Neonatal abstinence syndrome : breastmilk and formula milk selection

Abstract

The objective of this dissertation is to investigate the effect of breastfeeding on Neonatal Abstinence Syndrome (NAS). Neonatal abstinence syndrome is a series of comorbidities, signs and symptoms, that occur in newborns experiencing withdrawal symptoms from opioids after exposure during the prenatal phase. NAS presents as hyperactivity of the central and autonomic nervous system. NAS can also be defined as neonatal opioid withdrawal. Mothers´ use of opioids during pregnancy can have a devastating effect on both the maternal and infant health and is linked to poor fetal outcomes. A systematic literature search related to newborn feeding methods in neonates with NAS was conducted through the platforms of PubMED, HyDi and EBSCOhost. The search was aimed at answering the PICO question: “Does breastmilk, in comparison to formula milk, decrease withdrawal symptoms and the length of hospitalisation for babies with NAS?”, where the population is newborn infants with NAS (or at risk of), the intervention is breastmilk, comparison variable is formula milk and the outcome length of hospitalisation. Studies eligible for inclusion met the following criteria: published in the English language between the years 2011 and 2021. A PRISMA process was carried out to ensure a structured search. Five articles were selected and appraised by using CASP tools. Research indicates that breast feeding decreases the incidence and duration of pharmacological treatment, length of hospital stay and severity of NAS symptoms in newborns exposed to methadone in utero. The researcher put forward several recommendations for practice, management, education and research. Healthcare providers and other stakeholders need to work collaboratively to educate addicted mothers, and their relatives, on the benefits of breastfeeding. Ongoing holistic support needs to be maintained to encourage and facilitate breastfeeding when possible. In view that research related to the subject of feeding methods and NAS in the local scene is very limited, the researcher recommends that a quantitative study is carried out to investigate the phenomenon in Malta.