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

BACKGROUND Neonatal abstinence syndrome (NAS) rates have dramatically increased. Breastfeeding is a nonpharmacologic intervention that may be beneficial, reducing NAS symptom severity, and thus, need for and duration of pharmacological treatment and length of hospital stay. OBJECTIVES Conduct meta-analysis to determine whether breastfeeding results in better outcomes for NAS infants. Variables included symptom severity, need for and duration of pharmacologic treatment, and LOS. METHODS PubMed, Scopus, Embase, Cochrane Library were searched from 2000-2020, and comparative studies examining breastfeeding for NAS infants were extracted. Randomized trials and cohort studies were included. Data were extracted and evaluated with RevMan 5.3. A random-effects model was used to pool discontinuous outcomes using risk ratio and 95% confidence intervals. Continuous outcomes were evaluated by mean differences and 95% confidence intervals. RESULTS Across 11 studies, 6,375 neonates were included in the meta-analysis. Using a random-effect analysis, breastfeeding reduced initiation of pharmacological treatment, reduced duration of pharmacological treatment, and reduced length of stay. No differences were detected for severity of NAS symptoms. Most studies only reported one to two variables of interest. For most studies, these variables were not the primary study outcomes. All studies were found to be of low risk and good quality based on Cochrane Risk Assessment Tools. Varying breastfeeding definitions limits generalizability. DISCUSSION Breastfeeding is associated with decreased initiation and duration of pharmacological treatment and length of stay.