Finnegan score calculator
Standardized scoring of neonatal withdrawal signs across CNS, autonomic, and GI domains.
Clinical disclaimer
How the score works
The Modified Finnegan tool assigns points to 20 symptom domains observed during a scoring interval. The total score reflects the severity of neonatal abstinence signs and helps guide monitoring and treatment decisions.
- Select the most severe finding for each symptom.
- Scores are typically recorded every 4 hours, with shorter intervals for higher totals.
- Serial scores are more informative than a single measurement.
Common interpretation bands
- 0-7: below treatment threshold (continue monitoring).
- 8-10: elevated; repeat scoring and follow protocol.
- 11+: high score; consider escalation per protocol.
Thresholds vary by institution and treatment pathway.
Clinical notes
- Score 30-60 minutes after feeds when possible and before the infant falls asleep.
- Avoid double-counting mutually exclusive findings (e.g., regurgitation vs projectile vomiting).
- Use clinical judgment for preterm infants or those with comorbidities.
Compare with
- Eat, Sleep, Console (ESC): use when the care pathway focuses on functional assessment and non-pharmacologic care response.
- Neonatal calculators hub: use when NAS scoring needs to stay beside feeding, glucose, maturity, and jaundice tools.
Related calculators
References
Frequently asked questions
It quantifies neonatal abstinence symptoms across neurologic, autonomic, and gastrointestinal domains. Higher totals indicate more severe withdrawal signs.
Many protocols use 4-hour scoring intervals and increase to 2-hour intervals when scores reach treatment thresholds. Follow local NAS guidelines.
No. Choose the single most severe option observed for each symptom during the scoring interval.
No. Treatment decisions depend on serial scores, clinical condition, and local protocols. Use the score as decision support only.