More Conservative Approach Improves Outcomes for Opioid-Exposed Infants

A new study suggests that a more conservative approach to medicating infants born with neonatal opioid withdrawal syndrome (NOWS) can lead to shorter hospital stays and more effective outcomes.

Published in the journal Hospital Pediatrics, the study compared a symptom-driven approach developed at Boston Medical Center with a fixed-schedule medication approach using methadone that is dosed every eight hours. The symptom-triggered approach focuses on keeping infants comfortable and “helps reduce the incidence of creating a dependence on the opioid medication, which can sometimes occur with the traditional fixed scheduled medication approach,” states a news release from Boston Medical Center.

The researchers found that infants receiving symptom-driven care had 5.6 fewer days of methadone treatment than the group receiving fixed-schedule treatment. Those receiving the more flexible treatment also had a median hospital stay of 10.5 days, compared with 17 days for the fixed-schedule group. All of the infants in the symptom-driven treatment group had been successfully treated by the end of the study period, with no adverse events reported.

Rates of NOWS have climbed over the course of the opioid crisis. An estimated 50 to 80% of opioid-exposed infants need medication to manage withdrawal symptoms that usually appear two to three days after birth.