Maternal Opioid Use and Hospital Management of Opioid-exposed Newborns: Establishing Baseline Data Before Piloting the Eat, Sleep, Console Model of Care in an Australian Public Health Organization

Aims: Eat sleep and console (ESC) is a model of care for neonatal opioid withdrawal with an emphasis on rooming-in with a constant parent as opposed to transferring the newborn to a neonatal unit for pharmacological treatment. The adoption of this care model in Australia is still limited. This study aimed to establish baseline data before piloting ESC in an Australian public health organization. Design: A descriptive study using a retrospective medical record audit. Methods: Patients who identified opioid as their principal drug of concern to a Substance Use in Pregnancy and Parenting Service between 2016 and 2020 were included in the audit. Data were extracted from maternal records, drug and alcohol treatment records, and neonatal records. A descriptive analysis was conducted. Results: Thirty-five singleton pregnancies were audited. The most frequently reported principal drug of concern was methadone, accounting for 54.3% of the pregnancies. This was followed by opioid analgesics (28.6%) and buprenorphine (14.3%). Heroin was reported in one pregnancy. Pharmacological treatment for withdrawal in newborns was provided in the neonatal unit but not in the postnatal ward. Among the 35 newborns, 25.7% were directly admitted to the neonatal unit and 22.9% were transferred to the neonatal unit after being admitted with their mothers to the postnatal ward. Among the newborns in the neonatal unit, 47.1% received pharmacological treatment for withdrawal. Compared with those admitted to the neonatal unit, newborns cared for alongside their mothers in the postnatal ward had a significantly higher breastfeeding rate (58.8% vs. 5.9%). Overall, 20 newborns had a Finnegan highest score ≥8. Among them, 35.0% (7/20) received nonpharmacological care in the postnatal ward. Conclusion: Baseline data for piloting ESC was established. More than a third of the newborns at risk of withdrawal received nonpharmacological care while staying with their mothers in the postnatal ward.