This version was machine-translated from German and has not been medically reviewed. The authoritative version is the German version.

Finnegan Neonatal Abstinence Score

Modified Finnegan chart: 21 withdrawal signs of the newborn with treatment thresholds

Crying

unremarkable 0 excessive high-pitched crying (under 5 minutes) 2 persistent high-pitched crying (over 5 minutes) 3

Sleep after the meal

sleeps longer than 3 hours 0 sleeps less than 3 hours 1 sleeps less than 2 hours 2 sleeps less than 1 hour 3

Moro reflex

normal 0 hyperactive 2 markedly hyperactive 3

Tremor

no 0 mild, when disturbed 1 moderate to severe, when disturbed 2 mild, at rest 3 moderate to severe, at rest 4

Increased muscle tone

absent 0 present 1

Excoriations (chin, knee, elbow, toes, nose)

absent 0 present 1

Myoclonic jerks

absent 0 present 3

Generalized seizure

absent 0 present 5

Sweating

absent 0 present 1

Temperature

below 37.2 °C 0 37.2–38.3 °C 1 above 38.4 °C 2

Frequent yawning (more than 3–4 times per interval)

absent 0 present 1

Mottled skin

absent 0 present 1

Stuffy nose

absent 0 present 1

Sneezing (more than 3–4 times per interval)

absent 0 present 1

Nasal flaring

absent 0 present 2

Respiratory rate

up to 60/min 0 above 60/min 1 above 60/min with retractions 2

Excessive sucking

absent 0 present 1

Poor feeding

absent 0 present 2

Regurgitation / vomiting

none 0 Regurgitation (≥ 2 times) 2 projectile vomiting 3

Stools

normal 0 loose 2 watery 3

Calculation aid for healthcare professionals: the calculator reproduces what the sources cited assign to the inputs. Clinical assessment and every treatment decision remain with the treating physician. Inputs and results are not stored.

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Sources

Neonatal abstinence syndrome: assessment and management (Addict Dis 2:141–158) Finnegan LP, Kron RE, Connaughton JF, Emich JP, 1975. Original paper (not freely accessible)
Neonatal Abstinence Scoring System – Modified Finnegan Neonatal Abstinence Score Sheet (after Finnegan 1990 and Finnegan & Kaltenbach 1992) Western Australian Centre for Evidence Based Nursing & Midwifery, 2007. Score sheet (secondary source, read)
Finnegan neonatal abstinence scoring system: normal values for first 3 days and weeks 5–6 in non-addicted infants (Addiction 105:524–528) Zimmermann-Baer U, Nötzli U, Rentsch K, Bucher HU, 2010. Original paper (reference values of healthy newborns; freely accessible via ZORA)
Neonatal Abstinence Syndrome – Reference Guide (M1175) Children's Minnesota, 2019. Clinic protocol (secondary source for the treatment threshold)

Scientific basis last reviewed: September 2026.

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Note

Calculation aid for healthcare professionals. Percentiles and z-scores describe the position of a measured value in the reference population; clinical assessment remains with the treating physician.