“Eat, Sleep, Console” Approach: Better Way to Help Newborns in Opioid Withdrawal

New approach called “Eat, Sleep, Console” gets newborns with symptoms of opioid withdrawal out of the hospital sooner and with less medication.

Rates of neonatal abstinence syndrome surged in recent years, but a newer approach to care for newborn babies exposed to opioids during pregnancy gets them out of the hospital sooner and with less medication, according to a study published in the New England Journal of Medicine.

Rising Levels of Neonatal Abstinence Syndrome

The United States has seen an explosion in the number of infants born with neonatal abstinence syndrome in recent years, swelling by about 82% between 2010 and 2017, according to the US Centers for Disease Control and Prevention.

Nearly 60 infants are diagnosed with NAS each day, based on data from the U.S. Agency for Healthcare Research and Quality in 2020. The United States’ opioid epidemic has been expanding in recent years and opioid deaths are the leading cause of accidental death in the US.

Drug Abuse in Pregnancy
Drug abuse during pregnancy has an adverse effect on the mother as well as the fetus. It is advisable to stop usage of illicit drugs well before pregnancy.

‘Eat, Sleep, Console encourages involvement from parents, and prioritizes care that doesn’t involve medication, such as swaddling, skin-to-skin contact, and breastfeeding.’

Opioid use during pregnancy has been linked to maternal mortality and risk of overdose for the mother, according to the CDC, while infants risk preterm birth, low birth weight, breathing problems, and feeding problems.

Newborns in opioid withdrawal may experience upset stomach, inconsolable crying, seizures, and extreme discomfort. The study looked at the impacts of the Eat, Sleep, Console care approach on 1,300 infants at 26 US hospitals, and compared them with the current standard for caring for infants exposed to opioids.

Eat, Sleep, Console Approach vs Usual Care for Neonatal Opioid Withdrawal

The usual approach involves a nurse measuring a baby’s withdrawal symptoms – such as their level of irritability, the pitch of crying, fever, or tremors – before providing treatment such as methadone or morphine.

Compared to usual care, the use of the Eat, Sleep, Console care approach substantially decreased the time until infants with neonatal opioid withdrawal syndrome were medically ready for discharge, without increasing specified adverse outcomes.

Virtual Overdose Monitoring Could Help in Reducing Drug Overdose
Smartphone applications and helplines could prevent overdose related fatalities.

The infants assessed with the Eat, Sleep, Console care method were discharged after eight days on average, compared with almost 15 days for the infants who were cared for by the standard approach.

Additionally, infants in the Eat, Sleep, Console care group were 63% less likely to receive opioid medication – 19.5% received medication compared with 52% in the group receiving usual care.

Long-term Unemployment Linked to Neonatal Abstinence Syndrome
Neonatal abstinence syndrome (NAS) is a withdrawal syndrome in babies exposed to opioids before birth. It occurs in counties in the US having long-term unemployment and a shortage of mental health services.

The current approach to usual care is a nurse-led way of assessing the infant, whereas the Eat, Sleep, Console approach involves the mom to assess the infant, and allows her to take part in trying to soothe the infant.

The Eat, Sleep, Console method was developed about eight years ago, and some hospitals have already implemented it. But this study’s findings could change how more hospitals practice caring for infants with neonatal abstinence syndrome.

Fatal Opioid Poisonings in Children Doubled in 13 Years
New study has found that the rate of fatal opioid poisonings among children more than doubled over 13 years despite increased regulation.

Source-Eurekalert