The modified Finnegan Neonatal Abstinence Scoring Tool is used every 3–4 hours in many neonatal units. Scores of 8 or more on three consecutive assessments (or 12 or more on two) usually prompt medical treatment. Newer approaches such as Eat, Sleep, Console focus on the baby’s function.
How to use the Finnegan Score Calculator
- Crying
- Sleep after feeding
- Moro reflex
- Tremors when disturbed
- Tremors when undisturbed
- Increased muscle tone
- Excoriation (skin abrasion)
- Myoclonic jerks
- Generalised convulsions
- Sweating
- Temperature
- Frequent yawning (more than 3–4 times)
- Mottling
- Nasal stuffiness
- Sneezing (more than 3–4 times)
- Nasal flaring
- Respiratory rate
- Excessive sucking
- Poor feeding
- Vomiting
- Stools
Results update as you type, and every field accepts the units shown in its menu.
How it works
Each answer carries the points shown in the published score. The calculator adds them up and maps the total to the published interpretation.
Scoring table
| Item | Answers and points |
|---|---|
| Crying | None = 0; Excessive high-pitched cry = 2; Continuous high-pitched cry = 3 |
| Sleep after feeding | 3 hours or more = 0; Less than 3 hours = 1; Less than 2 hours = 2; Less than 1 hour = 3 |
| Moro reflex | Normal = 0; Hyperactive = 2; Markedly hyperactive = 3 |
| Tremors when disturbed | None = 0; Mild = 1; Moderate to severe = 2 |
| Tremors when undisturbed | None = 0; Mild = 3; Moderate to severe = 4 |
| Increased muscle tone | No = 0; Yes = 2 |
| Excoriation (skin abrasion) | No = 0; Yes = 1 |
| Myoclonic jerks | No = 0; Yes = 3 |
| Generalised convulsions | No = 0; Yes = 5 |
| Sweating | No = 0; Yes = 1 |
| Temperature | Below 37.2 °C (99 °F) = 0; 37.2–38.2 °C (99–100.8 °F) = 1; Above 38.2 °C (100.8 °F) = 2 |
| Frequent yawning (more than 3–4 times) | No = 0; Yes = 1 |
| Mottling | No = 0; Yes = 1 |
| Nasal stuffiness | No = 0; Yes = 1 |
| Sneezing (more than 3–4 times) | No = 0; Yes = 1 |
| Nasal flaring | No = 0; Yes = 2 |
| Respiratory rate | 60/min or less = 0; Over 60/min = 1; Over 60/min with retractions = 2 |
| Excessive sucking | No = 0; Yes = 1 |
| Poor feeding | No = 0; Yes = 2 |
| Vomiting | None = 0; Regurgitation = 2; Projectile vomiting = 3 |
| Stools | Normal = 0; Loose = 2; Watery = 3 |
Inputs explained
| Field | What to enter |
|---|---|
| Crying | Choose one: None, Excessive high-pitched cry, Continuous high-pitched cry |
| Sleep after feeding | Choose one: 3 hours or more, Less than 3 hours, Less than 2 hours, Less than 1 hour |
| Moro reflex | Choose one: Normal, Hyperactive, Markedly hyperactive |
| Tremors when disturbed | Choose one: None, Mild, Moderate to severe |
| Tremors when undisturbed | Choose one: None, Mild, Moderate to severe |
| Increased muscle tone | Choose one: No, Yes |
| Excoriation (skin abrasion) | Choose one: No, Yes |
| Myoclonic jerks | Choose one: No, Yes |
| Generalised convulsions | Choose one: No, Yes |
| Sweating | Choose one: No, Yes |
| Temperature | Choose one: Below 37.2 °C (99 °F), 37.2–38.2 °C (99–100.8 °F), Above 38.2 °C (100.8 °F) |
| Frequent yawning (more than 3–4 times) | Choose one: No, Yes |
| Mottling | Choose one: No, Yes |
| Nasal stuffiness | Choose one: No, Yes |
| Sneezing (more than 3–4 times) | Choose one: No, Yes |
| Nasal flaring | Choose one: No, Yes |
| Respiratory rate | Choose one: 60/min or less, Over 60/min, Over 60/min with retractions |
| Excessive sucking | Choose one: No, Yes |
| Poor feeding | Choose one: No, Yes |
| Vomiting | Choose one: None, Regurgitation, Projectile vomiting |
| Stools | Choose one: Normal, Loose, Watery |
Health note: this calculator is for education and screening only and is not a diagnosis or treatment advice. Discuss your results with a qualified clinician.
Formula
Score = sum of the points for each item
Worked example
Inputs — Crying: None; Sleep after feeding: 3 hours or more; Moro reflex: Normal; Tremors when disturbed: None; Tremors when undisturbed: None; Increased muscle tone: No; Excoriation (skin abrasion): No; Myoclonic jerks: No; Generalised convulsions: No; Sweating: No; Temperature: Below 37.2 °C (99 °F); Frequent yawning (more than 3–4 times): No; Mottling: No; Nasal stuffiness: No; Sneezing (more than 3–4 times): No; Nasal flaring: No; Respiratory rate: 60/min or less; Excessive sucking: No; Poor feeding: No; Vomiting: None; Stools: Normal.
Results — Finnegan score = 0 points; Interpretation = Below 8 – continue non-drug care and monitoring.
Key terms
- NAS
- Neonatal abstinence syndrome (neonatal opioid withdrawal syndrome).
Frequently asked questions
How often is the Finnegan score done?
Every 3–4 hours, ideally between feeds.
What are non-drug treatments?
Rooming-in, skin-to-skin contact, breastfeeding when appropriate, swaddling and a calm environment.
Which drugs cause NAS?
Mostly opioids, but also benzodiazepines, some antidepressants and other substances.