Infant Feeding and Weight Trajectories in the Eat, Sleep, Console Trial
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Published:2024-10-01
Issue:10
Volume:178
Page:976
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ISSN:2168-6203
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Container-title:JAMA Pediatrics
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language:en
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Short-container-title:JAMA Pediatr
Author:
Merhar Stephanie L.12, Hu Zhuopei3, Devlin Lori A.4, Ounpraseuth Songthip T.3, Simon Alan E.56, Smith P. Brian7, Walsh Michele C.8, Lee Jeannette Y.3, Das Abhik9, Higgins Rosemary D.10, Crawford Margaret M.9, Rice Ward1211, Paul David A.12, Maxwell Jessie R.13, Telang Sucheta D.4, Fung Camille M.14, Wright Tanner15, Reynolds Anne-Marie16, Hahn Devon17, Ross Julie18, McAllister Jennifer M.1, Crowley Moira19, Shaikh Sophie K.20, Christ Lori21, Brown Jaime22, Riccio Julie23, Wong Ramsey Kara24, Braswell Erica F.25, Tucker Lauren26, McAlmon Karen27, Dummula Krishna28, Weiner Julie29, White Jessica R.30, Howell Meghan P.31, Newman Sarah32, Snowden Jessica N.33, Young Leslie W.34, , Hubberd De Ann35, Edwards Kathy35, Whalen Bonny L.35, MacMillan Kate35, Pahl Adrienne35, Sheehan Desselle Farrah35, White Katie35, Hibbs Anna Marie35, Clarke Leslie35, Serio Kathy35, Kertesz Maria35, Rodriguez Ashley35, Driscoll Sarah35, Hammond Kim35, Hines Deborah35, Kish Patricia35, Schmidt Taylor35, Stepp Jennifer35, Jackson Jodi35, Scott Allie35, Brown Rochelle35, Smith Kari35, Rieper My35, Miner Carrie35, Ray Lynne35, Kowel Karen35, Reynolds Victoria35, Castellone Diana35, Mackley Amy35, Schibler Kurt35, Beiersdorfer Traci35, Grisby Cathy35, Kirker Kristin35, McKeown Katherine35, Loudermilk M. Katherine35, Carnohan Amy35, Froese Patti35, Haddix April35, Summe Virginia35, Chlon Clara35, Kunk Rita35, Hamilton Jen35, Moore Sadie35, Ziegelmeyer Angela35, Rolfes Lucy35, Schomaker Erica35, Strike Holly35, Harvey Sharon35, Richards Paula35, Simon Ashley35, Russell David35, Gleason Christine A.35, Allen Marilee C.35, Boyle Robert J.35, Clemons Traci35, D’Alton Mary E.35, Steinhorn Robin35, Weiner Steven J.35, Blaisdell Carol J.35, Wilson Archer Stephanie35, Amiotte Annette35, Santos Moara35, Taosaka Jill35, Neal Charles35, Atz Andrew M.35, Summer Andrea35, Amaya Michelle35, Freeman Mary35, Johnson Madison35, Sarraf Layla Al35, Ros-Demarize Rosemary35, Sánchez Pablo J.35, Slaughter Jonathan L.35, Benninger Kristen35, Luzader Patricia35, Marzec Laura35, DeSantis Brittany35, Small Kristi35, Newton Julia35, Purnell Jessica35, Reedy Rachel35, Hanlon Cory35, Naik Tanvi35, Knox Jordan35, Tallikar Aishwarya35, Cobe Chelsea35, Resetar Megan35, McCool Jacqueline35, Frailey Erin35, Jones Stephanie35, Williams Stacy35, Staton Taise35, Palmer Jacqueline N.35, Erner Jana L.35, Kovalcik Jason B.35, Keels Erin L.35, McCarty Teri35, Harris Katherine35, DeSpain Meagan35, Boyd Jackie35, Watson Sara35, Sullivan Jan35, Walsh Timothy35, Anderson Brianna35, Hahn Devon35, Madden Christi35, Nascimbeni Anne35, Wilson Shannon35, Gibson Theresa35, Karlin John35, Bann Carla M.35, O’Donnell Auman Jeanette35, Turner Eugene35, Smith Emily35, Bradley Lauren35, Trochinski Lillian35, Gabrio Jenna35, Leblond David35, Pickett James35, Newman Jamie E.35, Zaterka-Baxter Kristin M.35, Baack Michelle L.35, Hogden Laurie A.35, Elenkiwich Chelsey35, Henning Megan M.35, Van Muyden Sarah35, Martino Anna-Lisa35, Lutz Allison35, Nelson Jeralyn35, Schumacher Bette35, Brodkorb Aimee35, Pritchett Deborah35, Ford Kristen35, Howard Darla35, Orland Ryan35, Diles Monique35, Shuttleworth Kay L.35, Hubberd