Skin-to-skin interventions in infants with neonatal abstinence syndrome

Abstract

BACKGROUND: The prevalence of neonatal abstinence syndrome (NAS) is on the rise in the United States, as the epidemic of opioid misuse continues1. Several infants with in utero exposure to opioids are born with NAS, and exhibit symptoms of withdrawal and dependence upon birth when the maternal source of opioid is discontinued2. Due to the novelty of the syndrome, there are several knowledge gaps in current literature that remain to be explored. LITERATURE REVIEW: The exact mechanism of development of NAS in infants remains unknown, yet the clinical symptomatology and results of a few recent studies suggest that there is an association with NAS severity and dysregulation of autonomic nervous system (ANS) functioning in these infants3. In recent years, pharmacological treatments for these infants have become standardized4. However, non-pharmacological treatments have been adopted from treatment guidelines of other high-risk infant populations and their efficacy warrants further evaluation in infants with NAS. Kangaroo care (KC) is a supportive therapy commonly applied to many high-risk infant populations because of its physiologically stabilizing effects5. The therapy has been demonstrated to be especially beneficial in the treatment of preterm infants, a population that similarly requires additional maturation of their ANS upon birth,6. Neurobehavioral theories suggest ANS functioning in infancy is a strong predictor of long-term social, behavioral, and cognitive development outcomes7,8. PROPOSED PROJECT: This prospective cohort study is designed to provide pilot data to establish if KC can be utilized to mature ANS maturation in infants with NAS. CONCLUSIONS AND SIGNIFICANCE: KC is an inexpensive, readily available, low risk intervention that could improve neurobehavioral outcomes in infants with NAS. The results of this study could reduce clinical symptoms, potentiate long-term behavior outcomes, and better define treatment practices for infants with NAS by facilitating a targeted intervention to improve outcomes.