Your newborn baby will go through a number of assessments when they are first born to make sure that they are in good health. Their first assessments, called the Apgar score, occur when they are just one minute and five minutes old.
The Apgar score assessment, developed by anaesthetist Virginia Apgar in 1952, is a scoring system to assess newborn babies’ well-being using five different categories:
- heart rate
- breathing
- muscle tone
- reflexes
- skin colour
The newborn baby is given a score between 0 and 2 for each category, and the highest possible score is 10. Scores are rarely higher than 9 out of 10. Below is a table of what the health-care team looks for when assigning the Apgar score.
| Factor | Score 0 | Score 1 | Score 2 |
|---|---|---|---|
| Heart rate | No heart rate | Below 100 beats/min | Above 100 beats/min |
| Breathing | No breathing | Slow and irregular | Good |
| Muscle tone | Limp and loose | Some flexing of arms and legs | Actively moving |
| Reflexes | No reflex responses | Grimaces or frowns when reflexes are stimulated | Vigorously cries when reflexes are stimulated |
| Colour | Blue and pale | Body is pink but hands and feet are blue | Entire body is pink |
The reason the Apgar score is checked at one and five minutes is to give an idea of how well the newborn baby is doing adapting to their environment following birth and whether their condition is improving or not. Apgar scores are assessments of the newborn baby at the time of the scoring. They are generally not useful predictors for future problems. Initially low Apgar scores do not tell the whole story. At birth, many rapid changes are taking place, which need only a few minutes or hours to resolve themselves. For instance, a newborn baby who is having some trouble breathing in the first few minutes of life may only need time to clear their lungs of amniotic fluid and might be breathing normally once this natural process has occurred.
The Apgar score is only one way of evaluating a newly born baby. The health-care team will use other assessments for babies who need help or treatment after birth.