Finnegan Neonatal Abstinence Score Calculator

Score severity of neonatal abstinence syndrome using the Finnegan scale.

For educational and clinical reference. Not a substitute for medical judgment. See the medical disclaimer.

Crying

Sleeps after feeding

Moro reflex

Tremors when disturbed

Tremors when undisturbed

Increased muscle tone

Excoriation (chin/knees/elbows)

Myoclonic jerks

Generalized convulsions

Sweating

Fever

Frequent yawning (> 3–4 /interval)

Mottling

Nasal stuffiness

Sneezing (> 3–4 /interval)

Nasal flaring

Respiratory rate

Excessive sucking

Poor feeding

Regurgitation / vomiting

Stools

Score

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Interpretation

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References

Finnegan LP, Connaughton JF, Kron RE, Emich JP. Neonatal abstinence syndrome: assessment and management. Addict Dis. 1975;2(1-2):141-158.

How to use

Score each of the 21 NAS signs every 3–4 hours.
The total and treatment guidance update instantly.
Start pharmacologic therapy when score is persistently ≥ 8 (3 consecutive) or ≥ 12 (2 consecutive).

Frequently asked questions

What is the Finnegan score used for?

It quantifies the severity of neonatal abstinence syndrome (NAS) to guide initiation and titration of pharmacologic treatment in opioid-exposed infants.

When is treatment indicated?

Most protocols start pharmacologic therapy when the Finnegan score is ≥ 8 on three consecutive assessments or ≥ 12 on two consecutive assessments.

How often is the score assessed?

Every 3–4 hours, typically before feeding to standardize conditions.

Finnegan vs ESC (Eat, Sleep, Console)?

ESC is a newer function-based approach that may reduce length of stay and morphine use. Many institutions are transitioning from Finnegan to ESC.

Last updated June 28, 2026