The problem is, many of the signs of opioid withdrawal look like typical newborn behaviors. Once they’re on the drug, it takes three to four weeks to wean them off, during which time they must remain in the hospital. Babies are assessed every three hours, and if they score eight or more on the Finnegan three times in a row, they are given medication. The Finnegan system tests for symptoms of opioid withdrawal, such as shaking, fever, sweating, high-pitched crying, gastrointestinal problems, sneezing, and yawning. Since the 1970s, the standard of care for NAS has been pharmacologic therapy - typically methadone or morphine - guided by the Finnegan Neonatal Abstinence Scoring System. ![]() “But it was what the standard was and what we were told to do.” “Taking these babies from their moms and putting them in a nursery where it’s noisy and lights are on has always seemed a little counterintuitive to what’s best for them,” said Susan Johnson, RNC, the NICU clinical coordinator at St. To anyone who’s taken care of an infant, Eat, Sleep, Console may sound obvious, but to physicians and nurses who treat babies with NAS, it’s a revolutionary departure from decades of practice recommended by experts. Joseph Hospital in Eureka, California, has adopted new protocols for treating newborns with opioid dependency. Studies at other institutions have shown newborns experience no adverse effects from this new protocol. Partnership said that in just the first three months of implementing the new approach, it saved $389,000. 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. ![]() This approach is known as “Eat, Sleep, Console,” meaning let the babies eat and sleep when they want and console them when they cry. And don’t give the baby opioids unless absolutely necessary. And when they finally can sleep, they may be awakened to be poked and prodded for medical tests and treatments.Ī 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. ![]() When they cry, there may be no one to hold them if the nurses are busy attending to other babies. Infants are fed not when they’re hungry but every three hours on a schedule. The NICU is busy, noisy, and bright, filled with beeping machines, other crying babies, and bustling nurses. 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). ![]() 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. The team includes, left to right, Carrie Griffin, DO, Candy Stockton, MD, and Susan Johnson, RN. The babies spend less time in the neonatal unit and receive less medication. Experts in Humboldt County changed the way they treat newborns dependent on opioids.
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