Aug 1, 2019, Dana G. Smith, for CHCF
When babies are born dependent on opioids, typically they are whisked away from their mothers, put into the neonatal intensive care unit (NICU), dosed with morphine to get them through withdrawal, and gradually weaned off the drug—a process that can take weeks.
Research now suggests that this long-established standard of care may be the worst way to care for a newborn with opioid dependency, or neonatal abstinence syndrome (NAS). The NICU is busy, noisy, and bright, filled with beeping machines, other crying babies, and bustling nurses. Infants are fed not when they’re hungry but every three hours on a schedule. When they cry, there may be no one to hold them if the nurses are busy attending to other babies. And when they finally can sleep, they may be awakened to be poked and prodded for medical tests and treatments.
A new initiative is turning NAS treatment on its head with a shockingly simple concept: treat the baby like a baby and the mom like a mom. Keep the baby and the mother together. Keep the baby out of the NICU. And don’t give the baby opioids unless absolutely necessary.
This approach is known as “Eat, Sleep, Console,” meaning let the babies eat and sleep when they want and console them when they cry. With this protocol, hospitals treating members of Partnership HealthPlan of California — a Northern California Medi-Cal managed care organization — reduced the average hospitalization of babies with NAS from 18 days to 11 days. Partnership said that in just the first three months of implementing the new approach, it saved $389,000. Studies at other institutions have shown newborns experience no adverse effects from this new protocol.
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