Eating, Sleeping, Consoling for Neonatal Opioid Withdrawal (ESC-NOW): a Function-Based Assessment and Management Approach

ESC-NOW was a cluster-randomized, controlled trial conducted at 26 U.S. hospitals, which enrolled 1305 infants with neonatal opioid withdrawal syndrome (NOWS). At a randomly assigned time, participants transitioned from usual care based on the Finnegan Neonatal Abstinence Scoring Tool�(FNAST) to the Eat, Sleep, Console (ESC) approach. The primary outcome was the time from birth until medical readiness for discharge as defined by the trial. The Eat, Sleep, Console care approach significantly decreased the number of days until infants born with NOWS were medically ready for discharge, without increasing specified adverse outcomes.