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Eat, Sleep, Console (ESC) for neonatal opioid withdrawal
Function-based care decision for neonatal opioid withdrawal.
Eat, Sleep, Console (ESC) for neonatal opioid withdrawal
Eating
Sleeping
Consoling
ResultAll ESC domains met
Continue non-pharmacologic, family-centred care (rooming-in, feeding on cue, low stimulation, holding/skin-to-skin).
- Domains not met
- 0
When to use
- Guiding management of the infant with neonatal opioid withdrawal (NOWS) using function rather than a symptom-count score.
Formula
Assess three functions: eats adequately, sleeps >=1 h undisturbed, and consoles within 10 min. Any domain unmet despite optimised supportive care prompts consideration of pharmacologic treatment.
Pearls and pitfalls
- ESC prioritises non-pharmacologic care and parental presence; it reduced length of stay and opioid treatment versus Finnegan-score-driven care.
- Impaired function should be judged as attributable to withdrawal, not other causes (e.g. hunger, illness).