Guides

CAN Score Calculator

Clinical Assessment of Nutrition at Birth

1 What is the CAN Score Calculator?

The CAN Score (Clinical Assessment of Nutrition) is a bedside physical-examination tool for grading a newborn's nutritional status at birth, independent of birth weight. It scores nine physical parameters — hair, cheeks, neck & chin, arms, legs, back, buttocks, chest, and abdomen — each from 1 (severe malnutrition) to 4 (normal), for a total ranging from 9 to 36. A total score of 25 or higher is classified as normal nutritional status, while a score below 25 indicates fetal malnutrition. The method is based on Metcoff's 1994 approach to detecting nutritional deficits in infants who may otherwise look appropriately grown for gestational age.

2 When to use it

  • Assessing a newborn's nutritional status at birth as part of the routine neonatal examination
  • Identifying fetal malnutrition in infants who are appropriate-for-gestational-age but may have hidden nutritional deficits
  • Distinguishing true malnutrition from low birth weight that is constitutional or due to prematurity alone
  • Supplementing anthropometric measures (weight, length, head circumference) with a physical-exam-based nutrition score
  • Guiding early decisions about nutritional support and follow-up for at-risk newborns

3 Formula & method

Nine parameters, each scored 1–4 (1 = Severe malnutrition, 2 = Moderate, 3 = Mild/Borderline, 4 = Normal), for a total score range of 9–36. A score ≥ 25 indicates normal nutritional status; a score < 25 indicates fetal malnutrition is present. The parameters — hair, cheeks, neck & chin, arms, legs, back, buttocks, chest, and abdomen — are assessed for physical signs of fat and muscle wasting, and the assessment is independent of birth weight.
  • Metcoff 1994

4 Frequently asked questions

What does the CAN score assess?

It assesses a newborn's nutritional status at birth by scoring nine physical signs of fat and muscle wasting — hair, cheeks, neck & chin, arms, legs, back, buttocks, chest, and abdomen.

What is a normal CAN score?

A total score of 25 or higher out of 36 is classified as normal nutritional status; a score below 25 indicates fetal malnutrition is present.

What parameters make up the CAN score?

Nine physical parameters: hair, cheeks, neck & chin, arms, legs, back, buttocks, chest, and abdomen, each scored from 1 (severe malnutrition) to 4 (normal).

Can a baby have a normal birth weight but still score low on the CAN score?

Yes — the tool notes that fetal malnutrition may be present even when birth weight is appropriate for gestational age, since the assessment is independent of birth weight.

Who developed the CAN score?

The method is credited in-app to Metcoff (1994), published in Pediatric Clinics of North America.

For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.