Apgar Score: Baby’s First Report Card

Apgar Score

Your baby’s Apgar score is your baby’s first report card. It comes one minute after birth. Don’t worry; it has nothing to do with getting into the best school. Apgar score does not predict future success or intelligence. Your baby will get another Apgar score at 5 minutes. These scores help your delivery team know if your baby needs any special care after birth. The Apgar scores are a quick measurement of how well your baby is doing.

What Is Apgar?

Apgar scoring was developed in 1952 by an anesthesiologist, Dr. Virginia Apgar. Apgar scores are usually given by a nurse in the delivery room. Apgar scoring gives a score number between 0 and 2 for these five baby functions:

  • Heart rate
  • Breathing
  • Muscle tone
  • Reflexes
  • Color

If your baby sticks the landing, he or she may score a perfect 10. Most babies do not score a 10, but a score of 7 or better is considered normal. Babies who are born early or need an emergency C-section tend to have lower Apgar scores. A low Apgar score is also more likely if labor has been long or difficult.

How Is Apgar Scored?

The scoring system is the same at 1 and 5 minutes. This is what the nurse looks for:

  • Heart Rate: Absent = 0, less than 100 = 1, 100 or more = 2
  • Breathing: Absent = 0, slow, irregular , or weak = 1, good and strong = 2
  • Muscle Tone: Limp = 0, some movement of arms and legs = 1, active motion = 2
  • Reflexes: Absent = 0, facial grimace =1, grimace, cough, and sneeze = 2
  • Color: Blue or pale = 0, Pink body but blue hands and feet = 1, Pink all over = 2

What Does the Score Mean?

The Apgar scores are just a temporary measure of well-being. They give your doctor and your delivery team information and guidance. The score will be combined with other factors to determine need for treatment. For instance, if breathing is absent, the rest of the score does not matter. Breathing needs emergency attention.

Most babies do not achieve a full-body pink color at 1-minute. Hands and feet are usually a bit blue. That’s why most babies don’t score a perfect 10. Here are some ways Apgar scores are used:

  • A 1-minute Apgar score of 7 or higher suggests no need for special care.
  • A 1-minute score of 4-6 suggests your baby needs assistance. This may include vigorous drying with a towel or breathing some oxygen.
  • A 1-minute score of less than 4 suggests your bay needs emergency assistance. This could include a breathing tube or fluids and medications given into the umbilical blood vessels.
  • A 5-minute score of 7 or higher suggests no special care is needed.
  • A 5-minute score of less than 7 means the score should be repeated every 5 minutes.
  • A 5-minute score of less than 4 suggests emergency treatment.
  • A 5-minute score of 5 or less suggests the need to check a blood sample from the umbilical cord blood vessels.

The Apgar scores only measures your baby’s well-being at a moment in time. They help your delivery team decide on immediate care. They are an important part of delivery care, but they do not predict future health.

Christopher Iliades
Dr. Chris Iliades is a medical doctor with 20 years of experience in clinical medicine and clinical research. Chris has been a full time medical writer and journalist since 2004. His byline appears in over 1,000 articles online including EverydayHealth, The Clinical Advisor, and Healthgrades. He has also written for print media including Cruising World Magazine, MD News, and The Johns Hopkins Children's Center Magazine. Chris lives with his wife and close to his three children and four grandchildren in the Boston area.

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