Approximately 22,000 babies are born in the United States each year experiencing withdrawal from drugs because of exposure during pregnancy, according to the Centers for Disease Control and Prevention. New research suggests a different approach to treating these newborns could help them recover faster and leave the hospital sooner.
A clinical trial funded by the National Institutes of Health found that symptom-based treatment for babies with neonatal opioid withdrawal syndrome (NOWS) could reduce the time they need medication and shorten their hospital stays.
NOWS occurs when babies exposed to opioids before birth experience withdrawal after delivery.
Doctors often treat newborns with moderate to severe symptoms by administering opioid medication on a set schedule and gradually reducing the dose as symptoms improve. However, the new study found that giving medication only when babies showed signs of withdrawal that met a specific threshold helped them stop treatment sooner and go home an average of two days earlier.
“Scheduled opioid dosing, which includes a taper, is necessary for some infants with NOWS, however it may overtreat others,” said study author Dr. Lori Devlin, a professor of pediatrics at the University of Louisville and Norton Children’s Neonatology. “The idea is that by matching treatment to disease severity, we can accelerate recovery and minimize exposure.”
The study included 383 infants with moderate to severe NOWS who received care through the family-centered Eat, Sleep, Console approach.
Of those infants, 194 received scheduled opioid doses that were gradually reduced once their withdrawal symptoms were under control. The other 189 received medication only when their symptoms reached a predetermined level of severity. Additional doses were given if symptoms again reached that threshold.
Since the trial, several participating hospitals have adopted the symptom-based strategy. Researchers say the findings could help guide its use at other hospitals.
“The opioid epidemic is still a huge problem, but this is a simple and powerful way we can get these babies ready to go home faster. This is best for their family and for their own development,” said study co-author Dr. Augusto Schmidt.
