413 - Characteristics of Children with a History of Neonatal Opioid Withdrawal Syndrome Who Received Breastmilk after Hospital Discharge

Poster Number: 413
Publication Number: 413.301

Maame Arhin, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Jennifer McAllister, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Brittany L. Smith, University of Cincinnati, Cincinnati, OH, United States; Laura Ward, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States

Background: There is an increasing incidence of Neonatal Opioid Withdrawal Syndrome (NOWS) in the United States. In the Cincinnati region, infants with NOWS are closely monitored for medical and developmental problems in a multidisciplinary follow-up clinic until the age of 3. Breastfeeding is known to be beneficial in this population through improved hospital outcomes, but little is known about the population that receives breastmilk beyond the birth hospitalization.

Objective: To describe characteristics of mothers and their infants with a history of NOWS who received breastmilk after hospital discharge and assess the duration of the receipt of breastmilk. 

Design/Methods: We performed a retrospective cohort study on infants in the NOWS Follow-up Clinic at Cincinnati Children’s Hospital Medical Center from 2016-2019 who received breastmilk after hospital discharge. We conducted a descriptive analysis on the cohort and examined potential relationships between variables of interest.  

Results: A total of 962 individual patients were seen in clinic during our study time period with 2596 patient encounters. Only 8% of patients received any breastmilk during follow-up care. Seventy-eight infants with NOWS were included. Infants were 53% male and 47% female, and 75% were born via vaginal delivery. The majority (87%) were exposed to long-acting opioids (buprenorphine or methadone), and only 17.9% of the infants had exposure to short acting opioids such as heroin/morphine or fentanyl. Maternal psychiatric diagnosis rate was 43.6%, hepatitis C positivity rate was 58%, and 84% of mothers were receiving Women, Infants, and Children (WIC) supplemental nutrition program.  Nearly all (97%) infants received opioid treatment for NOWS with a median length of treatment of 9 days. Median weight, height, and head circumference percentiles were 18, 8.8, and 34%, respectively. Median duration of receiving breastmilk was 1.8 months. Female infant sex was associated with a longer duration of receiving breastmilk. Upon hospital discharge, infants born to mothers who received methadone had a higher rate of exclusive breastfeeding compared to those born to mothers who received buprenorphine (p = 0.04), but there was no difference in duration of receiving breastmilk at follow-up. Conclusion(s): Previous work has shown that 45% of infants with NOWS in our region received some breast milk during birth hospitalization. Despite known benefits of receiving breast milk in this population, our study shows limited duration of breastfeeding after hospital discharge. This highlights ongoing challenges for these dyads to maintain breastfeeding.
Resume- Arhin pdf.pdf
Table 2. Maternal characteristicstable 2- NOWS.jpegrates of characteristics observed in the maternal population