The Evaluation of Nonpharmacological Interventions With Neonatal Abstinence Syndrome (NAS)

Abstract Problem Statement and Background: The prevalence of neonatal abstinence syndrome (NAS) is increasing, as is the need for evidence-based interventions to treat it. While both pharmacological and nonpharmacological methods are used, nonpharmacological methods are the focus of this review. One hospital’s protocol for treating NAS includes the nonpharmacological interventions of swaddling, rooming-in, and decreasing stimulation. Breastfeeding may also help in treating NAS. Purpose and Research Question: To determine if the nonpharmacological interventions in this hospital’s protocol reflect evidence-based practice and if the literature supports the practice of breastfeeding for the treatment of NAS. The research question addressed is: Do these interventions decrease adverse manifestations, length of stay, and need for pharmacological interventions in infants with NAS? Review of Literature: Swaddling may decrease excessive crying and pain in infants with NAS. Kangaroo care may calm infants with NAS, but further research is needed. Rooming-in can decrease the length of stay and amount of pharmacological interventions needed. No studies on decreased stimulation were found. As for breastfeeding, drug levels in the breast milk of women on drug therapy are low. Breastfeeding may decrease the length of stay and need for pharmacological treatment. Conclusions—Recommendations for Practice: The nonpharmacological interventions mentioned above may have positive effects on infants with NAS, including decreasing length of stay and need for pharmacological intervention, and should be included in their plan of care