APGAR Score

The APGAR score is the very first test your newborn will get after birth. The test is performed while the baby is still in the room with you, before they go to the nursery. This will help the staff at the hospital determine exactly what your baby’s physical needs are at the time. APGAR stands for Activity, Pulse, Grimace, Appearance and Respiration. Typically, this test is given one minute after birth, five minutes after birth, and if there is a concern about the baby’s score, again at 10 minutes after birth.

There are five factors that are used to test your baby. The score is from 0 to 2, with 2 being the highest. The total score ranges from 0 to 10, with 10 being the highest score possible.
This test is done by doctors, midwives or nurses and is necessary to determine whether your baby needs medical intervention for any health reason. This score is determined by the following criteria:

Apgar Score:

Heart Rate (pulse):
2 = normal (above 100 beats per minute)
1= Below 100 beats per minute
0=absent (no pulse)

Breathing (rate and effort):
2 = Normal rate and effort, Good cry
1= Slow or irregular breathing, weak cry
0= Absent

Grimace (responsiveness or “reflex irritability”)

2 = pulls away, sneezes, or coughs with stimulation
1 = facial movement only (grimace) without stimulation
0 – No response to stimulation

Activity (muscle tone):

2 = Active, spontaneous movements
1 = arms and legs flexed with little movement
0 = No movement, floppy tone.

Appearance (skin coloration)

2 = Normal color all over (hands and feet are pink)
1 = Normal color (but hands and feet are bluish)
0 = Bluish-gray or pale

Score

If your baby’s overall score on the test that is completed 1 minute after birth is below a 7, staff usually suctions the baby. It may simply mean that the baby’s airway has not been completely cleared. They really do not have much alarm at this point. However, if the score has not reached above a 7 within five minutes, they may want to monitor the baby to settle any concern they may have. Most who do not have a score of 7 within five minutes of birth do just fine. But they monitor the baby just in case.

Does the APGAR test predict future health?

No. The APGAR test cannot predict future health of a baby. It only works for the newborn phase. This is because babies develop so fast and change constantly over a short period of time. There are other tests that are set in place after this phase. More testing will be done before your baby leaves the hospital.


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