Eat, Sleep, Console: Hands-on Approach Helps Opioid-Addicted Infants
Infants who are starting life with an opioid addiction may benefit from a hands-on care approach that was tested at Cincinnati Children’s and other centers. The “Eat, Sleep, Console” (ESC) care approach is more effective than usual care approaches for treating opioid-exposed infants, according to multi-center study results announced April 30, 2023, at the Pediatric Academic Societies annual meeting.
Opioid-exposed newborns can develop symptoms of neonatal opioid withdrawal syndrome (NOWS), which includes tremors, excessive crying and irritability, and problems with sleeping and feeding. ESC determines withdrawal severity based on how well an infant can eat, sleep and be consoled. The focus is on nonpharmacologic care, including increased family presence, holding, swaddling and rocking in low-stimulus environments, as first-line treatment.
The study, involving more than 1,300 newborns treated at 26 hospitals across the US, found that newborns cared for with ESC were discharged approximately 6.7 days earlier and were 63% less likely to receive drug therapy, compared to newborns cared for under the more commonly used Finnegan Neonatal Abstinence Scoring Tool (FNAST) approach. Safety outcomes at 3 months of age were similar between both groups.
The findings have been published in The New England Journal of Medicine, with Cincinnati Children’s neonatologist Stephanie Merhar, MD, MS, among the leading co-authors. Three Cincinnati Children’s Perinatal Institute partner hospitals also participated: the University of Cincinnati Medical Center neonatal intensive care unit (NICU), TriHealth’s Good Samaritan Hospital NICU, and the St. Elizabeth Healthcare NICU. Together, these hospitals provided the largest number of study enrollees.
