APGAR Scoring and Implications

One minute outside of the womb and your baby is already taking a test! Fortunately for them they get a retake at five minutes after birth. Appearance, Pulse, Grimace, Activity, and Respiration or more commonly referred to as APGAR testing was developed by Virginia Apgar in the 1950’s. Since then, this testing method has been utilized in hospitals and healthcare settings in order to determine how well a baby tolerated the birthing process, which is depicted through the APGAR analysis given one-minute after birth. And how well your baby is adapting outside of the mother’s womb, depicted through the APGAR analysis given five-minutes after birth. Each of the five APGAR categories is graded a score of 0-2, then totaled in hopes of receiving the final score of 10/10, which is the best possible score and implies proper breathing and heart function.

You may be wondering how one can administer a test a one-minute old baby. A, for Appearance receives a 2/2 if the baby is completely pink, including hands and feet. Receiving a 2/2 for appearance is pretty rare immediately after birth as most babies maintain a blue-like color in their extremities. P, for pulse is examined through heart rate, if heart rate is greater than 100 beats per minute (bpm) the infant scores 2/2, considering the normal range for a newborn is between 110-160bpm. G, for grimace or reflex irritability receives a 2/2 if there is grimacing and a cough, sneeze, or vigorous cry. A, for activity measures muscle tone, if there is active motion, the infant scores 2/2 for muscle tone. Lastly, R for respiration receives a 2/2 if the infant cries well.

But what if your baby is not a perfect 10? Not to fret, a score between 7-10 is considered normal, and it is actually extremely common for babies to receive a score lower than normal at the one-minute mark and a normal score at the five-minute mark. Lower scores are typically attributed to fluid in a baby’s airway, cesarean section, or a difficult labor. Therefore, they may need oxygen and clearing out the airway to aid the baby in breathing, or even something as simple as physical stimulation to get the heart beating at a healthy rate. Also, it is important to remember that this quick screening is not a determinant of the baby’s future health.

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