Acupressure augmentation of standard medical management in the treatment of neonatal abstinence syndrome

Background: Opiate addiction during pregnancy remains a major comorbidity influencing maternal and neonatal health. Incidence of neonatal abstinence syndrome (NAS) may be as high as over 90% among newborns who were exposed to opiates in utero. Medical management and withdrawal routinely involve pharmacological intervention. Auricular acupuncture has been used in the U.S. to treat narcotic addiction. It has been suggested that these same ear points can be effectively stimulated with pressure instead of needles in neonates withdrawing from prenatal drug exposures; existence and activity of these ear points in newborns has been reported in the literature.

Methods: This randomized controlled trial was designed to evaluate the safety and potential efficacy of acupressure augmentation of standard medical management of babies with NAS, comparing length of stay and amount of pharmacologic support between babies randomized to receive standard medical management alone, or standard treatment plus auricular acupressure. A small herbal seed was taped to one to three left or right ear acupoints specific for detoxification for babies assigned to receive acupressure in addition to standard medical management.

Results: 79 newborns were recruited; 40 were randomized to receive acupressure plus standard, 39 were randomized to receive standard care alone. In the acupressure group, length of stay was reduced (p=0.08) and fewer days of pharmacological support were required (p=0.07).

Discussion: Although the trial did not yield findings that were statistically significant, we were able to demonstrate the feasibility and safety of conducting a trial of acupressure with newborns. No adverse events were reported. Families were very open to this integrative, non-invasive approach.