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Neonatal Abstinence Syndrome/Opioid Withdrawal in the Neonate

Neonatal Abstinence Syndrome/Opioid Withdrawal in the Neonate

To improve care for babies exposed to opioids before birth, HHS recently published a standardized definition for diagnosis of opioid withdrawal in neonates, or newborns. In utero exposure – or exposure in the womb before birth – to opioids and other substances can result in withdrawal once a baby is born. The standardized clinical definition is not meant to prove or imply harm but instead ensure babies and families with opioid exposure get the care they need.

Who is making the recommendation?

An HHS collaborative including an expert advisory board and national expert panels developed the new set of clinical “bedside” criteria for opioid withdrawal in neonates, or newborns. HHS partnered with national experts – clinicians, researchers, policy experts on maternal-child health, with a focus on substance exposure – and convened an advisory board comprised of experts in pediatric and obstetrics/gynecology clinical care, research, and policy.

Why is the recommendation being made now?

An increase in opioid use disorder across the U.S. has significantly affected pregnant people. The result: an increase in opioid exposure among mothers-to-be and their soon-to-be-born babies. Until now, the medical community lacked a standard clinical definition for withdrawal following in utero opioid exposure.

How is opioid withdrawal in the neonate (newborn) diagnosed?

Based on the new standardized definition, the two clinical criteria for diagnosing opioid withdrawal in the neonate are a known history of exposure to opioids in the womb (in utero) and a distinct set of withdrawal signs. This diagnosis includes newborns who require treatment with medication (pharmacotherapy) and those who do not require medication.

What do health care providers need to know?

The new definition is for clinical use by healthcare providers who provide care to mothers and infants with opioid exposure.

What do patients need to know?

The definition of opioid withdrawal in the neonate (newborn) is use by health providers, clinicians, researchers, and public health professionals.

It does not imply that a pregnant mother has harmed the newborn and should not be misunderstood as evidence to prosecute, punish, or remove newborns from parental custody.

What impact will the new definition have on understanding, preventing, and treating neonatal opioid withdrawal?

The new clinical definition focuses on diagnosing and treating newborns experiencing withdrawal symptoms specifically from opioids. Improving diagnosis will improve bedside care of the mother and baby and ensure they have better long-term clinical and comprehensive services.

Where I can get more information?

To read the full Journal of Pediatrics article, “Standardizing the Clinical Definition of Opioid Withdrawal in the Neonate,” visit:

To view the HHS press release announcing the new definition, visit: