Holmes Amy P, Schmidlin Holly N, Kurzum Eliana N
Pharmacy Department, Novant Health Forsyth Medical Center, Winston Salem, North Carolina.
Wake Forest Baptist Medical Center, Winston Salem, North Carolina.
Pharmacotherapy. 2017 Jul;37(7):861-869. doi: 10.1002/phar.1944. Epub 2017 Jun 22.
Breastfeeding offers many benefits to both mother and baby. Breastfeeding is generally recommended for mothers of infants with neonatal abstinence syndrome (NAS) unless some associated risk outweighs the benefits. Evidence indicates that infants with NAS who receive human milk require less pharmacologic treatment and have shorter hospital lengths of stay. Perhaps the greatest barrier to breastfeeding for women with opioid dependence is the inaccurate and inconsistent information they receive from different sources, including health care professionals. The American Congress of Obstetricians and Gynecologists, American Academy of Pediatrics, and Academy of Breastfeeding Medicine (ABM) have published statements that support breastfeeding infants with NAS. The ABM has a dedicated protocol to guide clinicians in deciding which mothers should and which mothers should not breastfeed their infants. In this review, studies evaluating the effects of breastfeeding, professional organizations' protocols and recommendations regarding breastfeeding, and barriers to breastfeeding infants with NAS are discussed, as well as the dangers of illicit drug exposure and avoiding rebound NAS in a breastfed infant. Clinicians can play an important role in in identifying, supporting, counseling, and advocating for mothers who wish to breastfeed their infant with NAS.
母乳喂养对母亲和婴儿都有诸多益处。一般建议患有新生儿戒断综合征（NAS）的婴儿的母亲进行母乳喂养，除非某些相关风险超过了益处。有证据表明，接受母乳的NAS婴儿需要的药物治疗较少，住院时间也较短。对于有阿片类药物依赖的女性来说，母乳喂养的最大障碍可能是她们从包括医疗保健专业人员在内的不同来源获得的信息不准确且不一致。美国妇产科医师大会、美国儿科学会和母乳喂养医学学会（ABM）都发表了支持对NAS婴儿进行母乳喂养的声明。ABM有专门的协议来指导临床医生决定哪些母亲应该以及哪些母亲不应该母乳喂养她们的婴儿。在这篇综述中，讨论了评估母乳喂养效果的研究、专业组织关于母乳喂养的协议和建议，以及母乳喂养NAS婴儿的障碍，还有非法药物暴露的危险以及避免母乳喂养婴儿出现反弹性NAS的问题。临床医生在识别、支持、咨询和倡导希望母乳喂养其NAS婴儿的母亲方面可以发挥重要作用。
