WIP 79 - NG tube placement rates and utilization of increased kilocalorie formula in infants with NOWS evaluated with Eat, Sleep, Console Methodology vs the Finnegan Neonatal Abstinence Score

Poster Number: WIP 79
Publication Number: WIP 79.2494

Background: Neonatal opioid withdrawal syndrome (NOWS) continues to affect many infants nationwide. Infants with NOWS have a spectrum of feeding patterns, from poor feeding coordination to hyperphagia. Previously, infants with NOWS had been treated with opioids based on evaluation with the Finnegan Neonatal Abstinence Score (FNAS). Recently, many institutions have transitioned to evaluating the symptoms related to NOWS with Eat, Sleep, Console methodology (ESC). This approach has highlighted non-pharmacologic care, and decreased pharmacologic intervention, length of hospital stay, and NICU admissions of NOWS infants. In comparison to infants evaluated by FNAS treated with pharmacologic therapy, infants managed with non-pharmacologic therapy per ESC may experience weight loss and feeding challenges in the first week of life, necessitating increased rates of NG placement or increased kilocalorie formula supplementation to maintain adequate growth.

Objective: To assess differences in nutritional needs and growth patterns in infants affected by NOWS evaluated with FNAS vs ESC Methodology through review and comparison of growth trends, NG placement rates, and the fortification of formula utilized.

Design/Methods: Our study involves retrospective chart review of infants with NOWS at our institution by data collection on 115 infants born between 2018-2019 that were evaluated with FNAS, as well as 100 infants born between 2022-2023 evaluated with ESC methodology. This chart review involves maternal and infant demographics including: birth weight and z-score, discharge weight and z-score, maternal urine toxicology screen at time of delivery, infant toxicology screens, maternal medication or substance use in pregnancy, pharmacologic therapy of infant, whether or not infant required NG tube for feeding, length (in days) of NG feeding assistance, highest kilocalorie formula utilized during hospitalization. Data collection is still underway and will be complete by 2/17/2024. Data analysis will then begin using descriptive analysis with the plan to have all data analysis complete by 3/8/2024.