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Early Weight Loss Percentile Curves and Feeding Practices in Opioid-Exposed Infants

Frances Y Cheng, Veronika Shabanova, Adam K Berkwitt

    Hospital Pediatrics
    |September 8, 2022
    PubMed

    Insights

    Infants with neonatal opioid withdrawal syndrome (NOWS) managed with the eat, sleep, console approach experienced greater weight loss than typical infants. Further research is needed to optimize feeding strategies for these newborns.

    Area of Science:

    • Neonatal care
    • Pediatric pharmacology
    • Infant nutrition

    Background:

    • Neonatal Opioid Withdrawal Syndrome (NOWS) is a growing concern, often managed with non-pharmacologic approaches like eat, sleep, console.
    • Understanding infant weight loss patterns is crucial for assessing health outcomes in NOWS.
    • Existing data on weight loss in NOWS infants managed with eat, sleep, console is limited.

    Purpose of the Study:

    • To describe the weight loss patterns of infants hospitalized with NOWS who were managed using the eat, sleep, console approach.
    • To compare the weight loss of these infants to established early weight loss nomograms.

    Main Methods:

    • Retrospective analysis of 744 infants with NOWS, with 330 meeting inclusion criteria (≥35 weeks gestation, no NICU transfer).
    • Weight loss percentile curves were generated by delivery type using mixed-effects quantile modeling.
    • Comparison of 95% confidence intervals for weight loss to published early weight loss nomograms.

    Main Results:

    • Infants with NOWS managed by eat, sleep, console showed significantly greater weight loss at 48 and 72 hours compared to nomograms for both vaginal and cesarean deliveries (P < .001).
    • Median weight loss at 48 hours was 6.9% for vaginally-delivered and 6.5% for cesarean-delivered infants.
    • Overall, 27.9% of infants lost more than 10% of their birth weight.

    Conclusions:

    • Infants with NOWS managed with the eat, sleep, console approach exhibit distinct weight loss patterns, losing more weight than non-opioid-exposed infants.
    • These findings highlight potential increased risks for morbidity and healthcare utilization in NOWS infants.
    • Further studies are warranted to investigate optimal feeding practices for infants with NOWS.
    Abstract

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