Neonatal behavioral assessment scaleNeonatal Behavioural Assessment Scale (NBAS) is used to support parents in the neonatal unit, especially around discharge home. The aim is to increase parents' confidence in understanding their baby. An infant's reaction are state related. So it is extremely important that observations of state be considered as a starting point from which all other observations are made. The ideal time to administer the examination is when the infant is asleep and midway between feeding cycles.Scores Sleep statesState 1 : Sleep with regular breathing, eyes closed, no spontaneous activity except startles or jerky movements at quite regular intervals.a State 2 : Sleep with eyes closed; rapid eye movements can often be observed under closed lids; low activity level with random movements and startles. Awake statesState 3 : Drowsy or semidrowsy; eyes may be open but dull and heavy lidded, or closed, eyelids fluttering; activity level minimal, Movements are usually smooth, although there may be startles. Some infants may also show fuss/cry vocalizations in this state. What distinguishes state 3 from state 5 when both are accompanied by fuss/cry vocalizations is the minimal movement in state 3 and considerable movement in state 5. State 4 : Alert, eyes open with bright look. Motor activity is minimal; there can be a glazed look that is easily changed into a brighter look with appropriate stimulation.State 5 : Eyes likely to be open; considerable motor activity, with thrusting movements of the extremities, and even a few spontaneous startles; reactive to external stimulation with increase in startles or motor activity.State 6 : Crying : characterized by intense, loud, rhythmic, and sustained cry vocalizations that are difficult to break through with stimulation; motor activity is high.Coming to the questionAccording to above staging, the newborn in our question comes under state 6 (crying lustily, and moving all 4 limbs). If you have any confusion, read the following facts on crying (state 6) :-"it is important to distinguish between crying as a state (stage 6) from the fuss/ay vocalization that can occur in state 5 and even state 3. Some infants show repeated episodes of fuss /cry vocalization in state 5 but may not reach state 6. This may also be a maturational issue, because some preterm infants may not have energy reserves to sustain state 6. In general, state 6 Can be distinguished from state 5 by the intensity and sustained quality of the crying (at least 15 seconds) and unavailability of infant in state 6. Repeated brief episodes of cry /fuss in state 5 do not mean that the infant has moved into state 6. Examiners need to give the infant the opportunity to show state 6"So, crying lustily with all limbs moving (child in question), straight away goes in state 6.