Effects of Breastfeeding on NAS Symptom Severity, Infant Pharmacologic Use, and Length of Hospital Stay [12O]

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 135 Suppl 1; no. 1; pp. 159S - 160S
• Main Authors: Turkheimer, Lena, Valea, Fidel A, Simcox, Kimberly, Hays, Jacinda
• Format: Journal Article
• Language: English
• Published: by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved 01.05.2020
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/01.AOG.0000663776.80827.2a

INTRODUCTION:Prenatal opioid maintenance therapy (OMT) exposure is associated with neonatal abstinence syndrome (NAS) (Finnegan, Connaughton et al., 1975). Our study examines the effects of breastfeeding on NAS symptom severity, pharmacologic use, and length of treatment. METHODS:Data was extracted retrospectively from the medical charts of 74 infants born to mothers on OMT at Carilion Roanoke Memorial Hospital (CRMH) and analyzed using propensity score matching, which examines group differences in outcome while controlling for pre-existing differences in background variables (Rosenbaum & Rubin, 1985). IRB approval was obtained. RESULTS:Of the sixty infants included, at five days old thirty were being fed formula only, thirteen were breastfed only, and seventeen were fed both breastmilk and formula. Propensity score matching was used to match the thirteen breastmilk only infants to thirteen of the formula-only infants. Mean peak NAS Finnegan scores in the formula and breastmilk groups were 11.54 and 6.54, respectively (P=.03). Mean length of infant pharmacologic treatment was 1.46 months for formula fed infants and .33 months for breastfed infants (P=.02). Among matched pairs with one infant receiving pharmacologic treatment and one not receiving treatment, the formula fed infant was more likely to have received pharmacologic treatment (P=.04). CONCLUSION:This study shows that breastfeeding decreases symptom severity, infant pharmacologic use and length of pharmacologic treatment. The use of propensity matching accounts for confounding variables more appropriately than previous studies, likely increasing the reliability of the findings.