Eat, Sleep, Console: A non-pharmacological paradigm for neonatal withdrawal

Background Neonatal Abstinence Syndrome (NAS) inclusive of Neonatal Opioid Withdrawal Syndrome (NOWS) is commonly managed with pharmacotherapy, often resulting in extended hospital stays. The Eat, Sleep, Console (ESC) model offers a function-based, non-pharmacological approach to care. Purpose To synthesise global evidence on the benefits of ESC model of care and to examine its implementation in Australian neonatal units, with particular focus on its impact on length of stay and pharmacotherapy rates among infants with NAS. Methods Using Whittemore and Knafl's (2005) approach to integrative review, five databases were searched based on a pre-defined inclusion and exclusion criteria. Results One hundred and twenty-seven (127) studies were screened for eligibility and 18 eligible studies included in the review. Data were analysed using narrative analysis. Two main themes were developed; (1) Outcomes of ESC model, demonstrating reductions in pharmacotherapy use and length of hospital stay and (2) ESC implementation, describing the operationalisation of ESC in neonatal units for successful outcomes. No Australian study was identified, demonstrating a lack of evidence in ESC implementation in Australia. Conclusions The Eat, Sleep, Console model for assessment and management of NAS is associated with favourable short-term outcomes in primarily opioid-exposed, full-term neonates, and in settings where non-pharmacological care can be optimised. Further robust research assessing the implementation and use of ESC is needed in Australia.