Matthew Grossman, MD and Eric Gibson, MD
How can we better care for opiate exposed infants with neonatal abstinence syndrome? Evidence from the successful development and implementation of the “Eat, Sleep, Console” model at Yale-New Haven Children’s Hospital
The opioid epidemic in the United States has resulted in an exponential increase in the number of drug-exposed infants with neonatal abstinence syndrome. Historically, these infants have been treated with the Finnegan scoring system as a basis for the introduction and slow weaning of opioid medication. The traditional scoring system, however, may too heavily rely on signs and symptoms of withdrawal that may not be clinically significant. Additionally, pharmacologic management can commit the infant to a lengthy course of treatment and hospitalization. Recently, a new model called Eat, Sleep, Console (ESC) has been developed that focuses on the comfort and care of these infants by maximizing nonpharmacologic therapies, increasing maternal involvement in the care of the infant, and a shift to focus on the ability of the infant to perform basic neonatal functions such as feeding and soothing. Additionally, pharmacologic treatment is done only with as needed dose of opiates. At Yale-New Haven Children’s Hospital, this treatment strategy has resulted in increased mother/infant bonding, increased parental preparedness for discharge, and significantly decreased length of stay.