Function-based NOWS care approach. Replaces numeric Finnegan scoring with three functional assessments (eat, sleep, console) to guide treatment decisions. (Grossman et al., Pediatrics 2017; Yale New Haven ESC model)
Small frequent feeds; pacifier for non-nutritive sucking
Gentle rocking/soothing; minimize handling
Escalation Pathway: If any ESC domain fails despite optimized nonpharmacologic care → Team huddle → Optimize environment → If still failing after 30-60 min → Consider PRN morphine 0.05-0.1 mg/kg PO q3-4h → If requiring ≥3 PRN doses in 24h → Consider scheduled morphine with wean protocol
Edinburgh Postnatal Depression Scale (EPDS)
10-item self-report screening tool for perinatal depression. Cox JL, Holden JM, Sagovsky R. Br J Psychiatry. 1987;150:782-786.
0
Low risk
⚠ ITEM 10 ALERT: Patient endorsed thoughts of self-harm. Immediate safety assessment required regardless of total score.
Breastfeeding Safety Reference
Based on ABM Protocol #21, LactMed, and current clinical guidelines. Always individualize based on clinical context.