GNYHA’s Maternal Health Learning Series Highlights Origins of Eat, Sleep, Console

July 24, 2023

GNYHA recently held the third forum of the Advancing Maternal Health and Well-Being Learning Series, “A Person-Centered Approach to Treating Newborns Affected by Substance Use,” which reviewed the Eat, Sleep, Console (ESC) approach to treat newborns affected by substance use.

GNYHA Senior Director Kendall LaSane promoted patient and provider tools and resources available from the New York State Department of Health’s Perinatal Quality Collaborative and the New York City Department of Health and Mental Hygiene’s Doula and Maternity Hospital Quality Improvement Network initiatives.

Matthew Grossman, MD, Associate Professor of Pediatrics (Hospital Medicine); Vice Chair for Quality, Department of Pediatrics; and Quality and Safety Officer at Yale New Haven Children’s Hospital, reviewed the origins of the ESC approach, which leverages the bond between parent and child as a first-line treatment and empowers birthing people to actively care for their infants. In the mid-1970s, the Finnegan Scoring Tool was used to help doctors determine how much medication to give babies based on the severity of their withdrawal symptoms. While it became the foundation for the national standard approach to infants with Neonatal Abstinence Syndrome (NAS) and was used for decades, its reliance on the use of opioid medications led to newborns with NAS having the longest in-hospital stay.

The ESC approach followed based on a 2014-15 study of 50 babies admitted to the general inpatient unit of Yale New Haven Children’s Hospital. The babies were assessed every two to six hours, during which clinicians relied less on medication and more on ties to the parent.

“We knocked 10 days off the length of stay by just adding the mom,” said Dr. Grossman. “We began to think of mom as the medication.”

The study also determined that sending babies to the neonatal intensive care unit (NICU), where parents could only visit them, was the least welcoming and supportive place for a baby in withdrawal and their parents. “We kept mom and baby together versus sending the baby to the NICU,” said Dr. Grossman. The ESC approach also had other positive impacts, including substance use stigma reduction among hospital staff and parents.

GNYHA’s Maternal Health Learning Series shares up-to-date information from Federal, State, and local government agencies on advancing maternal health equity. Each session spotlights member programming focused on closing identified gaps in care delivery across the maternal health care continuum. GNYHA will continue to provide support and resources with the latest information to help member hospitals provide high-quality care, advance maternal health equity, and improve care outcomes.