Use of positioning to reduce the severity of neonatal narcotic withdrawal syndrome.
OBJECTIVE
This study tested the hypothesis that highly fretful, narcotic-withdrawing neonates experience less distress in a prone-lying position than comparable, supine-lying neonates.


METHODS
Equivalent numbers of randomly assigned, narcotic-withdrawing newborns were assigned to prone-lying (n = 25) or supine-lying (n = 23) conditions. Subjects in the two groups were similar with regard to gestational age, birth weight, and clinical presentation. Peak and mean withdrawal severity, as measured by Neonatal Abstinence Scoring System (NASS) scores and daily caloric intake, were compared between supine and prone groups by Wilcoxon's two-sample test.


RESULTS
The prone-lying neonates had lower peak NASS scores (p < 0.0001), lower mean NASS scores (p < 0.0001), and lower caloric intake (p < 0.001) than supine-lying, narcotic-withdrawing newborns.


CONCLUSIONS
The fretfulness associated with neonatal withdrawal and other stressful conditions can be moderated by laying the affected infant prone. The pronate quieting response is a significant, endogenous source of neonatal pacification.
Maichuk
G T
GT
Department of Nursing, University of Medicine and Dentistry of New Jersey, Newark, USA.
Zahorodny
W
W
Marshall
R
R
D002149:Energy Intake; D006801:Humans; D007231:Infant, Newborn; D009357:Neonatal Abstinence Syndrome / Q000503:physiopathology* / Q000628:therapy*; D016684:Prone Position; D016683:Supine Position