The opioid crisis surged in recent years, and New England has been hit particularly hard. Infants exposed to opioids in the womb can develop neonatal opioid withdrawal syndrome (NOWS), with symptoms including tremors, stiff muscles, upset stomach, excessive crying, and problems with sleeping and feeding. Historically, treatment of these infants involves a nurse measuring a baby’s withdrawal symptoms — such as level of irritability, pitch of crying, fever, or tremors — and often providing opioid medications, including morphine and methadone, as part of their care. Many of these infants experience long hospital stays to help them manage their withdrawal symptoms.
New research led by Leslie Young, M.D., associate professor of pediatrics at UVM’s Larner College of Medicine, demonstrates that the “Eat, Sleep, Console” care approach (ESC), which uses a function-based assessment of withdrawal severity and emphasizes parent involvement, skin-to-skin contact, breastfeeding, rocking, and a calm environment, is more effective than usual care approaches for treating infants exposed to opioids in the womb. The current findings are published in the New England Journal of Medicine.
The ESC-NOW trial, funded by the National Institutes of Health (NIH), examined the impact of the ESC care approach and found that it substantially decreased the time until infants were medically ready for discharge. Newborns cared for with ESC were medically ready for discharge 6.7 days earlier and were 63 percent less likely to receive medication, compared to newborns cared for under the usual care approach.