Functional Scoring and Console care approach improves treatment of Neonatal Opioid Withdrawal syndrome

A new study by Leslie Young and team found that the number of days it took for babies with newborn opioid withdrawal syndrome to be medically ready for release dramatically reduced when the Sleep, Eat, Console care method was used, compared to normal care, without worsening any of the specified negative outcomes. The findings of this study were published in The New England Journal of Medicine.

Although the Finnegan Neonatal Abstinence Scoring Tool has long been used by clinicians to gauge the severity of neonatal opioid withdrawal, the Eat, Sleep, Console care approach is a more recent function-based method that is gaining popularity. In order to determine if the new strategy may safely shorten the period of time until newborns are medically prepared for release, it was decided to perform this study.

Infants with newborn opioid withdrawal syndrome who were born at 36 weeks or more were included in this cluster-randomized, controlled experiment at 26 U.S. hospitals by researchers. At a randomly assigned period, hospitals shifted from standard treatment that employed the

Finnegan tool to the Eat, Sleep, Console strategy. Staff members at each institution were educated to apply the new strategy over a three-month transition phase. The trial's definition of the period from birth to medical fitness for release served as the primary outcome. In-hospital safety, unscheduled medical visits, and nonaccidental trauma or death were all composite safety outcomes that were evaluated during the first three months postnatal age.

The key findings of this study were:

1. 1305 babies in all were enrolled.

2. The number of days from birth till readiness for hospital discharge was 8.2 in the Eat, Sleep, Console group and 14.9 in the usual-care group in an intention-to-treat analysis that included 837 babies who fulfilled the trial criterion for medical readiness for discharge, yielding a rate ratio of 0.55.

3. In both groups, the frequency of unfavorable outcomes was comparable.

In conclusion, a more recent function-based method of treating newborn opioid withdrawal syndrome successfully prepared infants for an earlier return home.

Reference: 

Young, L. W., Ounpraseuth, S. T., Merhar, S. L., Hu, Z., Simon, A. E., Bremer, A. A., Lee, J. Y., Das, A., Crawford, M. M., Greenberg, R. G., Smith, P. B., Poindexter, B. B., Higgins, R. D., Walsh, M. C., Rice, W., Paul, D. A., Maxwell, J. R., Telang, S., Fung, C. M., … Devlin, L. A. (2023). Eat, Sleep, Console Approach or Usual Care for Neonatal Opioid Withdrawal. In New England Journal of Medicine. Massachusetts Medical Society. https://doi.org/10.1056/nejmoa2214470