A Meta-Analysis of Breastfeeding Effects for Infants With Neonatal Abstinence Syndrome

Chu, Lan; McGrath, Jacqueline M.; Oiao, Jianhong; Brownell, Elizabeth A.; Recto, Pamela; Cleveland, Lisa M.; Lopez, Emme; Gelfond, Jonathan; Crawford, Allison D.; McGlothen-Bell, Kelly

doi:10.1097/nnr.0000000000000555

Cited by 16 publications

(21 citation statements)

References 47 publications

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“…Investigating the use of targeted nutritional immunological interventions (ie, provision of human milk and pre- and probiotic supplementation) may be a fundamental contribution to improve NOWS-related outcomes, specifically those related to GI dysfunction, via the gut microbiome 20. Given current evidence, nurses can promote the use of human milk as the optimal source of nutrition for infants with POE and NOWS 14…”

Section: Discussionmentioning

confidence: 99%

A Scoping Review of Neonatal Opioid Withdrawal and the Infant Gut Microbiome

McGlothen-Bell¹,

Groër²,

Brownell³

et al. 2023

Advances in Neonatal Care

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Background: While a growing body of literature has established the role of human milk as a mechanism of protection in the formation of the infant gut microbiome, it remains unclear the extent to which this association exists for infants with neonatal opioid withdrawal syndrome. Purpose: The purpose of this scoping review was to describe the current state of the literature regarding the influence of human milk on infant gut microbiota in infants with neonatal opioid withdrawal syndrome. Data Sources: CINAHL, PubMed, and Scopus databases were searched for original studies published from January 2009 through February 2022. Additionally, unpublished studies across relevant trial registries, conference proceedings, websites, and organizations were reviewed for possible inclusion. A total of 1610 articles met selection criteria through database and register searches and 20 through manual reference searches. Study Selection: Inclusion criteria were primary research studies, written in English, published between 2009 and 2022, including a sample of infants with neonatal opioid withdrawal syndrome/neonatal abstinence syndrome, and focusing on the relationship between the receipt of human milk and the infant gut microbiome. Data Extraction: Two authors independently conducted title/abstract and full-text review until there was consensus of study selection. Results: No studies satisfied the inclusion criteria, which resulted in an empty review. Implications for Practice and Research: Findings from this study document the paucity of data exploring the associations between human milk, the infant gut microbiome, and subsequent neonatal opioid withdrawal syndrome. Further, these results highlight the timely importance of prioritizing this area of scientific inquiry.

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Section: Discussionmentioning

confidence: 99%

A Scoping Review of Neonatal Opioid Withdrawal and the Infant Gut Microbiome

McGlothen-Bell¹,

Groër²,

Brownell³

et al. 2023

Advances in Neonatal Care

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“…Findings from a recent meta-analysis aimed at examining the effect of breastfeeding on NOWS-related outcomes suggest that breastfeeding improves the health outcomes for affected infants (Chu et al, 2022). Breastfeeding was found to be associated with decreased severity of NOWS symptoms, shorter duration of hospital stays, and reduced need for pharmacologic treatment in infants with NOWS (Chu et al, 2022). National guidelines exist encouraging the use of breastfeeding as an infant feeding method for childbearing women with OUD who are stable on medication treatment (American College of Obstetricians and Gynecologists [ACOG], 2017).…”

Section: Stigma and Childbearing Women With Oudmentioning

confidence: 99%

Section: Stigma and Childbearing Women With Oudmentioning

confidence: 99%

Intersectional stigma and infant feeding in childbearing women with opioid use disorder.

McGlothen-Bell¹,

Cleveland²,

Spencer³

et al. 2023

Stigma and Health

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Opioid use disorder (OUD) in childbearing women is a complex multilayered public health concern that creates increased vulnerability for affected women and infants, placing them at risk for stigmatization. The role of intersectional stigma is not well understood in the context of OUD and mothering; however, it may have implications for health-related behaviors such as infant feeding. The aim of this study was to understand how intersecting stigmas influence the infant feeding choices of childbearing women with OUD. Using an intersectional lens, this study highlights how multiple stigmas related to their diagnosis and role as mothers converge and affect decisions regarding infant feeding. We conducted a secondary analysis of semistructured individual interviews from 14 participants who were mothers of infants treated for Newborn Opioid Withdrawal Syndrome. The original study was a qualitative, multiple case study analysis of infant feeding experiences of mothers receiving medication for OUD. Interview data were analyzed using qualitative content analysis. Three overarching themes revealed mothers' awareness of the stigma attached to mothering with OUD: (a) you have to go that extra mile, (b) everybody has their reasons, and (c) just do what you got to do. The mothers' assignment of good mothering behaviors based on infant feeding choice further underscored their perceived stigma. Understanding the intersections between OUD-related stigma within the context of mothering may provide opportunities to better support infant feeding choices in childbearing women with OUD.

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“…Although limited by small sample sizes, breastmilk analyses have shown that the concentrations of buprenorphine and methadone are low and pose minimal risks to neonates ( 31 , 32 ). There are clear benefits of breastfeeding including less severe withdrawal, less need for pharmacotherapy, and shorter length of hospital stay ( 33 , 34 ). The American Academy of Pediatrics (AAP) has recommended breastfeeding based on long-term benefits such as lower risk of type II diabetes, hypertension, and cancer in mothers and lower respiratory tract infections, diarrhea, otitis media, sudden infant death syndrome, asthma, and obesity in infants and children ( 28 ).…”

Section: Ongoing Management and Long-term Effects Of Nasmentioning

confidence: 99%

The immediate and long-term effects of prenatal opioid exposure

Yen

Davis

2022

Front. Pediatr.

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The opioid epidemic has adversely affected neonates and children, yet the mechanisms by which it impacts this population are not well understood. Not only does prenatal opioid exposure result in short-term consequences shortly after birth, it also creates long-term sequelae that may predispose these children to physical, emotional, psychiatric, cognitive, and socioeconomic problems in the future. This article provides a scoping overview of the long-term effects of antenatal opioid exposure on neonates and children as well as quality improvement and research efforts to understand and mitigate this major public health concern.

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A Meta-Analysis of Breastfeeding Effects for Infants With Neonatal Abstinence Syndrome

Abstract: Supplemental digital content is available in the text.

Cited by 16 publications

References 47 publications

A Scoping Review of Neonatal Opioid Withdrawal and the Infant Gut Microbiome

A Scoping Review of Neonatal Opioid Withdrawal and the Infant Gut Microbiome

Intersectional stigma and infant feeding in childbearing women with opioid use disorder.

The immediate and long-term effects of prenatal opioid exposure

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