Treating infants with neonatal abstinence syndrome: an examination of three protocols

Abstract

Objective

Describe the characteristics of infants with NAS and determine if treatment outcomes varied between three protocols.

Study design

Based on medical record data, infant treatment for NAS-related withdrawal reflected one of three protocols: (1) No rescue dose (n = 836, 52.7%): Prescriber ordered initiation and escalation doses and determined when infants were eligible for weaning, (2) Rescue dose (n = 233, 14.7%): No rescue dose with the addition of a prescriber-ordered rescue dose, (3) Rescue dose by order set (n = 516, 32.6%): Rescue dose with addition of nurse-assisted order of morphine during escalation.

Results

The no rescue dose group had longer length of stay, days to wean, and inpatient days, and greater initial morphine dose than the two rescue dose groups (p < 0.001). Treatment outcomes between the two rescue dose protocols did not differ.

Conclusions

The benefits related to rescue dosing further inform the development of a standardized NAS treatment protocol.

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Correspondence to Laurie L. Meschke.

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Hartgrove, M.J., Meschke, L.L., King, T.L. et al. Treating infants with neonatal abstinence syndrome: an examination of three protocols. J Perinatol 39, 1377–1383 (2019). https://doi.org/10.1038/s41372-019-0450-6

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