Article ; Online: Current management of neonatal abstinence syndrome: a survey of practice in the UK and Ireland.
Archives of disease in childhood. Fetal and neonatal edition
2024 Volume 109, Issue 3, Page(s) 261–264
Abstract: Objective: To study the current management practices of neonatal abstinence syndrome (NAS) throughout the UK and Ireland and identify changes in practice from the most recent survey in 2008.: Design: Postal questionnaire to a consultant paediatrician ...
Abstract | Objective: To study the current management practices of neonatal abstinence syndrome (NAS) throughout the UK and Ireland and identify changes in practice from the most recent survey in 2008. Design: Postal questionnaire to a consultant paediatrician or neonatologist in all 215 neonatal units in the UK and Ireland in January 2020. Results: Response rate was 62%. An objective scoring tool was used in 97% of units and the Finnegan score was favoured by 70%. Morphine sulfate use as first line for the treatment of opiate withdrawal was almost universal and 70% used a dose of 40 µg/kg every 4 hours (240 µg/kg/day). Phenobarbitone administration as a second-line agent for opiate withdrawal increased to 61% of units with significant reductions in chloral hydrate and chlorpromazine use compared with the previous survey. Morphine sulfate and phenobarbitone remain the preferred first-line and second-line agents, respectively, for polysubstance withdrawal. There was a significant increase in chlorpromazine use as first line for polydrug withdrawal (1.5-14.2%). The practice of units discharging infants' home on medication increased to 46% from 29%. All units now permit breastfeeding in mothers taking methadone, compared with 81% previously. Conclusion and relevance: Compared with the previous survey, improvements in evidence-based practices were noted, highlighting the benefits of this type of research. Nonetheless, significant variation still exists in some aspects of the management of NAS. Post-discharge follow-up varies widely, with particular deficits in ophthalmology follow-up. |
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MeSH term(s) | Female ; Infant, Newborn ; Humans ; Morphine/therapeutic use ; Neonatal Abstinence Syndrome/drug therapy ; Ireland/epidemiology ; Chlorpromazine/therapeutic use ; Aftercare ; Patient Discharge ; Phenobarbital/therapeutic use ; Methadone/therapeutic use ; Surveys and Questionnaires ; United Kingdom ; Opioid-Related Disorders/drug therapy |
Chemical Substances | Morphine (76I7G6D29C) ; Chlorpromazine (U42B7VYA4P) ; Phenobarbital (YQE403BP4D) ; Methadone (UC6VBE7V1Z) |
Language | English |
Publishing date | 2024-04-18 |
Publishing country | England |
Document type | Journal Article |
ZDB-ID | 2007331-8 |
ISSN | 1468-2052 ; 1359-2998 |
ISSN (online) | 1468-2052 |
ISSN | 1359-2998 |
DOI | 10.1136/archdischild-2023-326204 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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