Finnegan Neonatal Abstinence Scoring System

Assess the severity of neonatal abstinence syndrome symptoms. Score each category based on the infant's current condition.

1. High-pitched cry

0 - Normal

1 - High-pitched

2 - Continuous high-pitched

2. Sleep (hours of sleep after feeding)

0 - ≥3 hours

1 - <3 hours

2 - <1 hour

3. Moro reflex

0 - Normal

1 - Hyperactive

2 - Markedly hyperactive

4. Tremors (disturbed)

0 - None

1 - Mild

2 - Moderate to severe

5. Increased muscle tone

0 - Normal

1 - Increased

2 - Markedly increased

6. Excoriation (skin breakdown)

0 - None

1 - Mild

2 - Moderate to severe

7. Myoclonic jerks

0 - None

1 - Mild

2 - Moderate to severe

8. Generalized convulsions

0 - None

1 - Present

9. Sweating

0 - None

1 - Mild

2 - Profuse

10. Fever (≥37.2°C/99°F)

0 - <37.2°C

1 - 37.2-38.3°C

2 - >38.3°C

11. Frequent yawning (>3-4 times/observation)

0 - ≤3 times

1 - >3 times

12. Mottling

0 - None

1 - Present

13. Nasal stuffiness

0 - None

1 - Present

14. Sneezing (>3-4 times/observation)

0 - ≤3 times

1 - >3 times

15. Nasal flaring

0 - None

1 - Present

16. Respiratory rate (breaths/min)

0 - <60

1 - 60-80

2 - >80

17. Excessive sucking

0 - None

1 - Present

18. Poor feeding

0 - Good

1 - Fair

2 - Poor

19. Regurgitation

0 - None

1 - Mild

2 - Moderate to severe

20. Loose stools

0 - Normal

1 - Loose

2 - Watery

Gestational Age at Birth (weeks)

Gestational age in weeks

Birth Weight (grams)

Birth weight in grams

Calculate Finnegan Score Reset

About Finnegan Score

The Finnegan Neonatal Abstinence Scoring System is a validated tool used to assess the severity of neonatal abstinence syndrome (NAS) in newborns.

Clinical Guidelines:

• • Score ≥8: Consider pharmacotherapy
• • Score ≥12: Strongly recommend treatment
• • Score ≥15: Intensive treatment needed
• • Maximum score: 21

Common Substances Causing NAS:

• • Opioids (heroin, methadone, buprenorphine)
• • Benzodiazepines
• • Antidepressants
• • Barbiturates
• • Alcohol
• • Cocaine

Assessment Timing:

• • Initial assessment: 2-4 hours after birth
• • Regular scoring: Every 3-4 hours
• • Peak symptoms: 48-72 hours
• • Duration: 1-4 weeks

Treatment Options:

• Non-pharmacological:
• • Swaddling and positioning
• • Minimizing stimulation
• • Frequent small feedings
• • Skin-to-skin contact
• Pharmacological:
• • Morphine
• • Methadone
• • Buprenorphine
• • Phenobarbital

Risk Factors:

• • Maternal substance use during pregnancy
• • Type and amount of substance
• • Duration of exposure
• • Gestational age at birth
• • Genetic factors
• • Maternal health status

Complications:

• • Seizures
• • Dehydration
• • Poor weight gain
• • Respiratory distress
• • Feeding difficulties
• • Developmental delays