NAS Finnegan Neonatal Abstinence Score Calculator

Excessive high pitched cry None or normal High pitched but consolable Continuous high pitched and inconsolable Sleep after feeding (hours) More than 3 hours 2 to 3 hours 1 to 2 hours Less than 1 hour Moro reflex Normal Hyperactive Markedly hyperactive Tremors disturbed None Mild Moderate to severe Tremors undisturbed None Mild Marked Increased muscle tone Absent Present Excoriation Absent Present Myoclonic jerks Absent Present Generalized seizures Absent Present Sweating Absent Present Fever Less than 37.3 37.3 to 38.3 More than 38.3 Frequent yawning Less than 3 episodes More than 3 episodes Mottling Absent Present Nasal stuffiness or flaring Absent Present Respiratory rate Less than 60 More than 60 More than 60 with retractions Excessive sucking Absent Present Poor feeding Absent Present Vomiting Absent Projectile or frequent Loose stools Normal Loose Watery NAS Finnegan Neonatal Abstinence Score Explanation and Clinical Overview Neonatal Abstinence Syndrome represents withdrawal signs in infants born from mothers that consumed opioids during pregnancy. The Finnegan scoring system is widely used to evaluate severity through neurologic gastrointestinal and autonomic features. A total score of eight or more on two consecutive assessments often indicates the need for pharmacologic treatment.

Monitoring should be serial every three to four hours depending on clinical stability and feeding tolerance. This scoring tool guides intervention timing medication titration and discharge planning to reduce complications such as dehydration seizures and poor weight gain. References Finnegan LP et al Treatment of neonatal abstinence syndrome.

Curr Probl Pediatr. 1975 Hudak ML et al Neonatal Drug Withdrawal American Academy of Pediatrics Pediatrics 2012