Breastfeeding and Formula Selection in Neonatal Abstinence Syndrome

Area of Science:

• Neonatal care
• Pediatric nutrition
• Clinical outcomes research

Background:

• Neonatal Abstinence Syndrome (NAS) management requires careful consideration of infant feeding methods.
• The optimal formula choice for NAS infants remains unclear, with limited data comparing standard, low lactose, and breast milk feeding.

Purpose of the Study:

• To evaluate the impact of formula selection (low lactose vs. standard term formula) on clinical outcomes in Neonatal Abstinence Syndrome (NAS) infants.
• To compare these formula feeding outcomes with those of breastfed infants.

Main Methods:

• A retrospective cohort study analyzed 249 neonates (≥35 weeks gestation) diagnosed with NAS.
• Feeding methods were categorized as majority standard formula, majority low lactose formula, or majority breast milk.
• Primary outcomes included length of stay (LOS) and length of pharmacologic treatment (LOT); secondary outcome was daily weight change.

Main Results:

• No significant differences were observed in LOS, LOT, or daily weight change between infants fed standard term formula and those fed low lactose formula.
• Breastfeeding was associated with a significant reduction in LOT (6.9-10.8 days) and LOS (7.4-10.3 days) compared to both formula groups.
• Infants fed breast milk showed a greater positive daily weight change compared to those fed formula.

Conclusions:

• Low lactose formula does not provide a demonstrable benefit over standard term formula for NAS infants regarding LOS, LOT, or weight change.
• Breastfeeding is associated with significant clinical improvements in LOS and LOT for NAS infants.
• While beneficial for LOS and LOT, breastfeeding may be associated with a greater initial weight loss in NAS infants.