Current Trends in Care for Infants Diagnosed with Neonatal Abstinence Syndrome in Canada: A Discussion Paper


  • Sarah Madeline Gallant Dalhousie University and IWK Health
  • Mari Somerville Dalhousie University and IWK Health
  • Sydney Breneol Dalhousie University and IWK Health
  • Christine Cassidy Dalhousie University and IWK Health



Eat, Sleep, Console (ESC), Finnegan Neonatal Abstinence Scoring Tool (FNAST), Neonatal abstinence syndrome (NAS), Perinatal nursing care


Introduction: Neonatal abstinence syndrome (NAS) is a growing epidemic across the globe. Infants diagnosed often require resource-intensive nursing care and are at risk for future complex health conditions. A shift in approaches to care for this population has been identified as a priority health care need across Canada. Objectives: This discussion paper aims to highlight the current shift in care for the NAS population, focusing on the Finnegan Neonatal Abstinence Scoring Tool (FNAST) and the Eat, Sleep, Console (ESC) model of care. Methods: A comprehensive search strategy was developed to explore the current trend in care for infants diagnosed with NAS: the transition from the FNAST to the ESC model of care. Four scholarly databases (CINAHL, PubMed, Cochrane, and Google Scholar) were searched. Relevant articles were critically analyzed for their implications on infant and family health, family experience, health system outcomes, and nursing practice. Discussion: In our review of the literature, the FNAST was the most used tool when caring for infants diagnosed with NAS. Although this tool has guided care for infants for decades, it presents some limitations, including subjectivity, invasive and lengthy assessments, and lack of collaboration. Many facilities across Canada are shifting to the ESC model of care as an alternative model. It has potential to address challenges of the care guided by the FNAST, with the ESC model emphasizing non-pharmacological care, a focus on the birth-parent–infant dyad, and dedication to a function-based assessment. Conclusion: Further efforts are needed to support the real-world implementation of evidence-based models of care for this population.

Author Biographies

Sarah Madeline Gallant, Dalhousie University and IWK Health

School of Nursing, PhD in Nursing Student

Mari Somerville, Dalhousie University and IWK Health

PhD, MPH, RDCIHR Health System Impact Fellow (Postdoctoral Stream)IWK Health & Dalhousie UniversityHalifax, NS 

Sydney Breneol, Dalhousie University and IWK Health

PhD (c) in Nursing

Christine Cassidy, Dalhousie University and IWK Health


Assistant Professor, School of Nursing

Faculty of Health | Dalhousie University

Affiliate Scientist | IWK Health


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