Effects of Partially Hydrolyzed Formula on Severity and Outcomes of Neonatal Abstinence Syndrome

Abstract

Objective This article compares the effect of partially hydrolyzed formula (PHF) and standard formula (SF) on the severity and short-term outcomes of neonatal abstinence syndrome (NAS). Study Design We performed a retrospective chart review of 124 opioid-dependent mothers and their term or near-term infants. Infants were categorized according to the predominant type of formula consumed during the hospital stay. Finnegan's scale was used to assess symptoms of withdrawal. Results A total of 110 infants met our inclusion criteria. Thirty-four (31%) infants were fed predominantly PHF, 60 (54%) infants were fed SF, and 16 (15%) infants were fed maternal breast milk. There was no difference between the infants in the PHF and SF groups with respect to requirement of morphine (MSO4) therapy, maximum dose of MSO4 used, duration of MSO4 treatment or length of hospital stay after performing multivariate analyses to control for type of drug used by the mother, maternal smoking, regular prenatal care, inborn status, and maximum Finnegan score prior to MSO4 treatment. Conclusion Use of PHF failed to impact short-term outcomes in infants treated for NAS including maximum MSO4 dose, duration of MSO4 treatment, and length of hospital stay. A prospective randomized controlled trial may be indicated to confirm this finding.

Predictive value of indicators for identifying child maltreatment and intimate partner violence in coded electronic health records: a systematic review and meta-analysis

“…In total, 65 cross-sectional and 23 longitudinal studies (81 unique publications), involving 20 indicators and 3 875 183 individuals from 11 different countries met the inclusion criteria ( figure 1 ). Overall, 13 studies provided indicators for NAS, 36–45 7 for FAS, 46–52 50 for CM (0–18 years) 14 53–98 and 18 for IPV among women (12–50 years). 99–116 Most studies were from the USA (72 studies, 81%), with a minority from Australia (8 studies, 9%) and Europe (4 studies, 4%).…”

Breastfeeding and Formula Selection in Neonatal Abstinence Syndrome

“…One retrospective study by Alsaleem et al compared hydrolyzed versus standard term formula and breast milk and reached similar outcomes to our study. 26 Their study included 34 hydrolyzed infants, 60 term standard formula, and 16 breastfeeding babies. They concluded that partially hydrolyzed formula had no benefit in terms of morphine treatment length, but that they often required increased caloric content to achieve growth parameters.…”

“…They concluded that partially hydrolyzed formula had no benefit in terms of morphine treatment length, but that they often required increased caloric content to achieve growth parameters. 26 Bogen et al investigate term standard formula versus term formula fortified to 22 calories, and determined that there may be benefit of early return to birthweight not reaching significance and weight gain over time which did reach significance. 8 Bogen et al also examined stooling frequency between the two groups of standard calorie and higher calorie infants and found that they were equivocal.…”

Effect of Low Lactose Formula on the Short-Term Outcomes of Neonatal Abstinence Syndrome: A Systematic Review

“…For this review's specific aim, we focused mainly on whether using LLF was more beneficial regarding short-term outcomes in infants with NAS. Alsaleem et al 11 and Pandey et al 14 reported the type of LLF (Similac Sensitive (Abbott, Columbus, OH), and/or Enfamil Gentlease (Mead Johnson & Co., Glenview, IL)) that was used in the analysis. The other 2 studies did not specifically mention the kind of LLF used in the study population.…”

“…Among 41 articles selected, 4 met the inclusion criteria: 2 cohort studies, 1 randomized controlled trial, and 1 quality improvement study, Figure 1. [11][12][13][14] The inclusion of 1 other study was ruled out after discussion and agreement between the authors. 15 Study types, methodology, and limitations are shown in Table 1.…”