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 Researchers examined data from six previously published studies with
a total of 549 babies. Compared to opioid-exposed newborns treated
in neonatal intensive care units (NICUs), infants who “roomed-in”
with their mothers were 63 percent less likely to receive drugs like
morphine or methadone for withdrawal symptoms, the study found.
With rooming-in, these babies also tended to leave the hospital
about ten days sooner than infants treated in the NICU, a difference
that might be explained by fewer complications or better quality
care.
“Our findings support rooming-in as the standard of care for opioid-exposed
newborns, suggesting that mothers should be viewed as the first-line
treatment for these infants,” said study co-author Kanak Verma, a
researcher at the Geisel School of Medicine at Dartmouth in Hanover,
New Hampshire.
Within days after delivery, babies exposed to opioids during
pregnancy can develop neonatal abstinence syndrome, which can
include increased muscle tone, tremors, sweating, vomiting, and
diarrhea.
Amid a worsening national opioid crisis, a growing number of infants
are being born addicted to these narcotics and suffering withdrawal
symptoms. Between 1999 and 2013, the proportion of infants with
neonatal abstinence syndrome surged from 1.5 in 1,000 to 6 in 1,000,
researchers note in JAMA Pediatrics.
Standard care for these babies often includes a stint in the NICU
and medications to ease withdrawal symptoms. But the current
findings offer fresh evidence that opioid-exposed babies - like
other newborns - may benefit more from a mother’s touch than the
exposure to bright lights and loud sounds in the NICU.
“We believe that room-in improves outcomes by optimizing early
bonding and facilitating attachment between mother and infant,”
Verma said by email. “Parents and caregivers have an opportunity to
take a more active role in their infant’s care, allowing for
increased skin-to-skin contact, breastfeeding and cuddling with
their newborn.”
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Babies appeared to have a higher likelihood of breastfeeding and
better odds of being discharged home to live with their family after
rooming-in than after a stay in the NICU, although few studies in
the analysis examined this.
Three of the studies in the current analysis also suggested that the
cost of care may be cheaper with rooming-in than with the NICU.
The study wasn’t a controlled experiment designed to prove whether
or how rooming-in might directly improve outcomes or lower costs for
treating opioid-exposed newborns.
Another drawback is that the smaller studies in the analysis used a
variety of designs and measured different things, making it hard to
measure the effects of rooming-in, the authors note.
While the studies add to the evidence that rooming-in may benefit
babies, in the case of neonatal abstinence syndrome hospitals must
ensure that the mothers are drug-free and able to care for infants
before choosing this option instead of the NICU, said Joshua Brown,
a researcher at the University of Florida College of Pharmacy in
Gainesville who wasn’t involved in the study.
“No matter newborn status/health, rooming-in should be advocated to
increase skin-to-skin time, breastfeeding and a loving environment,”
Brown said by email. “However, the health and safety of a newborn
have to be defended, and in the case of neonatal abstinence syndrome
births, the mothers’ situation must be thoroughly vetted by hospital
staff to ensure that the room environment is safe and nurturing and
breast milk is free of opioids.”
SOURCE: http://bit.ly/2nFW6Pp JAMA Pediatrics, online February 5,
2018.
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