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Published on: August 25, 2014
Early postnatal weight changes in opioid-exposed infants managed using the Finnegan Neonatal Abstinence Scoring
Emma Dennison1, Helen Coo2, Faiza Khurshid2
1Queen's School of Medicine, Queen's University, Kingston, ON, Canada.
Insights
Eat, Sleep, Console (ESC) management for neonatal abstinence syndrome (NAS) did not increase infant weight loss compared to the Finnegan Neonatal Abstinence Scoring System (FNASS). Breastfeeding support is recommended during ESC transitions.
Area of Science:
- Neonatal care
- Pediatric pharmacology
- Infant health
Background:
- Neonatal Abstinence Syndrome (NAS) management has clinical benefits.
- Concerns exist regarding Eat, Sleep, Console (ESC) and infant postnatal weight loss.
- This study addresses the safety of ESC in comparison to the Finnegan Neonatal Abstinence Scoring System (FNASS).
Purpose of the Study:
- To compare early postnatal weight changes in opioid-exposed infants managed with ESC versus FNASS.
- To evaluate the impact of different management systems on infant weight dynamics.
Main Methods:
- Retrospective analysis of medical records for opioid-exposed infants (July 2017-May 2023).
- Comparison of weight changes and feeding types (breastfeeding, formula, combination) between FNASS and ESC groups.
- Statistical analysis controlling for feeding type.
Main Results:
- Feeding types differed significantly between groups: FNASS infants more often exclusively breastfed, ESC infants more often formula-fed.
- No significant differences in daily weight changes were observed between FNASS and ESC groups after controlling for feeding type.
- Average daily weight change during hospitalization did not significantly differ between the two management approaches.
Conclusions:
- The study found no evidence of excessive postnatal weight loss in infants managed with ESC compared to FNASS.
- Findings suggest that breastfeeding promotion and support are crucial when transitioning from FNASS to ESC.
- ESC is a viable management strategy for NAS without compromising early infant weight gain.
Abstract:
BackgroundDespite the many clinical benefits of Eat, Sleep, Console (ESC) to manage infants with neonatal abstinence syndrome (NAS), a recent article theorized that ESC may place infants at an increased risk of excessive postnatal weight loss. The objective of this study was to compare weight changes in the early postnatal period among infants exposed to opioids in utero and managed using 1) the Finnegan Neonatal Abstinence Scoring System (FNASS) or 2) ESC.MethodsPre-post analysis of medical records for opioid-exposed infants born July 1, 2017-May 31, 2023. Type of feeding (exclusive breastfeeding, formula only, combination) and weight changes were compared between the FNASS (n = 45) and ESC (n = 25) groups.ResultsType of feeding differed significantly between the groups during the first 5 days of life and at discharge: higher proportions of the FNASS group were exclusively breastfed and higher proportions of the ESC group received formula. There were no significant differences in daily weight changes over the first 5 days of life when we controlled for type of feeding. The average daily weight change during hospitalization did not differ significantly between the two groups (FNASS: median = -53.3 grams/day [IQR: -65.2, -40.8]; ESC: median = -45.9 [IQR: -57.8, -25.5]; p = 0.19).ConclusionsWe found no evidence of excessive weight loss in the early postnatal period among opioid-exposed infants managed using ESC as compared to FNASS. However, our findings suggest that breastfeeding should be more actively promoted and supported when centers transition from the FNASS model to ESC.
