Table 2 Studies of the nonpharmacologic management of neonatal management syndrome

Abdel-Latif, 2006[38]

Retrospective Cohort

To determine association between breastfeeding and NAS outcomes

Breastfed infants with NAS (n = 85)

Finnegan Score

Rx for NAS: OR = 0.36 (CI 0.18–0.71)*

Formula-fed infants with NAS (n = 105)

Mean LOS: 14.7 (SD 14.9) vs. 19.1 (SD 15.0) days*

Dryden, 2009[42]

Retrospective Cohort

To determine association between breastfeeding and NAS outcomes

Breastfed infants with NAS (n = 99)

Modified Lipsitz

Rx for NAS: OR = 0.55 (CI 0.34–0.88)*

Formula-fed infants with NAS (n = 351)

McQueen, 2011[39]

Retrospective Cohort

To determine association between breastfeeding and NAS outcomes

Breastfed infants with NAS (n = 8)

Modified Finnegan

Mean # of NAS scores: 25.0 (SD 23.5) vs. 56.2 (SD 39.1) vs. 95.6 (SD 34.6)*

Combination-fed infants with NAS (n = 11)

Mean NAS score 4.9 (SD 2.9) vs. 6.5 (SD 3.7) vs. 6.9 (SD 4.2)*

Formula-fed infants with NAS (n = 9)

Pritham, 2012[43]

Retrospective Cohort

To determine association between breastfeeding and NAS outcomes

Breastfed with NAS (n = 14)

Not specified

Mean LOS: -3.3 (SE 1.7) days

Infants combination-fed with NAS (n = 22)

Formula-fed infants with NAS (n = 96)

O’Connor, 2013[40]

Case Series

To describe association between breastfeeding and NAS outcomes

Breastfed infants with NAS (n = 65)

Modified Finnegan

Mean NAS score: 8.83 (SD 3.56) vs. 9.65 (SD 2.58)

Formula-fed infants with NAS (n = 20)

Rx for NAS: 23.1% vs. 30.0%

Wachman, 2013[9]

Prospective Cohort

To determine association of genetic variables with NAS outcomes

Breastfed infants with NAS (n = 38)

Modified Finnegan

Rx for NAS: 50% vs. 77%*

Formula-fed infants with NAS (n = 48)

Mean LOS: 15.8 (CI 11.5–20.1) vs. 27.4 (CI 22.5–32.3) days*

Welle-Strand, 2013[41]

Ambi-directional Cohort

To determine association between breastfeeding and NAS

Breastfed infants with NAS (n = 95)

Modified Finnegan

Rx for NAS: 53% vs. 80%*

outcomes

Formula-fed infants with NAS (n = 29)

Mean length of Rx: 28.6 (SD 19.1) vs. 46.7 (SD 26.3) days*

Hunseler, 2013[44]

Retrospective Cohort

To describe association between rooming-in and NAS outcomes

NAS infants exposed to rooming-in (n = 24)

Finnegan

Finnegan Score > 12: 6.3% vs. 6.4%

Control NAS infants (n = 53)

Rx for NAS: 79.2% vs. 88.7%

Mean length of Rx: 27 vs. 32.5 days

Mean LOS: 38 vs. 41.5 days

Abrahams, 2007[45]

Retrospective Cohort

To describe association between rooming-in and NAS outcomes

Infants with NAS exposed to rooming-in (n = 32)

Modified Finnegan

Mean length of Rx: 5.9 vs. 18.6 days*; 5.9 vs. 18.6 days*

Control infants with NAS (n = 38) (historical comparison)

Mean LOS: 11.8 vs. 23.5 days; 11.8 vs. 25.9 days*

Control infants with NAS (n = 36) (from another institution)

D’Apolito, 1999[46]

Nonblinded Random Assignment of Rx

To determine the association between infants sleeping in a rocking bed vs. controls with NAS outcomes

Infants with NAS exposed to rocking bed (n = 7)

Finnegan

Mean NAS score on day 7 of intervention: 10.2 (SD 2.1) vs. 8.0 (SD 1.8)

Control infants with NAS (n = 7)

Oro, 1988[47]

Randomized Assignment of Rx with Matched Controls

To determine the association between infants sleeping in a waterbed vs. controls and NAS outcomes

Infants with NAS exposed to a waterbed (n = 15)

Finnegan

Maximum NAS score: 6.2 (SD 0.7) vs. 6.4 (SD 1.0)

Control infants with NAS (n = 15)

Mean LOS: 10.5 (SD 1.2) vs. 11.5 (SD 3.4) days

Maichuk, 1999[48]

Randomized to Intervention; Nurses Blinded to Hypothesis

To determine the association between sleeping position with NAS outcomes

Infants with NAS placed in prone position (n = 25)

Finnegan

Maximum NAS score: 10.52 (SD 2.08) vs. 13.17 (SD 2.03)*

Infants with NAS placed in the supine position (n = 23)

Mean NAS score: 5.11 (SD 0.64) vs. 7.60 (SD 0.70)*

Filippelli, 2012[49]

Case Series

To describe the possible effects of NIA on infants with NAS

Infants with NAS exposed to NIA (n = 54)

Not applicable

Chart review revealed improvements in calming, sleep, and feeding