Eating, Sleeping, Consoling for Neonatal Opioid Withdrawal (ESC-NOW): a Function-Based Assessment and Management Approach study protocol for a multi-center, stepped-wedge randomized controlled trial

Increased opioid use has resulted in a dramatic increase in the number of infants born with in utero opioid exposure requiring management for NOWS [ 1 , 2 , 3 , 4 ]. Despite the significance of this problem, numerous critical gaps remain in our knowledge with respect to the best practices for identification and management of infants with NOWS, as well as our understanding of the outcomes of these infants [ 5 , 6 ]. The opioid epidemic particularly impacts rural and underserved communities represented by the ISPCTN and participating Neonatal Research Network (NRN) sites, which makes our networks well poised to address these critical gaps and improve the care of infants with NOWS.