Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ Key Features ++ Onset of symptoms commonly begins in the first 48 hours but may be delayed as long as 8 days, depending on the timing of the mother's last fix and her predelivery medication Left untreated, mortality rate may be as high as 45% +++ Clinical Findings ++ Usually small for gestational age Demonstrates yawning, sneezing, decreased Moro reflex, hunger but uncoordinated sucking action, jitteriness, tremor, constant movement, a shrill protracted cry, increased tendon reflexes, convulsions, vomiting, fever, watery diarrhea, cyanosis, dehydration, vasomotor instability, seizure, and collapse +++ Diagnosis ++ Can be confirmed easily by identifying the opioid in the urine of the mother and the newborn +++ Treatment ++ Phenobarbital (8 mg/kg/d intramuscularly or orally in four doses for 4 days and then reduced by one-third every 2 days as signs decrease) may be continued for as long as 3 weeks Methadone may be necessary in infants with congenital methadone addiction who are not controlled in their withdrawal by large doses of phenobarbital Dosage should be 0.5 mg/kg/d in two divided doses but can be increased gradually as needed After control of the symptoms is achieved, the dose may be tapered over 4 weeks Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth