Discussions about non-pharmacologic interventions for Neonatal Abstinence Syndrome and Neonatal Opioid Withdrawal Syndrome (NAS/NOWS) have been minor compared with wider attention to pharmacologic treatments. Although historically under-recognized, non-pharmacologic interventions are of paramount importance for all substance-exposed infants and remains as a first line therapy for the care of infants affected by NAS. Here we examine the role of non-pharmacologic interventions for NAS/NOWS by incorporating theoretical perspectives from different disciplines that inform the importance of individualized assessment of the mother-caregiver/infant dyad and interventions that involve both individuals. NAS/NOWS is a complex, highly individualized constellation of signs/symptoms that vary widely in onset, duration, severity, expression, responses to treatment and influence on long-term outcomes. NAS/NOWS often occurs in infants with multiple prenatal/postnatal factors that can compromise neurobiological self-regulatory functioning. We propose to rethink some of the long-held assumptions, beliefs, and paradigms about non-pharmacologic care of the infant with NAS/NOWS, which is provided as non-specific or as “bundled” in current approaches. This paper is Part I of a two-part series on re-conceptualizing non-pharmacologic care for NAS/NOWS as individualized treatment of the dyad. Here, we set the foundation for a new treatment approach grounded in developmental theory and evidence-based observations of infant neurobiology and neurodevelopment. In Part II, we provide actionable, individually tailored evaluations and approaches to non-pharmacologic NAS/NOWS treatment based on measurable domains of infant neurobehavioral functioning.

与对药物治疗的广泛关注相比，关于新生儿戒断综合征和新生儿阿片戒断综合征 (NAS/NOWS) 的非药物干预的讨论较少。尽管历史上未被充分认识，但非药物干预对所有接触物质的婴儿都至关重要，并且仍然是护理受 NAS 影响的婴儿的一线治疗。在这里，我们通过结合来自不同学科的理论观点来检验非药物干预对 NAS/NOWS 的作用，这些观点表明对母婴二元组进行个体化评估的重要性以及涉及双方的干预措施。NAS/NOWS 是一个复杂的、高度个体化的体征/症状群，在发病、持续时间、严重程度、表达、对治疗的反应和对长期结果的影响。NAS/NOWS 经常发生在具有多种产前/产后因素的婴儿身上，这些因素可能会损害神经生物学的自我调节功能。我们建议重新思考一些长期持有的关于 NAS/NOWS 婴儿非药物治疗的假设、信念和范式，这些在当前方法中以非特异性或“捆绑”的形式提供。本文是关于将 NAS/NOWS 的非药物治疗重新概念化为二元个体化治疗的两部分系列文章的第一部分。在这里，我们为基于发育理论和婴儿神经生物学和神经发育的循证观察的新治疗方法奠定了基础。在第二部分中，我们提供了可操作的，