Infant Journal
for neonatal and paediatric healthcare professionals

Non-pharmacological management in neonatal abstinence syndrome: an overview

Substance misuse continues to be a significant problem during pregnancy and is on the increase. Consequently, neonatologists are encountering an increasing number of infants born with symptoms of neonatal abstinence syndrome (NAS). Non-pharmacological measures are an effective means of managing infants with NAS and should be used in the first instance, however, most neonatal units do not have a guideline describing the non-pharmacological pathway, which is centred around promoting maternal involvement in care, minimising stimuli and increasing staff education. We outline the important aspects of non-pharmacological management of infants with NAS to encourage soothing strategies prior to the use of medications.

Raju Sunderesan
Consultant Neonatologist
University Hospital Crosshouse, Kilmarnock, Scotland

Christopher Cox
Senior House Officer
Taranaki Base Hospital, New Plymouth,
New Zealand

Sunderesan R., Cox C. Non-pharmacological management in neonatal abstinence syndrome: an overview. Infant 2023; 19(3): 105-10.

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non-pharmacological; neonatal abstinence syndrome (NAS); lighting; music therapy
Key points
  1. Non-pharmacological interventions should be the cornerstone for management of infants with NAS. Such methods show improved outcomes for babies and reduced length of hospital stay and use of pharmacological treatments.
  2. Non-pharmacological interventions are easy to implement and cost effective. Staff education is an integral part of management.
  3. Empowering the mother as principal caregiver is key to the success of managing babies without medications.
  4. Pharmacotherapy should be reserved for infants with severe NAS.

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