Key takeaway
Neonatal abstinence syndrome is newborn withdrawal from substances, including opioids, after exposure before birth. Neonatal opioid withdrawal syndrome is the opioid-specific form in the first 28 days of life. Signs often start within 72 hours, and not every exposed baby has them. Stay on a prescribed medicine unless your physician changes it.
Last updated: Mon Oct 05 2026 00:00:00 GMT+0000 (Coordinated Universal Time)
You are pregnant, or the baby is here, and you are afraid that staying on methadone or buprenorphine will make the baby withdraw. That fear makes people stop a medicine that the pregnancy still needs.
If you are in labor, bleeding heavily, having a seizure, or cannot breathe, call 911. If you might act on thoughts of suicide, call or text 988.
Do not stop the medicine tonight
Methadone and buprenorphine are the primary medicines for opioid use disorder in pregnancy. Taking them as prescribed has benefits that outweigh the risks. Neonatal abstinence syndrome can follow that treatment, and worry about it should not stop the prescription. Babies can be watched and treated. Talk with your physician before you change a dose. The comparison, and the danger of a quick stop, is on rehab during pregnancy and methadone and buprenorphine.
Questions about a specific medicine can go to MotherToBaby, weekdays from 8 a.m. to 5 p.m. local time, at 1-866-626-6847. If you are in labor or in withdrawal now, call your obstetric clinician first.
Two names, and the signs
Neonatal abstinence syndrome is a group of conditions that can occur when newborns withdraw from substances, including opioids, that they were exposed to before birth. Neonatal opioid withdrawal syndrome is the opioid-specific form in the first 28 days of life, after longer exposure before birth. Opioids given at delivery do not cause it. Not every exposed baby shows withdrawal.
Signs usually begin within 72 hours. They can include trembling, a high-pitched cry, poor feeding, and loose stools. Seizures are an emergency for the staff in the room, not a score to finish in the parking lot. Using 2020 hospital data, about 6 newborns were diagnosed for every 1,000 newborn hospital stays.
A plan of safe care is the services conversation, not a sentence you can read off a diagnosis. Ask the hospital social worker what it means where you delivered, and read the paperwork in plans of safe care. After you are home, the family question is in parenting in recovery.
Search FindTreatment.gov for a program that treats pregnant patients. Call or text (800) 653-9376 if you want help finding one.
Additional Resources
Sources cited on this page:
- CDC: About opioid use during pregnancy (updated May 1, 2026)
- CDC: Treatment of opioid use disorder before, during, and after pregnancy
- SAMHSA FindTreatment.gov
- 988 Suicide & Crisis Lifeline
Common Questions
Are neonatal abstinence syndrome and neonatal opioid withdrawal the same thing?
They are related, and they are not identical. Neonatal abstinence syndrome is a group of conditions that can occur when newborns withdraw from substances they were exposed to before birth, including opioids. Neonatal opioid withdrawal syndrome is withdrawal in the first 28 days of life from longer opioid exposure before birth. It is a subset of the broader syndrome. Opioids given at delivery do not cause it.
Will every baby exposed to opioids have withdrawal?
No. Not all babies exposed to opioids before birth show these signs. Severity depends on the substance, the amount, when it was last used, whether the baby was born early, and whether other substances were also involved. Long-term effects, including in babies who never showed the syndrome, are largely unknown. A quiet newborn is not a forecast, and a diagnosis is not the child's whole future.
What signs does the hospital watch for?
Signs usually begin within 72 hours after birth. They may include trembling or seizures, sleep problems, irritability with excessive or high-pitched crying, overly active reflexes, yawning, a stuffy nose or sneezing, poor feeding and sucking, loose stools, dehydration or vomiting, and increased sweating. Seizures in a newborn are an emergency. Tell the staff.
Should I stop methadone or buprenorphine so the baby will not withdraw?
No. Taking medication for opioid use disorder as prescribed in pregnancy has benefits that outweigh the risks. Methadone and buprenorphine are the primary medicines for pregnant patients. Talk with a physician before stopping or changing any prescribed medicine. Worry about newborn withdrawal is a reason to plan monitoring, not a reason to quit in secret.
How often is this diagnosed, and what about child welfare?
Using 2020 hospital data, about 6 newborns were diagnosed with neonatal abstinence syndrome for every 1,000 newborn hospital stays. The rate ranged from 1 per 1,000 in Hawaii to 43 in West Virginia. A plan of safe care is a services plan for certain infants and caregivers. Ask the hospital social worker what that means where you delivered, and ask a lawyer in your state if you have one. Do not skip obstetric care to avoid the conversation.