Razi Journal of Medical Sciences

fa تاثیر شیردهی در مادران وابسته به مصرف مواد مخدر بر سندروم محرومیت نوزاد: یک مطالعه مروری Investigating the Effect of Breastfeeding in Drug-Dependent Mothers on Neonatal Abstinence Syndrome: A Review Study پرستاری کودکان Pediatric Nursing مروري review article زمینه و هدف: در دهه اخیر، مصرف مواد مخدر در بارداری و به دنبال آن تولد نوزادان مبتلا به سندروم محرومیت از مواد (neonatal abstinence syndrome (NAS)) افزایش یافته که هزینه&rlm;های مراقبتی را بالا برده است. امروزه بر روش&rlm;های غیردارویی مانند شیردهی، جهت کاهش علائم NAS تاکید می&rlm;شود. بنابراین هدف از این مطالعه، بررسی تاثیر شیردهی مادران وابسته به مصرف مواد مخدر(اوپیوئیدها) بر سندروم محرومیت نوزاد بود. روش کار: این مطالعه، یک پژوهش مروری، با جستجو در پایگاه&rlm;های Google Scholar، Science Direct، Pub Med، Medline، SID، Magi ran، و کلید واژه&rlm;های“Breastfeeding” “opioids” “mothers” neonatal abstinence syndrome (NAS)” “Drug Abuse/Parenteral”“، در طی سال&rlm;های2020-2010، است. در نهایت 24 مطالعه انتخاب، و داده‌ها ارزشیابی و تحلیل شد. یافته&rlm; ها: میزان شیردهی در مادران وابسته به مواد مخدر بسیار پایین بود، در حالی که شیردهی در مادران وابسته به اوپیوئیدها یا تحت درمان با این داروها، ایمن در نظر گرفته می&rlm;شود. شیردهی، باعث کاهش طول مدت و شدت علائم NAS، طول مدت بستری، دارو درمانی، هزینه&rlm;های مراقبتی، سندروم مرگ ناگهانی و ایجاد پیوند عاطفی مادر و نوزاد و سازگاری مادر با بی&rlm;قراری حاصل از NAS می&rlm;شود. نتیجه &rlm;گیری: با توجه به تاثیر شیردهی مادران وابسته به اوپیوئیدها یا تحت درمان با این داروها در کاهش علائم NAS توصیه می&rlm;شود، کادر درمان با شناسایی، برداشتن موانع و حمایت روانی این مادران بر اهمیت شیردهی به عنوان یک روش ایمن، ارزان و موثر تاکید کنند. با این وجود، به علت مطالعات محدود در کشور ایران، پژوهش&rlm;های گسترده&rlm;تری در این زمینه لازم است.   Background & Aims: Breastfeeding is the safest and the best way to provide growth and development of newborn and protect against many diseases. breast feeding is known to be beneficial for many benefits such as reduction of neonatal death syndrome) Sudden Infant death syndrome-SIDS (childhood and postpartum depression are a major public health strategy. these benefits may be particularly important for families who are grappling with drug use. while the use of addictive substances is a global health problem and dependence on drugs causes a certain concern. because this affects maternal, fetal and newborn health. during the past decade, drug use has grown dramatically and now become a major public health problem. drug abuse during pregnancy has led to an increase in the birth rate of a number of children with the syndrome of substance (neonatal abstinence syndrome-NAS (. the cost of health care has skyrocketed. sudden cessation of drugs in newborns from mothers of drug users on the following days of birth leads to baby deprivation syndrome with symptoms such as tachycardia, tremor, agitation, increased tone, convulsions, nutrition and poor nutrition, vomiting, diarrhea, sweating, fever and nausea. in addition, the time of hospitalization of newborns with NAS in hospital was 16.4 days compared to other children who were 3.3 days. there are also 46 - 76 % of the probability that these babies undergo drug therapy, such as the treatment cost, whereas drug addicts have low economic status.  recent studies have shown that non - pharmacological agents should be used as the first line of treatment to reduce symptoms of NAS. among the non - pharmacological methods, breastfeeding may result in reduced severity and severity of symptoms. in addition, studies show a direct relationship between breastfeeding and decrease in length of admission, decrease of symptoms and necessity of drug interventions in NAS. the American academy of pediatrics and the world health organization, have a strong emphasis on breastfeeding for the first 6 months of life. In this regard, this study was conducted with the aim of investigating the effect of breastfeeding in mother's dependent on the use of narcotic drugs (opioids) on infant deprivation syndrome. Methods: The present article is a review study that researchers in Google Scholar, Science Direct, Pub Med, Medline, SID, Magi ran, using keywords Breastfeeding [mesh]", "opioids[mesh]", "neonatal abstinence syndrome (NAS) [mesh]” and “mothers [mesh]” “Drug Abuse/Parenteral [mesh]” and searched for 10 years between 2010-2020. inclusion criteria in this study were qualitative and quantitative studies on the effect of breast feeding on deprivation syndrome, in domestic and domestic practical journals, focusing on benefits and usefulness, descriptive and investigative and review, access to full text and English and Persian language articles were considered. and unrelated, repetitive, language having different language and weak relation with the goal of study, and without proper executive methods, were excluded. in the search phase of the texts, some studies were carried out based on inclusion criteria. then, the remaining studies were evaluated and analyzed in terms of content. the initial search result of 876 studies, which 48 studies, due to having a different language, 775 studies, after reviewing title and purpose , respectively 16 after reviewing the summary, 15 studies were deleted after reviewing the text and two studies were added as a result of manual search. in the end, 24 studies were included. after the evaluation of these studies, the data were analyzed through comparison, summing up and determining the validity. it should be noted that regarding the wide distribution of mothers ' breastfeeding in this article, it is necessary to review the effect of breast feeding on pain syndrome of newborn. Results: According to studies, mothers who struggle with addiction are one of the most vulnerable groups among mothers. the amount of breastfeeding in these cases is very low. according to the results of the study, the socioeconomic status, age, education, social influence, knowledge and knowledge of breastfeeding, the health and mental health status