"Mom is the Best Medicine"

Eat, Sleep, Console Implementation

Union Hospital Terre Haute Women and Children Services is launching Eat Sleep Console on June 1st as a new evidence-based model to care for infants who are exposed to opioids, and other substances, during pregnancy.

When a pregnant person uses substances, especially opioids, their new baby may experience withdrawal symptoms after delivery. This is called neonatal abstinence syndrome, or NAS. Symptoms may include extreme irritability, vomiting, fever, diarrhea, body tremors and more. Infants may also experience NAS if the mother is working closely with a physician to receive medication-assisted treatment and is no longer using illicit substances.

Traditionally, medical providers would use an assessment tool and score the infants severity of symptoms to determine NAS treatment. This traditional method often resulted in pharmacologic care and longer stays in the Neonatal Intensive Care Unit (NICU). Morphine was often used to combat the withdrawal symptoms experienced by the infant and extended hospital stays up to 23 days after delivery.

Developed by Dr. Matthew Grossman at Yale New Haven Children’s Hospital, Eat Sleep Console (ESC) is a simplified approach to monitoring and treating infants who were exposed to substances during pregnancy. Rather than scoring an infant based on the above-mentioned symptoms, ESC focuses on the newborn’s ability to simply eat, sleep, and be consoled. These are three basic functions of all newborns, regardless of their mother’s substance use.

ESC is a harm reduction effort to encourage moms to serve as treatment of NAS symptoms rather than pharmacologic intervention. Union Hospital Terre Haute will now teach, support, and encourage mothers to provide more direct care to their infants to reduce pharmacologic intervention and overall length of stay. Mothers, and other primary caregivers, will be asked to try care methods such as rooming in with the newborn, increasing skin-to-skin contact, breastfeeding, swaddling, limiting visitors and providing a low stimulation environment. The mother will also be asked to track the infant’s ability to eat, sleep, and be consoled using a Newborn Care Diary. This diary will enable the mother to be a key member of the infant’s care team by providing notes and documentation of the infant’s behaviors.

When the mother, or other primary caregiver, needs to sleep or cannot stay with their infant for any amount of time, Union Hospital will invite volunteer Cuddlers into the infant’s room to provide one on one care in their absence.

With support from the Indiana Department of Health Safety PIN funding, Union Hospital Terre Haute has all pulled together a multidisciplinary leadership team to create new protocols and educate all providers and support staff who work with newborns.

For additional information, please contact:

Sarah Briley at the Richard G. Lugar Center for Rural Health