Hello and Neonatal Withdrawl Scoring tools

[kimh]

Hello!

I am new to Nicu.org. I have been a neonatal Nurse in Kalamazoo MI for about 11 years. Have just started looking at this site but have seen some interesting info here.

I have a question to anyone who would be interested about Neonatal Withdrawl Scoring tools. We currently use NWI tool. However, when a pediatrician follows a baby on our unit, they will request we use the Finnegan tool. Does anyone have any information they would be willing to share or protocols? Any help would be appreciated. Thanks! Kim Holden

[Stefan Johansson]

Hi & welcome to 99nicu!

I had not heard about the NWI tool before but I guess you refer to this one:

http://journals.lww.com/pedresearch/Fulltext/1997/04001/The_Nwi__A_Simplified_Score_of_Infant_Narcotic.108.aspx

I must admit that I have not much experience from abstinence assessment (as we have rather few abusing mothers in our catchment area), but we use the Finnegan score.

While browsing the webb I found this image of a Finnegan score sheet:

http://www.virtualcurriculum.com/N3225/Spring2010/jessica_marzena/finnegan%20scale_diagnosis.jpg

Are you using the NWI tool? What is your experience?

[kimh]

Hello, I have tried twice to reply to this thread but have not been able to find it again after posting. I'm thinking it's user error on my part so I am going to post this short reply and then do the more lengthy one when I'm sure it will post!

[kimh]

Ok so that was easy, not sure what happened other than I was trying to post at work and that may have been the problem. Yes the link you have above is the NWI tool we use. The Finnegan tool seems to encompass more things and babies who are symptomatic score higher sooner and get treatment sooner. There is a certain amount of caution in treating babies pharmacologically (understandably) as our treatment is most often methadone. It's interesting that you do not have the problem with drug abusing moms. What about pregnant women on narcotics for chronic pain? We have many moms who come to us that are on methadone for chronic pain for whatever reason; we have found some of those reasons to be justified and some not. The result is the same---a drug addicted withdrawing baby. The Finnegan scoring tool seems more cumbersome also. The same things are looked at but Finnegan's at different degrees.

[Fifita]

Hi, I am interested in a combined care model where moms room in with their drug addicted babies.

This model is being used in a Canadian hospital.

The mom's get rehab while in combined care. They also learn how to care for their infant.

Finnegan scores are lower and the babies require less medication and a shorter hospital stay.

I have tried this in a limited capacity with good results, but would like to know if the combined care has been studied.

[Victoria]

Hi - this program is in Vancouver BC at BC Women's Hospital - it is called FIR Square. Findings have been published. Here is one citation: Abrahams, R., Kelly, A., Payne, S., Thiessen, P., MacIntosh, J., & Janssen, P. (2007). Rooming in compared with standard care for newborns of mothers using methadone or heroin. Canadian Family Physician, 53, 1722-1730.

Hi, I am interested in a combined care model where moms room in with their drug addicted babies.

This model is being used in a Canadian hospital.

The mom's get rehab while in combined care. They also learn how to care for their infant.

Finnegan scores are lower and the babies require less medication and a shorter hospital stay.

I have tried this in a limited capacity with good results, but would like to know if the combined care has been studied.

[ali]

    

NAS !! I've been thinking a lot about NAS!! No, not Lil NAS X (although lime green scrubs.....) but SSRI/SNRI NAS 🙂

We are experiencing more admissions of infants being scored under the NAS (Finnegan Score) for maternal SSRI/SNRI use, but is this really the most effective scoring tool to use?. Would really like to hear other members thoughts and experiences on this topic, and what pharmacological approach is being administered?

All the best

Al