The National Institutes of Health released a study where researchers found the “Eat, Sleep, Console” (ESC) is more effective than the Finnegan Neonatal Abstinence Scoring Tool (FNAST) in assessing and managing newborns with a history of opioid exposure.
According to a news release from the National Institutes of Health, compared to newborns who received FNAST care, those under ESC care were 63% less likely to need medication as part of their treatment and were ready medically for discharge approximately 6.7 days earlier.
ESC places a high priority on non-pharmacologic methods of care, including nursing, swaddling, skin-to-skin contact and low-stimulation environments, the release said. Additionally, ESC promotes parental involvement in the upbringing and evaluation of their young children.
“Medical care for newborns who were exposed to opioids during pregnancy varies widely across hospitals. These findings are an important step toward standard, evidence-based guidance for the care of these infants," Diana Bianchi, M.D., director of NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), said. NICHD co-led the study with the NIH Environmental Influences on Child Health Outcomes (ECHO) Program, according to the release.
Neonatal opioid withdrawal syndrome (NOWS), which includes tremors, excessive crying and irritability, difficulty with sleeping and eating, may manifest in neonates who have been exposed to opioids. FNAST has been the standard assessment method for newborns with NOWS for the past 50 years. The thorough scoring system evaluates withdrawal symptoms across more than 20 different domains, but it has been criticized for subjectivity and an overestimation of the requirement for opioid prescription in treatment.
In contrast, the ESC care approach has not been thoroughly studied in a large population, although it was created approximately eight years ago and is becoming more popular in nurseries, according to the release. The focus of the ESC evaluations pertains to an infant’s ability to eat, sleep and be comforted. Mother and child are kept together in these methods, and families are able to take a more active part in their child’s care, the release said. Widespread adoption of ESC without strong proof of its effectiveness and safety have created worry about under-treating infants or releasing them too soon, however.
