Modified Finnegan Neonatal Abstinence Score calculator

Clinical inputs

• Cry
• Sleep after feeding
• Tremor
• Increased muscle tone
• Skin excoriation
• Myoclonic jerks
• Generalized convulsion
• Sweating
• Temperature
• Frequent yawning
• Mottling
• Nasal stuffiness
• Sneezing
• Frantic sucking of fists
• Poor feeding
• Vomiting
• Stools
• Respiration

Primary source

Zimmermann-Baer U, Nötzli U, Rentsch K, Bucher HU. Finnegan neonatal abstinence scoring system: normal values for first 3 days and weeks 5–6 in non-addicted infants. Addiction. DOI: 10.1111/j.1360-0443.2009.02802.x. PMID: 20402996. Table 1 prints the modified score. One level is used inside each graded sign. Cry is 2, or 3 when the high-pitched cry lasts more than 2 hours. Sleep after feeding is 1, 2, or 3 for less than 3, 2, or 1 hour. Tremor is 1 or 2 when disturbed and 3 or 4 when undisturbed. Increased muscle tone is 2, skin excoriation is 1, myoclonic jerks in sleep are 3, and a generalized convulsion is 5. Sweating, frequent yawning, mottling, and sneezing are 1. Temperature 37.5 to 38.0 °C is 1 and above 38.0 °C is 2. Nasal stuffiness is 2. Frantic sucking is 1 and poor feeding is 2. Regurgitation is 2 and projectile vomiting is 3. Loose stools are 2 and watery stools are 3. Tachypnea above 60 per minute is 1, and the same rate with retractions is 2. Myoclonic jerks in sleep and a generalized convulsion are separate rows and are both scored. Myoclonus alone is 3, a convulsion alone is 5, and both together add 8. The total-score cell prints a maximum of 37. One highest level in every sign, including both of those rows, sums to 40. The returned score is capped at that printed maximum, so a raw sum of 38, 39, or 40 returns 37. A raw sum of 8 stays 8 and a raw sum of 37 stays 37. The text says values above 8 can be considered pathological. Pharmacologic treatment is described when the score is above 9 on at least two occasions, which a single assessment does not decide. (2010)