Why withdrawal can begin after birth
Before birth, an opioid taken by the pregnant person can reach the fetus through the placenta. With repeated exposure, the baby’s nervous system adapts to the drug’s presence. After delivery, that supply ends abruptly, and the adapted nervous system may become overactive—a process called neonatal opioid withdrawal.
The signs can include tremors, unusual fussiness, difficulty sleeping, trouble feeding, or loose stools. They do not necessarily appear immediately: onset and severity vary with the opioid involved and the individual baby. These symptoms can make ordinary tasks such as settling, eating, and gaining weight harder.
What the Finnegan score tells clinicians
The Finnegan score is a structured checklist: clinicians observe and rate withdrawal signs, then repeat the assessment over time. A score helps show whether symptoms are becoming more or less pronounced and helps guide treatment decisions. It is not a direct measure of how much opioid a baby was exposed to, nor does one number by itself tell the whole story; hospitals use the observations alongside the baby’s overall condition.
Care starts with helping the baby settle
When symptoms are manageable, care often centers on a calm environment, swaddling, skin-to-skin contact, and frequent feeding. These measures reduce stimulation and support sleep and feeding—two things withdrawal can disrupt.
If symptoms remain severe or interfere with eating, sleeping, or staying well, clinicians may give medication such as morphine and adjust it gradually as the baby improves. The aim is to control withdrawal safely, then taper the medicine rather than stop it suddenly. Tracking symptoms over days lets the care team respond to the baby’s actual course, not just the exposure history.
