NEWS | August 12, 2019

New protocol for babies born with opioid dependence

(SACRAMENTO)

UC Davis Children's Hospital is taking a new approach to care for babies born with physiologic dependence on opioids, also known as Neonatal Abstinence Syndrome (NAS).

Opioid use disorder has gone up more than four times among pregnant women, according to the U.S. Center for Disease Control and Prevention. Opioid use disorder has gone up more than four times among pregnant women, according to the U.S. Center for Disease Control and Prevention.

In July, UC Davis providers began using the “Eat, Sleep, Console” model in the UC Davis Neonatal Intensive Care Unit (NICU) to screen and direct treatment for babies with NAS. The “Eat, Sleep, Console” model launches this week in the UC Davis newborn nursery

In this model, babies with NAS are flagged if they have:

  • difficulty eating appropriate amounts
  • difficulty staying asleep for at least an hour
  • difficulty being consoled within 10 minutes (even when they are patted, held, talked to calmly, rocked)

The baby’s health care team ensures that they are providing non-pharmacological treatment first, including dimming lights, keeping the room quiet and allowing babies to feed on demand.

“We are also ensuring that a parent is present when possible, giving babies the chance to be held skin-to-skin or swaddled,” said Kara Kuhn-Riordon, neonatologist at UC Davis Children's Hospital.

If those additional measures are taken and the baby still has difficulty eating, sleeping and consoling, only then will oral morphine treatment begin.

“This is a new approach in contrast to the traditional Finnegan model, where we evaluate a series of behaviors including tremors, yawning, sneezing, mottled skin and more,” said Kuhn-Riordan, who has seen the incidence of NICU babies with NAS increase since she began working at UC Davis Children's Hospital nine years ago. “‘Eat, sleep, console’ is a functional model that has been shown to decrease length of hospital stay and reduce need for morphine among babies.”