Health News • Baby's First Test: APGAR

Well before any IQ or aptitude tests are in order your new baby will have already taken a widely used assessment. This is the APGAR scoring, by which your baby is assessed at birth by the neonatal nurses, pediatrician, or neonatologist.

This is a cumulative number ranging 0 to 10, with 0 being the lowest and 10 being the best. These are rapid assessments made by the delivery personnel at one minute, at 5 minutes and sometimes also at 10 minutes of life.

An anesthesiologist, by the name of Virginia Agar, devised this system, whereby the infant is given a 0, 1, or 2 in each of five categories. These are than totaled and reported to the OB/GYN or pediatrician, who then has an immediate idea of how well the baby is doing. This is particularly true if the one minute APGAR is low or borderline low. Hence, resuscitation or other medical intervention (such as oxygen or tactile stimulation) can be started immediately and even reassessed at the 5 minute APGAR.

As with other 10’s, a perfect score is 10 and an awful score is 0. These are the areas for this rapid assessment. Sometimes using the mnemonic APGAR helps in remembering the different areas:

Appearance: Babies with a red glow to their skin earn a 2, while those with bluish hands or feet will be given a 1. These babies may have cold extremities and are not in trouble. But those pale or blue babies who are not oxygenating may well need immediate resuscitation. These babies, of course, will be assigned a zero.
Pulse: A pulse of 100 per minute or more is normal and earns a two, while a slower pulse earns a one and no pulse earns a zero. But most babies’ heart rate will pick up with tactile stimulation.
Grimace or Muscle Tone: A baby who shows active movement holding his head up and grimacing while flexing his hand and feet earns a two.The baby with only slight movement receives a one. No movement or no grimacing earns no points at all.
Advanced Reflexes or Action: A baby who does not respond to tactile stimulation (such as a nasal catheter that is used to clear the nose of mucous) earns a zero. A mild response earns a one and a vigorous reaction earns a two.
Respiration: The lusty cry of a healthy normal newborn earns him a two, while a slow, irregular or weak cry will earn him only a one. Absence of breathing is a serious sign and is assigned a zero. Resuscitation begins immediately with tactile stimulation, oxygen and more if indicated.

A total of 7 to 9 is considered normal. Although a perfect score is 10, it is rarely given. The nurses and doctors monitor you baby carefully before, during and after your delivery to make sure your baby can have as perfect an APGAR score and life as possible.