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Table 2 Studies of the nonpharmacologic management of neonatal management syndrome

From: Review of the assessment and management of neonatal abstinence syndrome

Reference Study design Study objective Index vs. reference group(s) Assessment tool Results
Abdel-Latif, 2006[38] Retrospective Cohort To determine association between breastfeeding and NAS outcomes Breastfed infants with NAS (n = 85) Finnegan Score Rx for NAS: OR = 0.36 (CI 0.18–0.71)*
   Formula-fed infants with NAS (n = 105)   Mean LOS: 14.7 (SD 14.9) vs. 19.1 (SD 15.0) days*
Dryden, 2009[42] Retrospective Cohort To determine association between breastfeeding and NAS outcomes Breastfed infants with NAS (n = 99) Modified Lipsitz Rx for NAS: OR = 0.55 (CI 0.34–0.88)*
   Formula-fed infants with NAS (n = 351)   
McQueen, 2011[39] Retrospective Cohort To determine association between breastfeeding and NAS outcomes Breastfed infants with NAS (n = 8) Modified Finnegan Mean # of NAS scores: 25.0 (SD 23.5) vs. 56.2 (SD 39.1) vs. 95.6 (SD 34.6)*
   Combination-fed infants with NAS (n = 11)   Mean NAS score 4.9 (SD 2.9) vs. 6.5 (SD 3.7) vs. 6.9 (SD 4.2)*
   Formula-fed infants with NAS (n = 9)   
Pritham, 2012[43] Retrospective Cohort To determine association between breastfeeding and NAS outcomes Breastfed with NAS (n = 14) Not specified Mean LOS: -3.3 (SE 1.7) days
   Infants combination-fed with NAS (n = 22)   
   Formula-fed infants with NAS (n = 96)   
O’Connor, 2013[40] Case Series To describe association between breastfeeding and NAS outcomes Breastfed infants with NAS (n = 65) Modified Finnegan Mean NAS score: 8.83 (SD 3.56) vs. 9.65 (SD 2.58)
   Formula-fed infants with NAS (n = 20)   Rx for NAS: 23.1% vs. 30.0%
Wachman, 2013[9] Prospective Cohort To determine association of genetic variables with NAS outcomes Breastfed infants with NAS (n = 38) Modified Finnegan Rx for NAS: 50% vs. 77%*
   Formula-fed infants with NAS (n = 48)   Mean LOS: 15.8 (CI 11.5–20.1) vs. 27.4 (CI 22.5–32.3) days*
Welle-Strand, 2013[41] Ambi-directional Cohort To determine association between breastfeeding and NAS Breastfed infants with NAS (n = 95) Modified Finnegan Rx for NAS: 53% vs. 80%*
   outcomes Formula-fed infants with NAS (n = 29)   Mean length of Rx: 28.6 (SD 19.1) vs. 46.7 (SD 26.3) days*
Hunseler, 2013[44] Retrospective Cohort To describe association between rooming-in and NAS outcomes NAS infants exposed to rooming-in (n = 24) Finnegan Finnegan Score > 12: 6.3% vs. 6.4%
   Control NAS infants (n = 53)   Rx for NAS: 79.2% vs. 88.7%
     Mean length of Rx: 27 vs. 32.5 days
     Mean LOS: 38 vs. 41.5 days
Abrahams, 2007[45] Retrospective Cohort To describe association between rooming-in and NAS outcomes Infants with NAS exposed to rooming-in (n = 32) Modified Finnegan Mean length of Rx: 5.9 vs. 18.6 days*; 5.9 vs. 18.6 days*
    Control infants with NAS (n = 38) (historical comparison)   Mean LOS: 11.8 vs. 23.5 days; 11.8 vs. 25.9 days*
   Control infants with NAS (n = 36) (from another institution)   
D’Apolito, 1999[46] Nonblinded Random Assignment of Rx To determine the association between infants sleeping in a rocking bed vs. controls with NAS outcomes Infants with NAS exposed to rocking bed (n = 7) Finnegan Mean NAS score on day 7 of intervention: 10.2 (SD 2.1) vs. 8.0 (SD 1.8)
   Control infants with NAS (n = 7)   
Oro, 1988[47] Randomized Assignment of Rx with Matched Controls To determine the association between infants sleeping in a waterbed vs. controls and NAS outcomes Infants with NAS exposed to a waterbed (n = 15) Finnegan Maximum NAS score: 6.2 (SD 0.7) vs. 6.4 (SD 1.0)
   Control infants with NAS (n = 15)   Mean LOS: 10.5 (SD 1.2) vs. 11.5 (SD 3.4) days
Maichuk, 1999[48] Randomized to Intervention; Nurses Blinded to Hypothesis To determine the association between sleeping position with NAS outcomes Infants with NAS placed in prone position (n = 25) Finnegan Maximum NAS score: 10.52 (SD 2.08) vs. 13.17 (SD 2.03)*
   Infants with NAS placed in the supine position (n = 23)   Mean NAS score: 5.11 (SD 0.64) vs. 7.60 (SD 0.70)*
Filippelli, 2012[49] Case Series To describe the possible effects of NIA on infants with NAS Infants with NAS exposed to NIA (n = 54) Not applicable Chart review revealed improvements in calming, sleep, and feeding
  1. Abbreviations: NAS Neonatal Abstinence Syndrome, Rx Treatment, # Number, LOS Length of Hospital Stay, OR Odds ratio, CI 95% confidence interval, SD Standard deviation, SE Standard error.
  2. *p < 0.05.