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Risk of Feeding Problems Among Infants With Neonatal Abstinence Syndrome: A Retrospective Cohort Study
Nana A Mensah1, Erin F Madden, Fares Qeadan
1Department of Family and Preventive Medicine, University of Utah, Salt Lake City (Ms Mensah and Dr Qeadan); and Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, Michigan (Dr Madden).
Insights
Infants with neonatal abstinence syndrome (NAS) are almost three times more likely to experience feeding problems. This highlights the need for specialized feeding interventions for these vulnerable infants.
Area of Science:
- Neonatal care
- Pediatric nutrition
- Public health
Background:
- Neonatal Abstinence Syndrome (NAS) incidence surged over 500% from 2004-2016.
- Feeding issues in infants with NAS are documented but not quantified.
- The precise risk of feeding problems in NAS infants remains unestimated.
Purpose of the Study:
- To quantify the risk of feeding problems in infants diagnosed with NAS.
- To compare feeding problem incidence in infants with and without NAS.
Main Methods:
- Retrospective cohort study (2008-2017) using US hospital admission data.
- Matched analysis of infants with and without NAS diagnoses.
- Multivariable logistic regression to identify associations with feeding problems.
Main Results:
- Infants with NAS were 2.81 times more likely to have feeding problems (OR=2.81; 95% CI, 2.68-2.95).
- Lower birth weight, older infant age, Hispanic ethnicity, and Midwest location were associated with increased feeding problem risk.
- NAS infants with feeding issues had lower odds of receiving lactation services.
Conclusions:
- Findings indicate a significantly higher risk for feeding problems in infants with NAS.
- Targeted feeding interventions are crucial for infants diagnosed with NAS.
- Further research should explore maternal factors influencing NAS and feeding difficulties.
Background:
The rate of infants born with neonatal abstinence syndrome (NAS) increased by more than 500% between 2004 and 2016. Although feeding problems among infants diagnosed with NAS have been documented, the risk of feeding problems among infants diagnosed with NAS has not been estimated.
Purpose:
This study evaluates the extent to which feeding problems among infants diagnosed with NAS differ from thise in infants without an NAS diagnosis.
Methods/Search Strategy:
A matched retrospective cohort study (2008-2017) of infants diagnosed with NAS in the United States was conducted using hospital admission data from the Cerner Health Facts Database. Multivariable logistic regressions controlling for confounders were used to assess whether an NAS diagnosis is associated with hospital admission due to feeding problems.
Findings/Results:
Infants with NAS were nearly 3 times as likely (OR = 2.81; 95% CI, 2.68-2.95) to have feeding problems compared with infants without NAS after adjusting for infant and hospital characteristics. Lower birth weight, higher infant age, Hispanic ethnicity, and hospital location in the Midwest region were also associated with higher odds of feeding problems. Infants diagnosed with NAS who had feeding problems had slightly lower odds of being offered lactation services than infants without NAS who had feeding problems.
Implications For Practice:
These findings suggest the need for targeted feeding interventions.
Implications For Research:
Future research on infants with NAS may build on these findings by assessing the role of maternal factors such as nutrition and substance use to understand how parental characteristics also influence the risk for hospitalization.
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