Background 
loose stools, tremors, brain injury, watery, hyperthermia
DYSFUNCTION
A recent Signs associated with NOWS reflect dysfunction in several systems: central nervous system (tremors, high-pitched cry, hypertonicity), gastrointestinal (poor feeding, watery, loose stools), and autonomic (hyperthermia). There is widespread acceptance that initial care of infants exposed to opioids in utero should be individualized, supportive, and non-pharmacologic [Medical professionals do not universally agree on a standard of care for pharmacologically treated NOWS infants [Quality improvement methods to standardize NOWS treatment have been successful in reducing the length of treatment and hospital stay among NOWS infants [Kraft et al. summarized the use of morphine and methadone treatment for NOWS [Kraft et al. noted that methadone has a longer half-life than morphine and therefore may be attractive as a therapy due to less frequent administration [In contrast to variations for weaning in clinical practice, randomized trials have used 10% reductions of the stabilizing dose. In a single-site trial that compared methadone to morphine, clinical teams weaned both drugs by 10% reductions of the stabilizing dose with 4-h dosing intervals [Common outcomes of clinical trials of NOWS treatment are length of treatment, length of hospital stay, and safety outcomes. Although clinically evident brain injury on a neurological exam is not anticipated among infants with NOWS, there is support for abnormalities of neurobehavior [The NICU Network Neurobehavioral Scale (NNNS) is a comprehensive evaluation of 12 domains of neurologic and behavioral functioning as well as signs of stress, administered by trained, certified examiners [There is a lack of consensus on the effects of prenatal opioid exposure on neurodevelopmental outcomes in early childhood. A recent comprehensive review indicated that there are discrepant findings with respect to the presence or absence of altered neurodevelopment with in utero exposure [