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Neonatal Abstinence Syndrome

An Integrative Review of Neonatal Acupuncture to Inform a Protocol for Adjunctive Treatment

Jackson, Heather J., MSN, RN, FNP-BC; López, Cristina, PhD; Miller, Sarah, PhD, RN; Englehardt, Barbara, MD

Section Editor(s): Dowling, Donna PhD, RN; ; Thibeau, Shelley PH, RNC-NIC;

doi: 10.1097/ANC.0000000000000630
Clinical Issues in Neonatal Care

Background: The current opioid epidemic in the United States has given rise to a growing incidence of neonatal abstinence syndrome (NAS). Treatments for this condition optimize nonpharmacologic therapies in an effort to improve withdrawal symptoms and reduce or eliminate the need for opioid medications, thereby reducing hospital length of stay and improving healthy neonatal outcomes.

Purpose: The purpose of this review was to evaluate the current evidence for neonatal acupuncture treatments and identify essential characteristics that must be included in a treatment protocol for NAS.

Methods/Search Strategy: An integrative review was conducted under the guidance of the Whittemore and Knafl methodology and near-term infant conceptual framework. An evaluation of the quality and levels of evidence was also included.

Findings/Results: A total of 10 studies were identified in this review. Four of these studies were randomized controlled trials, and utilized acupuncture in the neonatal population to evaluate impact on pain, NAS, and weight gain.

Implications for Practice: This review provided the essential elements for the development of a complementary acupuncture treatment protocol for the management of NAS.

Implications for Research: Future research should include the identified essential characteristics in high-quality, blinded, randomized controlled trials to assess the treatment effect of acupuncture on neonates experiencing withdrawal symptoms.

Vanderbilt University Medical Center, Nashville, Tennessee (Mrs Jackson); College of Nursing, Medical University of South Carolina, Charleston (Drs Lopez and Miller); Monroe Carell Jr Children's Hospital at Vanderbilt, Vanderbilt University School of Medicine, Nashville, Tennessee (Dr Englehardt).

Correspondence: Heather J. Jackson, MSN, RN, FNP-BC, Vanderbilt University Medical Center, Nashville, TN 37232 (

We acknowledge Heather Laferriere, MLIS, Vanderbilt University's Annette and Irwin Eskind Family Biomedical Library and Learning Center.

The authors declare no conflicts of interest.

© 2019 by The National Association of Neonatal Nurses