Gallegos Juan A, Serke Laura, Feygin Yana, Jawad Kahir, Robinson Tonya, Telang Sucheta
Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky.
Department of Pediatrics, Dell Medical School, University of Texas, Austin, Texas.
Am J Perinatol. 2025 Apr;42(6):742-750. doi: 10.1055/a-2418-9886. Epub 2024 Oct 10.
The rising incidence of neonatal abstinence syndrome (NAS) has amplified the importance of nonpharmacological interventions in its management, which include the selection of feedings. With the goal of obtaining an accurate assessment of the effects of current feeding practices in NAS infants in our neonatal intensive care unit, we conducted a retrospective review of NAS infants at our hospital over a 3-year period to determine their nutritional selections and evaluate their length of stay (LOS), length of treatment (LOT), and growth outcomes.Retrospective chart review of term infants (≥37 weeks of gestation) with NAS. Maternal and infant demographics and characteristics were recorded. Infants were grouped based on majority (>50% of total feeding) nutritional selections and LOS, LOT, and growth parameters were evaluated. Linear regression was used to compare group outcomes. Significance was set at a -value <0.05.A total of 70 infants were included and grouped based on majority feeds into maternal breast milk (MBM), standard term formula (STF), low lactose formula (LLF), and extensively hydrolyzed formula (EHF) groups. Feeding selections were provider-dependent and infants were placed on MBM or STF as an initial selection. In all infants included in our review, LLF was selected as the first choice following MBM or STF for increased gastrointestinal (GI) disturbance-related Finnegan Neonatal Abstinence Scoring scores and changed to EHF if LLF failed to improve the GI-related symptoms. The STF-fed infants had the shortest LOS, and none of these infants required pharmacological treatment. The LOT and LOS were similar in the MBM- and LLF-fed groups. Infants who were EHF fed had the longest LOT and LOS. All feeding groups demonstrated appropriate growth.Nutritional selections in our NAS infants were modified for the severity of their withdrawal symptoms. All nutritional modifications driven by severity of withdrawal symptoms supported favorable growth outcomes in the infants. · Our NAS infants were fed with multiple types of nutrition.. · Infants with severe NAS required more elemental feeds.. · All formula selections supported favorable growth..
新生儿戒断综合征（NAS）发病率的上升凸显了非药物干预措施在其管理中的重要性，其中包括喂养方式的选择。为了准确评估当前喂养方式对我们新生儿重症监护病房中NAS婴儿的影响，我们对我院3年内的NAS婴儿进行了回顾性研究，以确定他们的营养选择，并评估他们的住院时间（LOS）、治疗时间（LOT）和生长结果。
对患有NAS的足月儿（≥37周妊娠）进行回顾性病历审查。记录母婴人口统计学和特征。根据主要营养选择（占总喂养量的>50%）对婴儿进行分组，并评估LOS、LOT和生长参数。使用线性回归比较组间结果。显著性设定为P值<0.05。
共纳入70名婴儿，并根据主要喂养方式分为母乳（MBM）、标准足月儿配方奶（STF）、低乳糖配方奶（LLF）和深度水解配方奶（EHF）组。喂养选择取决于医护人员，婴儿最初的选择是MBM或STF。在我们纳入审查的所有婴儿中，由于与胃肠道（GI）紊乱相关的芬尼根新生儿戒断评分增加，LLF被选为继MBM或STF之后的首选，如果LLF未能改善与GI相关的症状，则改为EHF。接受STF喂养的婴儿住院时间最短，且这些婴儿均无需药物治疗。MBM喂养组和LLF喂养组的LOT和LOS相似。接受EHF喂养的婴儿LOT和LOS最长。所有喂养组均显示生长正常。
我们的NAS婴儿的营养选择根据其戒断症状的严重程度进行了调整。所有由戒断症状严重程度驱动的营养调整均支持婴儿良好的生长结果。
· 我们的NAS婴儿接受了多种类型的营养喂养。
· 患有严重NAS的婴儿需要更多的要素喂养。
· 所有配方奶选择均支持良好的生长。
