Neonatal Abstinence Syndrome (NAS) is a constellation of withdrawal symptoms in neonates exposed to opioids in utero. While infants exposed to in utero opioids may have withdrawal symptoms, not all will progress to developing NAS. However, all Opioid Exposed Neonates (OENs) require specialized monitoring and care. Unfortunately, the incidence of OENs is increasing in the United States and, more specifically, in Tennessee. Non-pharmacological measures (soothing, swaddling, low stimulation environments, etc.) are the mainstay of therapy and are associated with shorter lengths of hospital stay, decreased severity of symptoms, and decreased pharmacological therapy utilization. However, despite maximizing non-pharmacological interventions some OENs with NAS will require pharmacological therapy.
This clinical practice guideline was developed with the goal of standardization of care for OENs, both those with and without NAS, based upon current evidence and best practices. This includes appropriate screening and monitoring, utilization of hospital resources to maximize non-pharmacologic care, guidance on appropriate pharmacological intervention and weaning, and best discharge practices. By following the standardized practices outlined in this CPG, this target, at-risk population can be best served to ensure optimization of their care during their birth hospitalization as well as creating a safety net for outpatient follow up and resources.
- Travis Crook - Hospital Medicine (contact)
- Stephan Patrick - NICU
- Alex Agthe - NICU
- Lauren Presley - General Pediatrics/Nursery
- Anna Morad - General Pediatrics/Nursery
- Erin Munn Child Life
- Alison Grisso, Pharmacy
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