The Apgar Score: What It Means for Baby’s Health

Your child will likely be taking a lot of tests in his or her life, many of which cause them (the SATs) and you (driver's license!) a lot of angst. But the first test your baby will ever take is the Apgar test, which he or she will "take" about a minute after being born. The test and resulting score, developed by Virginia Apgar, an obstetric anesthesiologist during the mid-1900s, are used worldwide as a quick, easy, and reliable way to gauge a newborn's health. And the good news is your baby is likely to pass with flying colors, so it's nothing you as a new mom should stress out about. And it won't hurt your baby one bit.

The Apgar measures: Appearance (skin color), Pulse (or heart rate), Grimace (or response to touch), Activity (or muscle tone based on degree of movement), and Respiration (evaluated by observing movement of the baby's chest).

The scoring is 0-10, with 0-3 meaning the baby needs resuscitation. A score of 4-6 means the baby is struggling to breathe. A score of 7-10 indicates a "stable" status. The Apgar test is usually given to a baby once at 1 minute after birth, then again at 5 minutes after birth, and later on if the infant is still having difficulties. While an Apgar score of 0-3 at 20 minutes is linked to a high rate of mortality, a less-than-stellar score at 1 or even 5 minutes is rarely a reason to worry.

"Babies do not need to have 'perfect 10s' to be very healthy," says Carol Weingarten, PhD, RN, a professor at Villanova’s College of Nursing. In fact, a 10 is highly unusual. "Lots of healthy 'normal' babies have a point deducted for such criteria as color or muscle tone," says Weingarten. "They 'pink up' quickly, can be very alert, and breastfeed well right after birth."

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Even if your baby falls in the 4-6 range and heart rate and respiratory effort are subpar, "Many times simple and swift interventions like removing fluids from the mouth or windpipe and giving oxygen correct respiratory issues and allow babies to breathe freely and normally," says Weingarten.

Bottom line: While the Apgar is great at determining if a baby needs immediate medical interventions, it is not an indicator of a baby's long-term health. So as long as your doctor has indicated there are no reasons to worry, don't stress if your newborn doesn't pass his first test with flying colors.

How did your newborn do on the Apgar?

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