DeAnn E.35, Edwards Kathy D.35, Lloyd Sherry L.35, Banks-Johnson Catrice35, Robinson Patrina35, Griffith Melissa35, Slaughter Amie35, Kilkenny Teresa35, Foster Kristina35, Cross Morgan35, Gier Jessica35, Roberts Natalie35, Wadman Jessica35, Cathey Kathy35, Todd Jenna35, Fratesi Emily35, Malloch Lacy35, Alur Radha35, Majure Joseph Marc35, Walker Courtney35, Powers Catherine35, Annett Robert D.35, Wellman Rachel35, Miller Kerry35, Anderson-Berry Ann35, Raissy Hengameh35, Kong Alberta35, McCalmont Kate35, Sundquist Beauman Sandra35, Sanders Sarah35, Eichenwald Eric C.35, Mancini Toni35, Ziolkowski Kristina35, Dhawan Megan35, Gambacorta Mary Kay35, Pulsifer Allie35, Brant Marisa35, Schumacher Aida35, Gocial Sydney35, Azuma Kristen35, Quigley Elizabeth35, Zachritz Whitney35, Pastore Nicole35, Barber Jessica35, McDowell Abby35, Ferri Alissa35, Parga-Belinkie Joanna35, Guillet Ronnie35, Jensen Rosemary L.35, Kent Alison35, Scorsone Ann Marie35, Lakshminrusimha Satyan35, Hartley-McAndrews Michelle E.35, Li Emily35, Donato Jennifer35, McKee Kimberly G.35, D’Angio Carl35, Jones Rachel35, Terrano Dacia35, Solpietro Stephanie35, Brei Lisa35, Krokovich Lisa35, Hart Sema35, Pastore John35, Kern Ashley35, Mars Margaret35, Volker Patricia35, Mioneo Brady Annette35, Voelker Kelsey35, Horn Emily35, Moreland Melissa35, Kneusel Marcia35, Balakrishnan Maya35, Childres Jillian35, Hanniman Melissa35, White Rebecca35, Ohls Robin K.35, Baserga Mariana35, Muniyappa Bhanu35, Shakib Julie35, Rau Carrie A.35, Baker Shawna35, Coleman Kathie35, McGrath Kandace M.35, Petersen Brandy35, Waldvogel Jael35, Bracken Monika35, Ferrin Meredith35, DeSantis Holly35, Perkins Traci35, Loertscher Manndi C.35, McAlmon Karen35, Goldstein Justin35, Angelidou Asimenia35, Donahue Nancy35
Affiliation:
1. Perinatal Institute, Division of Neonatology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio 2. Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio 3. Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock 4. Department of Pediatrics, University of Louisville, Louisville, Kentucky 5. Institutional Development Awards States Pediatric Clinical Trials Network, Environmental Influences on Child Health Outcomes Program, National Institutes of Health, Rockville, Maryland 6. Now with the National Center for Health Statistics, US Centers for Disease Control and Prevention, Rockville, Maryland 7. Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina 8. Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland 9. Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, North Carolina 10. Office of Research and Sponsored Programs, Florida Gulf Coast University, Fort Myers 11. St Elizabeth Healthcare, Edgewood, Kentucky 12. Division of Neonatology, Department of Pediatrics, ChristianaCare, Newark, Delaware 13. University of New Mexico School of Medicine, Albuquerque 14. Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City 15. Department of Pediatrics, University of South Florida, Tampa 16. Department of Pediatrics, University at Buffalo, Buffalo, New York 17. Oklahoma University Health Sciences Center, Oklahoma City 18. Medical University of South Carolina, Health Shawn Jenkins Children’s Hospital, Charleston 19. Department of Pediatrics, Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, Ohio 20. Department of Pediatrics, Duke University, Durham, North Carolina 21. Hospital of the University of Pennsylvania, Philadelphia 22. Department of Pediatrics, Spartanburg Regional Medical Center, Spartanburg, South Carolina 23. University of Rochester School of Medicine and Dentistry, Rochester, New York 24. Kapiʻolani Medical Center for Women & Children, Honolulu, Hawaii 25. Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus 26. Department of Pediatrics, University of Mississippi Medical Center, Jackson 27. Winchester Hospital, Winchester, Massachusetts 28. Department of Pediatrics, University of Kansas Medical Center, Kansas City, Missouri 29. Children’s Mercy, Kansas City, Missouri 30. Sanford Health, Sioux Falls, South Dakota 31. Tulane University School of Medicine, New Orleans, Louisiana 32. University of Nebraska Medical Center, Omaha 33. Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock 34. Larner College of Medicine at the University of Vermont, Burlington 35. for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network National Institutes of Health Environmental Influences on Child Health Outcomes Program Institutional Development Award States Pediatric Clinical Trials Network
Abstract
ImportanceInfants with neonatal opioid withdrawal syndrome (NOWS) cared for with the Eat, Sleep, Console (ESC) care approach receive less pharmacologic treatment and have shorter hospital stays compared to usual care with the Finnegan Neonatal Abstinence Scoring Tool, but the effects of these approaches on feeding and weight are unknown.ObjectiveTo evaluate feeding practices and weight trajectories in infants cared for with ESC vs usual care.Design, Setting, and ParticipantsESC-NOW is a cluster randomized trial of infants with NOWS born at 36 weeks’ gestation or later at 26 US hospitals from September 2020 to March 2022. Each site transitioned from usual care to ESC (the study intervention) at a randomized time. Feeding was per site practice and not specified by the intervention. Feeding and weight outcomes were assessed at hospital discharge.InterventionESC vs usual care.Main Outcomes and MeasuresOutcomes include prospectively identified secondary end points related to feeding and weight. z Scores were used for growth to account for corrected gestational age at the time of measurement. All analyses were intention to treat and adjusted for study design. Maternal/infant characteristics were included in adjusted models.ResultsThe analyses included 1305 infants (702 in usual care and 603 in ESC; mean [SD] gestational age, 38.6 [1.3] weeks; 655 [50.2%] male and 650 [49.8%] female). Baseline demographic characteristics were similar between groups. The proportion of breastfed infants was higher in the ESC group (52.7% vs 41.7%; absolute difference, 11%; 95% CI, 1.0-20.9). A higher proportion of infants cared for with ESC received exclusive breast milk (15.1% vs 6.7%; absolute difference, 8.4%; 95% CI, 0.9-5.8) or any breast milk (38.8% vs 27.4%; absolute difference, 11.4%; 95% CI, 0.2-23.1) and were directly breastfeeding at discharge (35.2% vs 19.5%; absolute difference, 15.7%; 95% CI, 4.1-27.3). There was no difference in proportion of infants with weight loss greater than 10% or maximum percentage weight loss, although infants cared for with ESC had a lower weight z score on day of life 3 (−1.08 vs −1.01; absolute difference, 0.07; 95% CI, 0.02-0.12). When pharmacologic treatment was added into the model, no breastfeeding outcomes were statistically significant.Conclusions and RelevanceIn this study, infants cared for with ESC were more likely to initiate and continue breastfeeding and had no difference in percentage weight loss. The improvement in breastfeeding with ESC may be driven by reduction in pharmacologic treatment and provision of effective nonpharmacologic care.Trial RegistrationClinicalTrials.gov Identifier: NCT04057820
Publisher
American Medical Association (AMA)
Cited by
2 articles.
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