methadone - Drugs and Lactation Database.

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

Last Revision: June 4, 2018.


Growth during the first year in infants affected by neonatal abstinence syndrome.

Corr TE, Schaefer EW, Paul IM.

BMC Pediatr. 2018 Nov 5;18(1):343. doi: 10.1186/s12887-018-1327-0.


Buprenorphine - Drugs and Lactation Database

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


Care-by-parent model as a tool for reduction in neonatal opioid withdrawal syndrome in neonates exposed to buprenorphine maintenance therapy in-utero.

Lawlor ML, Shook L, McQuerry K, Srinivasan A, Johnson QB, Chavan NR, Critchfield AS.

J Matern Fetal Neonatal Med. 2018 Dec 18:1-111. doi: 10.1080/14767058.2018.1558201.



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.



The Impact of Breastfeeding on Health Outcomes for Infants Diagnosed with Neonatal Abstinence Syndrome: A Review.

Wu D, Carre C.

Cureus. 2018 Jul 28;10(7):e3061. doi: 10.7759/cureus.3061. Review.


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)


Novel Withdrawal Symptoms of a Neonate Prenatally Exposed to a Fentanyl Analog.

Nellhaus EM, Murray S, Hansen Z, Loudin S, Davies TH.

J Pediatr Health Care. 2018 Nov 8. pii: S0891-5245(18)30204-9. doi: 10.1016/j.pedhc.2018.08.014.



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.


Opium use during pregnancy and infant size at birth: a cohort study.

Maghsoudlou S, Cnattingius S, Montgomery S, Aarabi M, Semnani S, Wikström AK, Bahmanyar S.

BMC Pregnancy Childbirth. 2018 Oct 1;18(1):358. doi: 10.1186/s12884-018-1994-8.