Neonatal Opioid Withdrawal Program

Neonatal Abstinence Syndrome (NAS)

At SSM Health Cardinal Glennon Children’s Hospital we’re on the leading edge of state and national efforts to improve outcomes for mothers and infants affected by a substance abuse disorder, particularly opioids.

Nationally, the number of newborn babies who have been exposed to opioids or other drugs prior to birth is on the rise. Within the last several years, a non-pharmaceutical, evidence-based model of care called Eat, Sleep, Console (ESC) has proven to be a safe and simpler method of transitioning newborns through their withdrawal period in the first few days of life while still reducing duration of hospitalization and post-natal exposure to medications such as morphine.

ESC focuses primarily on non-pharmacologic methods such as rooming-in with parents, breastfeeding, and minimizing stimulations after birth. This family-centered approach to care enables mother and baby to remain together. This is helpful for babies so they can be fed on demand and be rapidly consoled or cuddled as often as possible.

Positive Outcomes with Eat, Sleep, Console (ESC)

ESC was implemented at SSM Health Cardinal Glennon Children’s Hospital and SSM Health St. Mary’s Hospital - St. Louis in 2017. Prior to the start of the program, babies diagnosed with NAS often spent up to three weeks in special care nurseries or the NICU as they were treated with morphine for their addiction withdrawal symptoms. Overall length of stay in the hospital dropped significantly, from 2-3 weeks to 5-7 days and the number of babies transferred to the NICU was reduced from 70% to just 5%. Our study demonstrated how care can be safely provided to most infants with neonatal opioid withdrawal on a postpartum unit without needing transfer to another unit or to a higher level of care facility. Also, with mothers and families involved in specific care practices from the beginning, the families felt more involved and empowered in the process to improve their baby’s health.

This program was developed by a team from Yale University and Children’s Hospital at Dartmouth-Hitchcock and has led to a significant drop in the traditional use of morphine in infants and reduced transfers to neonatal intensive care units (NICUs).

In Missouri, state education efforts to spread the use of ESC for Neonatal Abstinence Syndrome (NAS) are available through the University of Missouri’s TeleHealth Network and the Show-Me ECHO (Extension for Community Healthcare Outcomes) program. The NAS consortium is headed by neonatologists and educators from SSM Health Cardinal Glennon Children’s Hospital and includes leaders from four other hospitals in Missouri as well as representatives from the Missouri Hospital Association.

*SSM Health Cardinal Glennon Children’s Hospital offers comprehensive, high-risk maternity care for individuals affected by opioid dependency is available at the WISH (Women and Infant Substance Help) Center at SSM Health St. Mary’s Hospital - St. Louis with neonatologists from SSM Health Cardinal Glennon Children’s Hospital.