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PostPosted: Fri Aug 04, 2017 10:42 pm 
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This new less aggressive better way to assess NAS study was with Mom's on methadone for opioid use disorder. No bup mom's. Know that a recent study showed bup babies have far lower NAS and hospital stays than methadone babies.

May 2017 New way to assess NAS called ESC- Eat Sleep Console to score NAS results in far shorter stays of 5.9 days vs 22.5 days and far less babies treated with morphine at 12% vs 60% as compared with the older Finnegan approach.
http://www.aappublications.org/news/201 ... SNAS050417

June 2017 New way to assess NAS Journal Abstract. Some of you have access to the full article.
https://www.ncbi.nlm.nih.gov/pubmed/28562267

June 2017 NICU Dr. blogs on this new simpler better way to assess NAS - Eat Sleep Console method. He spells out the differences between the older complicated Finnegan method and new simpler ESC method.
https://99nicu.org/blogs/entry/269-is-i ... bstinence/

May 2017 Medscape. If you're a Medscape member, copy and paste this title Skipping Finnegan Score Reduces NAS Treatment and Length of Stay into your search engine and see if it comes up- a nice article.

It says: 'Instead of looking at symptoms of withdrawal, clinicians assess whether an infant is able to eat 1 or more ounce per feeding, sleep for an hour or longer undisturbed, and be consoled in 10 minutes or less.'

'If all three of these criteria are met, we considered these infants well managed, despite other signs and symptoms of withdrawal'

'Even if babies have withdrawal signs, if they can be managed such that the baby can eat, sleep, and be consoled, then the baby is doing well and is well-managed.'

No NICU, reduces/avoids newborn opiate exposure, allows in room time w mom, regular breast feeding, bonding. This seems obviously better to me.

Hopefully this new approach will be implemented in hospitals across the US. With more babies born dependent, one big driver for hospitals is reducing tying up NICU beds for NAS and this new approach directly does that. Hate to even write that bc the real reason should be that its better for babies and their moms and families...

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PostPosted: Sat Aug 05, 2017 10:55 am 
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Thank u pelican, very informative as usual!

U know I think bk to my first born (I definitely wasn't addicted then) and how hard of an infant he was to take care of because of colic. Lordy mercy it was constantly from the time he was born seemed like. He wouldn't sleep and we had to even try several different formulas until he finally settled with a soy based formula. My thinking is, if I had been on buprenorphine and my baby had issues like colic, that would have easily been mistaken for withdrawal. I think babies that are always blamed for withdrawal when it could be something completely different. Anyway lol I was just thinking about that..... gosh that was a very difficult time in my life, he's 19 now but I've told him how he almost drove me to a nervous breakdown when he was born.

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PostPosted: Sat Aug 05, 2017 1:09 pm 
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Exactly jennjenn! Thx for bringing that up! Neonatologists saw non opiate exposed newborns with mild to terribly fussy symptoms with maybe the same level distress as opiate exposed and yet they are not subjected to NICU and held away from their moms. They thought maybe we should give opiate exposed newborns the chance to 'Let infants be infants' before further interventions. Worked well.

Separately, this link shows babies born to bup moms had far less NAS than methadone babies. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4165073/
'The results of the MOTHER study indicated that buprenorphine-exposed neonates required significantly less morphine to treat NAS and had a significantly shorter duration of hospitalization compared to methadone-exposed neonates'

It also says 'NAS scales were developed with rudimentary validation testing in the mid-1970s, driven by dramatic increases in the number of opioid-exposed neonates in many urban hospitals as a result of an epidemic of heroin use. While these scales were landmark steps in advancing the assessment and treatment of NAS in this vulnerable population, there have been few studies since to improve NAS scales.'

This link with study shows giving bup to opiate dependent babies instead of morphine, halves NAS treatment time. buprenorphine-halves-neonatal-abstinence-syndrome-treatment-t13531.html

I keep thinking of our member here, Marie, who took lots of info to all her providers, hospital and she had a great experience. Use the search field above, in keyword field type NAS in author field type in marie, her pregnancy/delivery posts come up. Maybe follow marie's lead - take this info to your OBs, to the hospital and Pediatricians.

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PostPosted: Sat Aug 05, 2017 1:51 pm 
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Yes I remember Marie's journey. If it were me, I would print out everything under the sun from these links pelican has provided and other things from the forum and put it all in a folder and give it to my OB and anyone else I had dealings with. That way, they'll know that u have done ur research and are thoroughly educated in ur treatment.

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PostPosted: Fri Aug 11, 2017 4:13 pm 
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I was lucky that Jacob took to nursing right away, but I had trouble maintaining my supply sometimes. Between 3 to 6 weeks he always cried in the evening, no matter what. I think that colic is mainly caused by acid reflux from having an immature digestive system, but I don't know for sure.

I appreciate that there are studies going on that will lead to fewer diagnoses of NAS! A mother who is addicted has enough trouble without her baby being stuck in a hospital for weeks.

Amy

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PostPosted: Sat Aug 12, 2017 9:34 am 
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Colic is pretty much just gas and causes the baby's tummy to just be in pain a lot. Poor things! My oldest cried 24/7 for a good while. The doctor prescribed him some type of gas drops but it honestly didn't work at all. So some of these babies could be experiencing colic or something totally different than withdrawal. My son was inconsolable, if I'd been on buprenorphine at the time of his birth the nurses would have swore his crying fits were withdrawal. I just feel that not every baby's cries or fussiness is withdrawal, my fear is that some are too quick to say it is.

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