Penn Highlands Healthcare Offers “Eat, Sleep and Console” for Substance-Exposed Newborns

Substance use disorder affects thousands of people in Pennsylvania including some of our tiniest residents — newborns. Traditionally, babies who were exposed to substances in utero have been assessed at birth by the Finnegan Neonatal Abstinence Scoring System to evaluate their withdrawal symptoms. Most often, their symptoms were treated with medication. Now, Penn Highlands Healthcare is among a growing number of health systems offering “Eat, Sleep and Console” (ESC). This new model of care is part of the health system’s New Approach to Success Program that focuses on the health and wellness of a mother with substance use disorder throughout her pregnancy one year after delivery. “Eat, Sleep and Console” is the result of evidence-based research which focuses on providing comforting care without medication.

“’Eat, Sleep and Console’ is a safe and effective way to provide withdrawal care to newborns who were exposed to substances in utero,” said Suzanne J. McCullough, BSN, RN-NIC, Director of the Neonatal ICU at Penn Highlands DuBois. “This program is having a positive impact on the babies because it significantly reduces the number of newborns who need medication for their withdrawal symptoms, provides a great bonding opportunity for the babies and their parents and enables the infants to go home sooner.”

According to Mrs. McCullough, “Eat, Sleep and Console” was introduced in the maternity units and Neonatal Intensive Care Unit at Penn Highlands DuBois and Penn Highlands Elk in January 2023 and since then only three babies who were exposed to substances in utero required medication for their symptoms. “Eat, Sleep and Console” is a four- to seven-day program with most newborns being discharged within four to five days. While the baby is in the program, the Penn Highlands Maternal Child health team will observe the infant’s feeding — is the baby eating an adequate amount for growth and development? The team will also monitor the baby’s sleeping — is the infant sleeping at least one hour without waking? They also will assess if the baby can be consoled within 10 minutes. Babies who require medication in addition to the comfort care may require a longer hospital stay.

“Eat, Sleep and Console” focuses on calming and soothing techniques that include:

• Encouraging parents to be with the baby for the four to seven days that they are in the program because the newborns respond best to their parents.
• Skin-to-skin contact between the babies and their parents. The baby’s bare chest is pressed against its parents’ bare chests to help calm the infant, as well as promote sleep self-regulation and ultimately parent-child bonding.
• Creating an atmosphere with dim lighting to avoid overstimulation.
• Swaddling the infants to help them feel safe and calm and protect them from startling easily.
• Holding and rocking the babies because the holding makes them feel secure and the rocking motion has a soothing affect.

During Mrs. McCullough’s nursing career, which has spanned some 35 years, she has witnessed many positive changes in care including the introduction of “Eat, Sleep and Console.”

“We have had parents whose babies received care in our maternity units and Neonatal Intensive Care Unit using the Finnegan Neonatal Abstinence Scoring System and then had other babies go through our ‘Eat, Sleep and Console’ program tell us that they find the new program more satisfying because it caused them less distress. Some said that it was comforting to know that their babies did not have to go through withdrawal by substituting one medication for another. Plus, most parents were able to take their infants home sooner with the new program.”

In addition to “Eat, Sleep and Console,” Penn Highlands Healthcare employs a Substance Use Disorder (SUD) Care Coordinator to assist pregnant women and their newborns with substance use disorder. Shannon Gill, RN, is the Care Coordinator who provides a continuum of care to the mother and baby from pregnancy to postpartum. She follows the moms-to-be throughout their pregnancies and provides information and education to help them transition from pregnancy to postpartum successfully. In addition, she provides follow-up care with the mothers and babies up to a year postpartum via emails, texts, video chats and home visits.

“The New Approach to Success Program with ‘Eat, Sleep and Console,’ is a little gem in our region,” added Mrs. McCullough.