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Some neonates may be withdrawing from opioids +/-benzodiazepines as well as nicotine and/or alcohol Modified Lipsitz Score Tool
About
Seen with
Clinical
Investigations
Scoring
Signs
0
1
2
3
Tremors (muscle activity of limbs)
Normal
Minimally increased when hungry or disturbed
Moderate or marked increase when undisturbed; subside when fed or held snugly
Marked increase or continuous even when undisturbed, progressing to seizure-like movements
Irritability (excessive crying)
None
Slightly increased
Moderate to severe when disturbed or hungry
Marked even when undisturbed
Reflexes
Normal
Increased
Markedly increased
Stools
Normal
Explosive, but normal frequency
Explosive, more than 8 per day
Muscle tone
Normal
Increased
Rigidity
Skin abrasions
No
Redness of knees and elbows
Breaking of skin
Respiratory rate / minute
< 55
55-75
76-95
Repetitive sneezing
No
Yes
Repetitive yawning
No
Yes
Vomiting
No
Yes
Fever
No
Yes
Management of Neonate
References