"Eat, Sleep, Console" Program In Central Indiana Helps Babies With Neonatal Abstinence Syndrome

INDIANAPOLIS, Indiana - Newborn babies who have been exposed to opioids and other drugs in the womb often experience withdrawal in the hours and days after birth. Historically, caregivers for infants with neonatal abstinence syndrome resorted to administering medications for withdrawal symptoms. But a growing body of research shows that for many of these babies, a simpler way to console the baby may be the answer.  

"Eat, Sleep, Console" is an evidence-based method of care that helps new parents care for their infants who may be suffering from neonatal abstinence syndrome or NAS. The program seeks to change the stigma around neonatal exposure and withdrawal and helps provide family-centered care to the family unit.

The "Eat, Sleep, Console" method can be tried first, before seeking pharmacological options for neonatal abstinence syndrome. Franciscan Health Indianapolis was the first hospital system in Indiana to adopt the "Eat, Sleep Console" model. 

Eat, Sleep, Console focuses on three key areas to help separate withdrawal symptoms from normal newborn behavior:

• Eat: Is the baby feeding normally?
• Sleep: Is the baby able to sleep between feedings?
• Console: Can the baby be consoled or comforted within 10 minutes of crying?

In its first year, more than 5,000 families have been touched by the model, which allows mom and baby to stay together so that babies can be fed on demand and rocked and cuddled as much as possible.

This has led to a significantly less intensive care stays and fewer days in the hospital for affected newborns and a significantly smaller number of infants requiring medication assistance for neonatal abstinence syndrome.

"If there's not severe withdrawal, there are things we can do," explained Angela Bratina, MSN, RN, APRN-BC, NE-BC, administrative director for Women & Children at Franciscan Health Indianapolis. Bratina helped introduce the "Eat, Sleep, Console" program to Franciscan Health last year.

Rather than sending a baby to the NICU and administering morphine for withdrawal, the program empowers new moms to learn the baby's signals and assist in their caregiving.

Before moving to "Eat, Sleep, Console," "The biggest feeling among the moms was that they were less helpful, less involved with their care," Bratina said.  We know that "Every baby wants to be held, especially if there's substance abuse." And this program allows families to do just that.

Guiding Families

Infants with known opiate exposure are observed for 5 to 7 days before discharge from the hospital is considered, and if mom is discharged before the baby, the infant is transferred to Pediatrics to continue bonding and supportive care. Pediatric nurses help educate new moms or foster parents on ways to help soothe their child after leaving the hospital.

"We're making sure our care is given when the baby's awake," Bratina said. "With feeding, we're swaddling and avoiding startling the baby. Around the time we need to be up to feed, we might dim the lights and put music on. If you're trying to help the baby sleep at night, maybe we will pace, swaddle, etc."

Recovery from Opioid Use

"Eat, Sleep, Console" is one of several initiatives Franciscan Health has implemented to help care for patients with opioid abuse. In 2017, Franciscan Health launched the Grace Project, which helps drug-addicted mothers and their babies.

Franciscan Health Foundation, on behalf of Franciscan Alliance, has been awarded a three-year, $1.57 million federal grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) to support medication assisted treatment (MAT) for opioid use disorder at Franciscan Health hospitals in Marion and Lake counties in Indiana.