Every day in the United States, dozens of infants are born with opioid exposure. While much attention has been focused on the immediate withdrawal period, parents and caregivers are increasingly reporting a broader set of long-term challenges in their children—challenges that extend well beyond the neonatal stage.

Through the lived experiences of families, Generation O has identified 11 common symptoms seen across children with prenatal opioid exposure. Much like Fetal Alcohol Spectrum Disorder, no two children present identically. Instead, each child exhibits a unique constellation of symptoms drawn from this shared set. These include difficulties in feeding, sleeping, regulation, vision, and other developmental domains.

At present, these constellations remain unnamed, under-recognized, and insufficiently studied in the medical community. As a result, children are often misdiagnosed, misunderstood, or left without appropriate supports. By acknowledging these symptom patterns as specific outcomes of prenatal opioid exposure, we can move toward more accurate identification, earlier intervention, and more effective long-term care.

We developed the Constellation of Symptoms model to illustrate the common outcomes and the unique ways they combine in individual children. Our goal is to spark dialogue among clinicians, researchers, and policymakers on the urgent need to formalize, name, and study these outcomes—ensuring that children affected by prenatal opioid exposure receive the recognition and resources they need to thrive.

Generation O believes these children deserve more than survival. They deserve to be seen, understood, and supported.