Neonatal withdrawal scoring chart for term infants used at Royal Prince Alfred Hospital (modification of neonatal abstinence scoring system6,7)
| System | Signs | Score | Date and Time in hours | ||
|---|---|---|---|---|---|
| Central nervous system disturbances | High pitched cry | 2 | |||
| Continuous high pitched cry | 3 | ||||
| Sleeps<1 hour after feeding | 3 | ||||
| Sleeps<2 hours after feeding | 2 | ||||
| Sleeps<3 hours after feeding | 1 | ||||
| Mild tremors, disturbed | 1 | ||||
| Mod-severe tremors, disturbed | 2 | ||||
| Mild tremors, undisturbed | 3 | ||||
| Mod-severe tremors, undisturbed | 4 | ||||
| Increased muscle tone | 2 | ||||
| Excoriation (specify area) | 1 | ||||
| Myoclonic jerks | 3 | ||||
| Generalised convulsions | 5 | ||||
| Metabolic/ vasomotor/ respiratory disturbances | Fever (37.3–38.3°C) | 1 | |||
| Fever (38.4°C and higher) | 2 | ||||
| Frequent yawning (3–4 times) | 1 | ||||
| Nasal stuffiness | 1 | ||||
| Sneezing (>3–4 times) | 1 | ||||
| Nasal flaring | 2 | ||||
| Respiratory rate>60/min | 1 | ||||
| Respiratory rate>60/min with retractions | 2 | ||||
| Gastrointestinal disturbances | Excessive sucking | 1 | |||
| Poor feeding | 2 | ||||
| Regurgitation | 2 | ||||
| Projectile vomiting | 3 | ||||
| Loose stools | 23 | ||||
| Watery stools | 3 | ||||
| TOTAL SCORE | |||||
| SCORER’S INITIALS | |||||