Table 1

 Neonatal withdrawal scoring chart for term infants used at Royal Prince Alfred Hospital (modification of neonatal abstinence scoring system6,7)

SystemSignsScoreDate and Time in hours
Central nervous system disturbancesHigh pitched cry2
Continuous high pitched cry3
Sleeps<1 hour after feeding3
Sleeps<2 hours after feeding2
Sleeps<3 hours after feeding1
Mild tremors, disturbed1
Mod-severe tremors, disturbed2
Mild tremors, undisturbed3
Mod-severe tremors, undisturbed4
Increased muscle tone2
Excoriation (specify area)1
Myoclonic jerks3
Generalised convulsions5
Metabolic/ vasomotor/ respiratory disturbancesFever (37.3–38.3°C)1
Fever (38.4°C and higher)2
Frequent yawning (3–4 times)1
Nasal stuffiness1
Sneezing (>3–4 times)1
Nasal flaring2
Respiratory rate>60/min1
Respiratory rate>60/min with retractions2
Gastrointestinal disturbancesExcessive sucking1
Poor feeding2
Projectile vomiting3
Loose stools23
Watery stools3