Influence of Eat, Sleep, and Console on Infants Pharmacologically Treated for Opioid Withdrawal

The function-based eat, sleep, console (ESC) care approach significantly reduces the need for pharmacological treatment in infants suffering from neonatal opioid withdrawal syndrome (NOWS). While this decrease raises concerns about heightened postnatal opioid exposure in treated infants, the influence of the ESC approach on hospital outcomes remains unclear.

A recent study compared opioid exposure and total hospital stay duration for infants receiving pharmacological treatment under the ESC approach versus the conventional Finnegan tool-based care. The findings indicated:

• Lower mean total opioid exposure in the ESC care approach group than in usual care. 
• Longer mean time from birth to initiation of pharmacologic treatment with the ESC care approach vs usual care. 
• No significant difference in mean peak opioid dose between the two groups. 
• Shorter mean length of treatment in the ESC care approach group vs usual care group
•  Shorter mean LOS with the ESC care approach than with usual care.

Overall, this study suggests that the ESC care method correlates with reduced opioid exposure and shorter hospital stays for infants receiving pharmacological treatment for NOWS compared to conventional care methods. Despite the delayed initiation of pharmacological treatment under the ESC approach, it does not increase peak opioid dosage.

Devlin LA, Hu Z, Merhar SL, et al. Influence of Eat, Sleep, and Console on Infants Pharmacologically Treated for Opioid Withdrawal: A Post Hoc Subgroup Analysis of the ESC-NOW Randomized Clinical Trial. JAMA Pediatr. Published online April 15, 2024. doi:10.1001/jamapediatrics.2024.0544