We use the term Generation O to describe the generation of children born with prenatal opioid exposure during the ongoing opioid crisis, beginning in 2000.

We also use the term Generation O to describe the organization. Our mission is to support parents and caregivers through education, resources and community. We provide information and scientific research, in plain English, about the long term outcomes of prenatal opioid exposure.

Recent estimates range from 7 newborns diagnosed with neonatal abstinence syndrome (NAS) for every 1,000 newborn hospital births to as high as 50 per 1000 in some US States. On the low end, that is approximately one baby diagnosed with NAS every 24 minutes in the United States, or more than 59 newborns diagnosed every day.

Not all babies exposed to opioids in utero receive a diagnosis of NAS. This can occur for many reasons, including having no symptoms of withdrawal at birth, or experiencing withdrawal after leaving the hospital. It is also possible a Neonatal Opioid Withdrawal Syndrome (NOWS) diagnosis can be given.

Long term outcomes associated with prenatal opioid exposure are not necessary linked to a newborn diagnosis of NAS or NOWS.

According to 2019 self-reported data, about 7% of women reported using prescription opioid pain relievers during pregnancy. Of those, 1 in 5 reported misuse of prescription opioids, defined by this survey as getting them from a non-healthcare source or using them for a reason other than to relieve pain. Due to the stigma associated with opioid use, many women using opioids during pregnancy don’t report its use, and therefore are not included in this 7%. Additionally, women may use non-prescription opioids such as heroin and fentanyl.

If only seven percent of the 3.7 million babies born in America in 2020 were exposed to opioids in utero, Generation O grew by 259,000 children.

Babies who receive a newborn diagnosis of Neonatal Abstinence Syndrome or Neonatal Opioid Withdrawal Syndrome have an average stay in the hospital Neonatal Intensive Care Unit (NICU) lasting almost 5 times longer than babies needing NICU stays for other reasons.

The expense of this additional hospitalization is 7 times greater than the cost of a typical NICU stay.

Opioids taken by a pregnant women readily cross the placenta. If opioids are taken regularly, both the mother’s and fetus’s bodies can become dependent on them.

At birth, as baby is separated from it’s opioid source, it’s body begins the painful withdrawal process. This may happen 24-72 hours after birth. Common symptoms include

High pitched cry

Irritability

Difficulty sleeping

Increased muscle tone

Tremors

Skin excoriation, due to excess movement

Hyperthermia and/or sweating

Loose stool

Yawning

Nasal Stuffiness

Sneezing

This collection of symptoms has been known as Neonatal Abstinence Syndrome, and more recently, Neonatal Opioid Withdrawal Syndrome. Also common in these babies is;

Central nervous system hyperactivity

Autonomic nervous system dysfunction

Gastrointestinal problems

Premature birth

Smaller head circumference (even when adjusted to gestational age)