The Finnegan Neonatal Abstinence Scoring System (FNASS) assesses the severity of neonatal abstinence syndrome (NAS), including neonatal opioid withdrawal syndrome (NOWS), by evaluating withdrawal-specific behaviors and responding with pharmacological treatment. However, because FNASS has limited scientific support and because it was identified as a cause of unnecessary hospital admissions, FNASS has increasingly been replaced by the new Eat, Sleep, Console (ESC) protocol. Unlike FNASS, ESC evaluates the severity of NAS by monitoring an infant’s nutrition intake, their ability to sleep for more than one hour and whether they can be consoled in less than 10 minutes.
Elizabeth McGregor, a student in the undergraduate bioethics minor at The Ohio State University College of Medicine, works at a local children’s hospital caring for infants managing withdrawal symptoms after being born addicted to opioids. Abraham Graber, PhD, professor in the Department of Biomedical Education and Anatomy at the Ohio State College of Medicine, mentors undergraduate students who are planning to pursue medicine by working with them on writing and publishing academic research.
When the hospital where McGregor works began transitioning from FNASS to ESC, she approached Dr. Graber to collaborate on a project assessing the contemporary state of the evidence in support of ESC. Their commentary, “Popular Protocol or Evidence-Based Practice: A Reassessment of ‘Eat, Sleep, Console,’ was recently published in Pediatric Research.
Their review shows that in comparison to FNASS, ESC:
These findings indicate that, in order for ESC to become a new standard of care, more evidence is needed to show that ESC improves the well-being of babies born dependent on opioids.
