neonatology

Finnegan Neonatal Abstinence Scoring Tool (FNAST)

21-item scoring system assessing severity of neonatal abstinence syndrome (NAS) in neonates born to mothers using opioids or other substances. Scored every 3–4 hours. Total score guides pharmacological treatment initiation and weaning.

Cry*

Sleep after feeding*

Moro reflex*

Tremors (disturbed)*

Increased muscle tone*

Excoriation (chin, knees, toes, nose)*

Myoclonic jerks or generalised seizures*

Sweating*

Temperature*

Frequent yawning (>3–4 times per 5-min observation)*

Mottling*

Nasal stuffiness*

Sneezing (>3–4 times per 5-min observation)*

Nasal flaring*

Respiratory rate*

Excessive sucking*

Poor feeding (infrequent/uncoordinated suck)*

Regurgitation (≥2 times during/post feeding)*

Projectile vomiting*

Stools*

References

Finnegan LP et al. Neonatal abstinence syndrome: assessment and management. Addict Dis. 1975;2(1–2):141–158.
NICE NG212. Neonatal abstinence syndrome. National Institute for Health and Care Excellence. 2021.

Curated clinical cross-links plus same-class fallbacks.

Drugs

Decision support only — verify against MDCalc, NICE, or your local guideline before clinical use.

References

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