Pros And Cons Of The Finnegan Scoring System

Scoring Due to the lack of a standardized treatment protocol, there is variability in infant assessment and treatment in relation to NAS (Sarah Mary Bagley, Elisha M Wachman, Erica Holland and Susan B Brogly). There are multiple tools used for scoring infants with Neonatal Abstinence Syndrome. By far, the most widely used and studied is the Finnegan Scoring System. It is based off of the nurse’s subjective observations. It looks at the infants central nervous system, respiratory system, gastrointestinal system, and items such as yawning, and sneezing frequency. Disadvantages to this system are it is very time consuming, it does not monitor the infant constantly and nurse measurements are extremely subjective (Hayleigh, A., & Sarah, G. (2012).
The increased metabolic demands, GI upset, hyperactivity, and neurological complications caused by NAS require more than pharmacological treatment. Non-pharmacological treatment options include swaddling, rocking, minimal stimulation and breastfeeding. Including these treatments in the infants’ plan of care proves to reduce scores. The central theme in studies involving non-pharmacological treatment was the infant feeding method (Sarah Mary Bagley1*, Elisha M Wachman2, Erica Holland3 and Susan B Brogly? According to (Bio, L. L., Siu, A., & Poon, C. Y. (2011) , infants that were breastfed compared to formula fed infants, had a lower Finnegan score, reduced hospital stay, and a reduction in the amount of pharmacotherapies and treatment time. Methadone transfers minimally into the breast milk and does not pose an issue with dependence in the infant. The controversy lies at the criteria to permit breastfeeding. Providers have no way of knowing if the mother supplying the milk is only taking methadone. One study found breastfed infants had a slower withrawal requiring treatment (10 vs. 3 days) and decreased Finnegan scores in the first 9 days of life (Sarah Mary Bagley1*, Elisha M Wachman2, Erica Holland3 and Susan B
Again, there are a lack of studies in this area due to the fact that there or so many other confounding variables. Most mothers addicted to opiates are also dealing with environmental and socio-economical issues as well. These mothers are often single mothers, or exposed to abuse, living in inadequate housing. Therefor, having a study with only certain factors in place is very difficult. A study by Logan, Brown and Hayes, assessed infants at 12 & 18 months using the Mental Development Index (MDI) was substantially lower in opiate exposed children at 12 & 18 months. These infants grow into children with deficits such as motor rigidity, which in turn, were associated with less social responsivity and shorter attn spans. Motor delays were more attributed to maternal absinteeism and birth weight. (REWORD) What we do know is the socio-economical background of the infant plays a significant role in the child’s well being. An infant who is addicted to opiates to birth but also has a poor home environment with absent parental involvement will have far worse outcomes than an infant addicted to opiates at birth who then has a nurturing, fulfilled childhood. Thus, acquiring standard data on these children is very difficult as every childhood has different extrinsic