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Am J Perinatol 2021; 38(14): 1488-1493
DOI: 10.1055/s-0040-1713754
Original Article

Breastfeeding and Formula Selection in Neonatal Abstinence Syndrome

Amy L. Lembeck
1   Division of Neonatology, Department of Pediatrics, Einstein Medical Center Montgomery, CHOP Newborn Care Network, East Norriton, Pennsylvania
,
Deborah Tuttle
2   Department of Pediatrics, Christiana Care Health System, Newark, Delaware
3   Sidney Kimmel School of Medicine at Thomas Jefferson University, Philadelphia, Pennsylvania
,
Robert Locke
2   Department of Pediatrics, Christiana Care Health System, Newark, Delaware
3   Sidney Kimmel School of Medicine at Thomas Jefferson University, Philadelphia, Pennsylvania
,
Laura Lawler
2   Department of Pediatrics, Christiana Care Health System, Newark, Delaware
,
Pamela Jimenez
2   Department of Pediatrics, Christiana Care Health System, Newark, Delaware
,
Amy Mackley
2   Department of Pediatrics, Christiana Care Health System, Newark, Delaware
,
David A. Paul
2   Department of Pediatrics, Christiana Care Health System, Newark, Delaware
3   Sidney Kimmel School of Medicine at Thomas Jefferson University, Philadelphia, Pennsylvania
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Abstract

Objective This study aimed to determine if formula selection, low lactose versus standard term formula, has an effect on outcomes with a comparison to breastfed infants.

Study Design Retrospective cohort study of neonates ≥35 weeks gestation born with Neonatal Abstinence Syndrome (NAS) was conducted from July 2014 to November 2016. Primary outcomes included length of pharmacologic treatment (LOT), and length of stay (LOS), and weight change per day comparing term standard and low lactose formula majority feeding infants with secondary outcomes comparing breast fed majority feeding infants.

Results After investigating feeding methods for 249 NAS infants, a direct comparison of formula groups showed no differences in LOS (3, 95% confidence interval [CI]: −1.1 to 7 days), LOT (3.9, 95% CI: −0.4 to 8.1 days), or weight change per day (−2.4, 95% CI: −11.7 to 6.9 g/day). Breastfeeding improved LOT by 6.9 (95% CI: 3.4–10.5) and 10.8 days (95% CI: 5.9–15.6) and LOS by 7.4 (95% CI: 4.1–10.7) and 10.3 (95% CI: 5.8–14.9) days all reaching significance, in comparison to term and low lactose formula groups, respectively. Weight change per day was greater in the breast versus formula feeding groups when compared individually.

Conclusion We detected no benefit to low lactose formula in NAS infants. Breastfeeding is associated with clinical reduction in LOS and LOT but is associated with increased weight loss.

Key Points

  • Best formula choice for a neonatal abstinence syndrome (NAS) infant is unknown.

  • Many NAS moms cannot breastfeed.

  • Low lactose formula has no impact on NAS outcomes.

Keywords

neonatal abstinence syndrome - feeding - formula


Publication History

Received: 14 December 2019

Accepted: 21 May 2020

Article published online:
30 June 2020

© 2020. Thieme. All rights reserved.

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