Related Experiment Video
Updated: Nov 18, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Baby STRENGTH: Eat, Sleep, Console for Infants With Neonatal Abstinence Syndrome
Patricia A Miller1, Tina Willier
1UPMC Pinnacle, Harrisburg, Pennsylvania.
Insights
The Eat, Sleep, Console (ESC) model significantly reduced hospital stays and morphine use for infants with neonatal abstinence syndrome (NAS). Breastfeeding rates also increased, showing improved infant care outcomes.
Area of Science:
- Neonatal care
- Pharmacology
- Public Health
Background:
- Traditional management of neonatal abstinence syndrome (NAS) leads to prolonged hospitalizations.
- Nonpharmacologic interventions, such as the Eat, Sleep, Console (ESC) model, show promise in reducing length of stay (LOS).
Purpose of the Study:
- To evaluate the impact of the ESC model on LOS and morphine administration in infants with opioid withdrawal.
- To compare the ESC model with traditional medication management for NAS.
Main Methods:
- Retrospective review of NAS patient data before and after ESC model implementation.
- Analysis of demographic data, maternal history, LOS, morphine use, and infant weight.
- Statistical analysis including t-tests and chi-square tests to compare outcomes.
Main Results:
- Mean LOS decreased from 17.7 to 5.9 days (P < .0001).
- Infants receiving morphine dropped from 58.9% to 2.7% (P < .0001).
- Breastfeeding rates increased from 41.18% to 64.86% (P = .0456).
Conclusions:
- The ESC model effectively reduces LOS and morphine requirements for NAS infants.
- Increased maternal breastfeeding rates observed with the ESC model.
- Further research is needed on long-term neurodevelopmental outcomes.
Background:
Traditional medication-based management of neonatal abstinence syndrome (NAS) results in long hospitalizations. Nonpharmacologic treatment and using the Eat, Sleep, Console (ESC) model of care have been shown to decrease lengths of stay (LOSs).
Purpose:
To determine whether using the ESC model of care to treat infants with opioid withdrawal resulted in decreased LOSs and number of infants receiving morphine when compared with traditional medication management.
Methods:
Retrospective medical review for all patients admitted for NAS 12 months before and 12 months after implementing the ESC model of care. Data collected from electronic health records included demographic data, maternal history, infant LOS, infants receiving morphine, and birth weight/weight on day of life (DOL) 5. Univariate analysis was used to control for demographic data/risk factors. A 2-samples t test was used to compare average LOSs. Chi-square test was used to detect differences in the number of infants receiving morphine. Data were analyzed using SAS 9.4 software.
Results:
LOS decreased from mean of 17.7 days to a mean of 5.9 days (P < .0001). The number of infants receiving morphine decreased from 20 (58.9%) to 1 (2.7%) (P < .0001). No statistically significant difference was noted in the percentage of weight loss on DOL 5. Data showed an increase in breastfeeding rates from 41.18% to 64.86% (P = .0456).
Implications For Practice:
The ESC model of care decreased infant LOS and the number of morphine doses administered for opioid withdrawal symptoms. Maternal breastfeeding rates increased.
Implications For Research:
More research is needed to determine long-term neurodevelopmental outcomes of infants managed using ESC principles.
Related Concept Videos
01:24Substance Use Disorders Affecting Sleep
Understanding the concepts of physical dependence,...
01:15REM Sleep Behavior Disorder
RBD is significantly associated with...