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Evaluating the Impact of Eat, Sleep, Console in Neonatal Abstinence Syndrome Treatment for Infants Exposed to

Shannon V McGrath1, Allie Rivera1, Christopher Kennie-Richardson1

  • 1Department of Pharmacy (SVM, JC, CK-R, AR, VF), Cone Health Women's and Children's Center, Greensboro, NC.

The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG
|April 10, 2024
PubMed

Insights

The Eat, Sleep, Console (ESC) approach significantly reduced the need for pharmacologic treatment in infants with neonatal abstinence syndrome (NAS). This approach also decreased hospital length of stay for affected newborns.

Area of Science:

  • Neonatal care
  • Pharmacology
  • Public health

Background:

  • Maternal substance use, including licit/illicit drugs, alcohol, and tobacco, is increasing, leading to a rise in neonatal abstinence syndrome (NAS).
  • Current NAS management trends favor the Eat, Sleep, Console (ESC) approach before resorting to pharmacologic interventions.

Purpose of the Study:

  • To assess the effectiveness of the Eat, Sleep, Console (ESC) approach combined with pharmacologic treatment for NAS in infants with in utero substance exposure.
  • To evaluate the impact of ESC on the rate of pharmacologic therapy initiation and other clinical outcomes.

Main Methods:

  • A retrospective cohort study involving infants with known in utero substance exposure or withdrawal symptoms.
  • Comparison of outcomes, including pharmacologic therapy initiation rate, length of stay, and timing of treatment, before and after ESC implementation.
  • Subgroup analysis for infants with maternal polysubstance use.

Main Results:

  • The rate of pharmacologic therapy initiation decreased from 58% to 30% post-ESC implementation (p < 0.01).
  • Fewer infants required scheduled morphine (33%, p < 0.01) and the duration of pharmacologic therapy was reduced (14.6 days vs. 6.47 days, p < 0.01).

Conclusions:

  • Implementation of the ESC guideline effectively reduced the length of hospital stay.
  • The ESC approach significantly decreased the rate of pharmacologic intervention required for infants diagnosed with NAS.
Abstract

Keywords:
infantneonatal abstinence syndromepregnancy

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