Finnegan NAS Score

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Assess the severity of Neonatal Abstinence Syndrome in newborns.

CNS Disturbances

Excessive High-Pitched Cry

Sleep after feeding

Hyperactive Moro Reflex

Tremors

Increased Muscle Tone

Myoclonic Jerks / Convulsions

Metabolic / Vasomotor

Sweating

Fever

Frequent Yawning (≥3-4 times)

Mottling

Nasal Stuffiness / Sneezing

Respiratory Rate (>60/min)

Gastrointestinal

Excessive Sucking / Poor Feeding

Regurgitation / Projectile Vomiting

Loose / Watery Stools

Withdrawal Assessment

Total NAS Score0

Clinical ActionContinue non-pharmacological care

Routine NAS nursing care recommended.

Newborn Protocol

About this calculator

Overview

The Finnegan Neonatal Abstinence Scoring System (FNASS) is the standard clinical tool for monitoring infants born to mothers with substance use disorders (primarily opioids). It quantifies the severity of withdrawal symptoms across neurological, metabolic, and gastrointestinal systems to guide pharmacological treatment.

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Pro Tips

Score based on observations made since the last assessment, not just the moment of scoring.
The infant should be assessed in a state of comfort if possible, to avoid scoring normal hunger or wakefulness as withdrawal.
Consistency between providers (inter-rater reliability) is crucial for accurate management.

Fun Facts

"A score of 8 or higher on three consecutive assessments is a common trigger for starting medication."
"Infants are usually scored every 2-4 hours, often after being fed and settled."
"NAS typically appears within 24-72 hours after birth, but can be delayed with methadone exposure."
"Non-pharmacological care (rooming-in, swaddling, quiet environment) is the first line of treatment."

Formula: Sum of points across 31 items (abbreviated version used here).