Hospitals do not test newborns routinely for buprenorphine/naloxone (Suboxone). Newborn drug testing may be performed by a hospital in certain circumstances if medical providers believe the infant’s mother engaged in high-risk behaviors (e.g., a history of drug misuse and/or addiction), had minimal or no prenatal care, or underwent unexplained obstetric events.
Neonatal abstinence syndrome (NAS) is drug withdrawal that may result in newborns due to maternal opioid use during pregnancy, including the use of methadone or buprenorphine for the treatment of opioid use disorder. NAS is generally characterized by irritability, high-pitched cry, poor sleep, and uncoordinated sucking reflexes that lead to poor feeding. The long-term health outcomes for babies with NAS are not completely understood, and this is an active area of research within medicine. However, it is currently believed that the harms of relapse and/or untreated addiction to the patient and baby far outweigh the harms of NAS.
All major authorities on maternity care, including the American College of Obstetricians & Gynecologists (ACOG), the American Society of Addiction Medicine (ASAM), agree that untreated opioid use disorder during pregnancy is dangerous, and they all universally support MAT for expectant mothers with OUD. Many pregnant women are on Subutex (buprenorphine without naloxone) or Suboxone (buprenorphine with naloxone) during pregnancy. While infants can experience mild withdrawal symptoms if their mother is taking buprenorphine during pregnancy, these symptoms are usually self-limited to the first few days of life. It is generally thought that the risks of relapse during pregnancy are more dangerous than the risks of taking buprenorphine during pregnancy; thus, most providers recommend the continuation of buprenorphine during pregnancy.