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
raju.sunderesan@aapct.scot.nhs.uk

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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Keywords
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.

Also published in Infant:

VOLUME 16/ISSUE 2, MARCH 2020
A multidisciplinary approach to the implementation of non-pharmacological strategies to manage infant pain
Newborn infants, both term and preterm, endure many painful procedures when receiving treatment on a neonatal intensive care unit. Unmanaged neonatal pain can have a negative influence on short- and long-term neurodevelopmental outcomes and can also impact on parental wellbeing. While clinicians are aware of the efficacy of non-pharmacological strategies to reduce pain, these are not always implemented into neonatal care. This article summarises efforts made by a multidisciplinary team to improve the use of non-pharmacological approaches in the management of infant pain during procedures on a level 2 neonatal unit

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