Baby Rating System

You're familiar with the term "Apgar" and you know that doctors use this method to assess a baby's condition just after birth, but just how it works is kind of a blur. In short, your baby is tested at one minute after his birth and once again, five minutes later. Your baby's Apgar scores let your doctor know if your baby is in good health or whether he may just need some medical care.

Perfect Ten

Developed by anesthesiologist Virginia Apgar in 1952, the Apgar today is used worldwide. In the Apgar test, your baby is assigned numbers from 0-2 representing his score in each of the following categories: appearance, pulse, respiration, activity, and response. The numbers are totaled to represent your baby's Apgar score. A ten is considered a perfect Apgar. You can use the term Apgar as a mnemonic device to remember the categories tested: Appearance, Pulse, Grimace (response), Activity, and Respiration.

*Appearance refers to the infant's skin color. A score of zero signifies a pale or bluish-gray complexion. If the color is good but the extremities are bluish, the baby scores a one. A baby who is pink all over receives a two.

*Pulse is the newborn's heart rate. If no heart beat is detected, the score is zero. Fewer than 100 beats a minute gets a one. 100 or more beats a minute rates a two.

*Grimace is the healthy newborn's neurological response during the suctioning of his airways. If this reflex is missing, the baby receives a score of zero. A grimace during suctioning rates a one. If the baby should grimace and show other activity such as coughing, sneezing, or pulling away during suctioning, he gets a two.

*Activity refers to the infant's muscle tone. A limp, lethargic baby rates a zero. A baby who does a bit of arm and leg-flexing gets a one. A nice active baby gets a two.

*Respiration is breathing. A baby that isn't breathing scores a zero. Weak whimpering and slow or irregular breathing rates a one. A big lusty cry and good steady unobstructed breathing rates a two.

Pinking Up

A score of 7-10 on the one-minute Apgar signifies your baby is in good health and needs no extra medical attention. Quite often, a baby will have blue extremities during the one-minute Apgar but will pink up by the five-minute test. Don't be too concerned if your baby's score is not a perfect ten at the one-minute point.

But a baby with a score of 4-6 at the one-minute test may need some breathing help. He may require more suctioning of his airways or need a bit of massage. It's possible he may need some oxygen.

The baby who scores 3 or less will need more intensive help. It's possible he will need some resuscitation. But there is still no need to panic. Babies are often fine after receiving a bit of help.

At the five-minute mark, your baby should have a score of 7-10. Anything below this requires some thought on your doctor's part about what might be done to help your baby.