The introduction of the eat, sleep, console (ESC) approach in 2017 represented a significant change in the approach to clinical care of neonates with neonatal opioid withdrawal syndrome (NOWS). The ESC approach uses 3 components of infant functioning to drive decision-making instead of scoring systems based on individual withdrawal symptoms. These nonpharmacologic interventions are first-line strategies that are maximized before the potential introduction of opioid therapy, and caregiver presence at the neonatal bedside is emphasized to ensure success of this approach. Since the introduction of the ESC method, several studies have examined its effectiveness and outcomes compared with prior traditional methods of NOWS management. By understanding the components of ESC management and the outcomes of neonates treated by this approach, clinicians can promote evidence-based best practices to optimize the care of neonates experiencing NOWS.
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