of the mothers of the opioid - dependent mothers, support and pre - natal education influence the decision to breastfeed. in a study conducted (Wachman et al (colleagues on the extent of breastfeeding among the dependent mothers, the results indicated that only a small number of mothers of breast - feeding infants fed their infants. more than half of those, after a week of breast feeding, stopped feeding their baby and did not feed their baby at all. the results of the present study were shown by Volstrand et al. Breastfeeding rates were high in mothers treated with opioids (methadone and buprenorphine), but early cessation of breastfeeding is common among them. however, the effect of opioids on opioids is not considered safe, since opioids are considered to be immune to opioids as a result of opioids consumption in the mother, its secretion in milk is low and there is no risk for baby. according to the results of the study, breastfeeding can help to create an emotional bond between mother and baby, especially in addicted mothers with opioids, breastfeeding increases the release of oxytocin hormone, which has calm effects on mother. perhaps one of its benefits is the help of mother 's adaptation with agitation from NAS in the infant and reduce the likelihood of getting the baby by these mothers. also, breast feeding leads to decrease in severity of symptoms such as severity of symptoms, duration of stay in hospital, need for drug delivery and decrease of care costs. in addition, breastfeeding in these mothers reduced incidence and duration of neonatal signs symptoms in newborns. breastfeeding also has a positive effect on the prevention of sudden infant mortality (SID). therefore, it is recommended to be conducted on children at risk such as newborns with opioids in the uterus of breast feeding. the results of this study showed that the need for drug for treatment of deprivation syndrome in neonates fed by breastfeeding mothers was higher than newborns who had not been fed with breast milk. most of these neonates had normal weight and had better weight gain. also, according to the research, exclusive breast feeding was more effective in reducing the symptoms of breast feeding with breast milk, compared to breast feeding, or a combination of breast milk and formula. previous studies in 2012 - 2016 showed that compared to breastfed infants in 2012 - 2016, breastfeeding in mother's dependent to opioids leads to shortening the length of stay of newborns with NAS in hospital. although the study showed that breastfeeding reduced the duration of hospitalization and decreased the need for treatment of NAS, but in a research it was stated that the need for treatment for newborns with NAS and the other group that were fed with milk had been fed. there was no significant difference in this study suggesting that breast - feeding practice is more important than milk pharmaceutical content and more research should be done in this regard. therefore, it is suggested that opioids are dependent on opioids use to help their children if NAS occur, unless the hazards are greater than the benefits. according to the studies, clinicians have played a very important role in understanding, supporting, consulting and defending mothers ' rights that they wish to feed their children with the syndrome of food deprivation, and to inform them of the complications of drug use on their babies before the full cessation of breastfeeding. they also need to be encouraged to not consume alcohol, cigarettes or other illegal drugs throughout the lactation and receive mental support and medication from health centers and health care providers. Conclusion: The World Health Organization recommends methadone and buprenorphine in substance use treatment for all individuals, especially in women during pregnancy and lactation, along with psychotherapy. in the case of reducing the rate of symptoms in the infant, mothers who were treated with methadone (74 %) or buprenorphine (78 %) had no difference after delivery to their infants. in the study of johnson et al., the amount of methadone released in breast milk is -21-462 ng / ml, and it is unlikely to have a trace amount of methadone that is transmitted through the breast milk. therefore, the infants of methadone and Buprenorphine mothers can be fed by mother 's milk and can be used as a beneficial benefit. in addition, mothers can also use a good mother 's sense of breastfeeding as an opportunity to change their course of life. although some mothers of breast - feeding are challenging to their newborn, because the vibration, weak muscle tone, bound movements and poor swallowing will cause problems in breast and breast feeding. on the other hand, the approach and the frustrations of health care givers were not effective in breast feeding. therefore, understanding the benefits of breastfeeding depends on the use of opioids in reducing infant Deprivation to treatment staff to recommend breast feeding to these high - risk mothers. in addition, successful breastfeeding in these mothers requires nurses " education, understanding psychological problems , creating a secure environment, observing privacy and physical and mental protection by health care providers and eliminate the barriers to breastfeeding. شیردهی, سندروم محرومیت نوزاد, مادران, سوء مصرف مواد/وریدی, اوپیوئیدها Breastfeeding, Neonatal abstinence syndrome, Mothers, Drug Abuse/ Parenteral, Opioids 195 203 http://rjms.iums.ac.ir/browse.php?a_code=A-10-4370-2&slc_lang=fa&sid=1 Niloofar Hajiaraghi نیلوفر حاجی عراقی 3900319475328460071291 3900319475328460071291 No MSc of Pediatric Nursing, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran کارشناس ارشد پرستاری کودکان، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی جندی شاپور، اهواز، ایران Seyed Maryam Mousavi مریم موسوی smmousavi@khuisf.ac.ir 3900319475328460071292 3900319475328460071292 Yes گروه پرستاری کارشناس ارشد پرستاری کودکان، گروه پرستاری، واحد گلپایگان، دانشگاه آزاد اسلامی، گلپایگان، ایران