Eat, Sleep, Console (neonatal opioid withdrawal)
Records the three Eat, Sleep, Console observations for an infant in neonatal opioid withdrawal, and says what follows.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Consoling
- Yes
- Rooming-in with a parent or caregiver present
- Yes
- Holding, or skin-to-skin contact
- Yes
Result: 1 of 3 items not met, with 2 of 5 care measures in place
The tool opens with these values already filled in. Replace them with your own.
What the result means
- The three questions
- Can the infant feed adequately, does it sleep an hour or more after a feed, and can it be consoled within about ten minutes with caregiver support.
- Any one not met
- Review and escalate non-pharmacologic care, then reassess. That is the response, not medication.
- Still not met
- When an infant cannot eat, sleep or be consoled despite maximized non-pharmacologic care, that is the point at which pharmacologic treatment is considered by the team.
- Not a score
- Nothing is added up, there is no total and no threshold. It is not interchangeable with a Finnegan score: one medicates on a number, the other on function.
- The care is the treatment
- Rooming-in, parental presence, holding, a quiet low-light room, feeding on cue and clustered care are the intervention, not a preliminary to one.
- Attribution
- An item counts as not met only when the failure is attributable to withdrawal. A hungry infant, or one unwell for another reason, is not an item failure.
What you enter
- Eating: feeding is limited by withdrawal (functional item)
- Sleeping: sleeps less than an hour after a feed, because of withdrawal (functional item)
- Consoling: cannot be consoled within about ten minutes with caregiver support (functional item)
- Another cause for the difficulty is suspected (an item counts only when the failure is attributable to withdrawal)
- Rooming-in with a parent or caregiver present (non-pharmacologic care)
- Holding, or skin-to-skin contact (non-pharmacologic care)
- A quiet, low-light environment (non-pharmacologic care)
- Feeding on cue, with a supported feeding plan (non-pharmacologic care)
- Clustered care, so the infant is disturbed less (non-pharmacologic care)
How this is calculated
Grossman MR, Berkwitt AK, Osborn RR, et al. An initiative to improve the quality of care of infants with neonatal abstinence syndrome. Pediatrics. 2017;139(6):e20163360. Young LW, Ounpraseuth ST, Merhar SL, et al. N Engl J Med. 2023;388(25):2326-2337. Read the sources: Grossman 2017 ↗, Young 2023 ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.