No description available.

Background: The incidence of neonatal opioid withdrawal syndrome (NOWS), a drug withdrawal syndrome mainly associated with opioid exposure in-utero has significantly increased in the United States over the last decade with infants with NOWS staying longer in the hospital than those without NOWS. Objectives: To determine if feeding tube use while on admission is associated with length of hospital stay among infants diagnosed with NOWS. We also compared the differences between infants with NOWS who required the use of feeding tubes while on admission, and those that did not, based on infant and maternal characteristics. Methods: This was a retrospective cohort study of infants delivered between July 1, 2011 and June 30, 2016 at Ballad Health System. Our inclusion criteria were infants who were exposed to opioids in-utero and received a diagnosis of NOWS based on 2 consecutive Finnegan scores of 10, or 3 consecutive scores of 8, or treatment with morphine. Medical chart record of 294 infants who met these criteria were reviewed for infant and maternal characteristics. Our outcome variable was infant length of hospital stay and our predictor variable was feeding tube use an indicator for feeding difficulties. Chi-square test and t-test were used to compare infant and maternal characteristics by feeding tube use. Simple linear regression models were used to assess the effect of feeding tube use and infant and maternal characteristics on infant length of hospital stay. Multiple linear regression was used to model infant length of hospital stay predicted by feeding tube use, while adjusting for neonatal intensive care unit (NICU) admission, treatment with morphine, and maternal benzodiazepine use during pregnancy. All analyses were done using SAS 9.4. Results: Of the 294 infants diagnosed with NOWS, 22.11% had feeding difficulties that necessitated use of feeding tubes. Infants who used feeding tubes were significantly more likely to be born preterm (20.31% vs 8.73%, p=0.0096) to be admitted into the NICU (98.46% vs 51.09%, p=

Opioid use disorder (OUD) impacts 5.6 million people in the US. Buprenorphine (BUP) is a commonly prescribed opioid medication used to treat OUD, including in pregnant women. However, opioid use during pregnancy is associated with poorer infant outcomes including reduced fetal growth, neurodevelopmental deficits, and neonatal opioid withdrawal syndrome (NOWS). Recent clinical data suggests that providing mothers with a lower dose of BUP may result in fewer negative outcomes in infants. Here, a preclinical rodent model of low-dose perinatal BUP exposure was used to study offspring health outcomes in the neonate, juvenile, and adolescent offspring. Dams were given clinically relevant doses of BUP prior to and throughout gestation, and continuing through weaning to mimic human doses and exposure. Although the lowest BUP dose still elicited signs of NOWS in offspring, there were fewer negative effects on overall brain morphology across the early lifespan than that of the higher BUP dose compared to controls.

No description available.

This study examined healthcare professionals’ perceptions on feeding difficulties experienced by infants with NOWS, the involvement of SLP in care, knowledge and experience levels of professionals, and trends in education and follow up care. A 34-question survey was developed to obtain data from participants involved in the care of exposed infants using the secure webbased RedCap™ platform. Nonparametric inferential statistics and descriptive analysis were used to interpret data. Feeding difficulties in infants exposed were reported by all respondents with SLP involvement reported by 42.2%. Results found that 51.9% of respondents were confident in their ability to educate families about feeding difficult with 60% reported inadequate time to provide education. Discharge follow up was inconsistent amongst facilities. The study supports early involvement of SLPs to address feeding difficulties and improve education.