Newborn Care: Apgar Scoring

Just after a baby is born, the attending practitioner automatically assesses the baby's physical condition according to five criteria. This score can be useful when trying to understand some of the problems a baby or child has later on. Each of the five criteria can be rated at 0, 1 or 2, depending on how well that function is operating. The total possible score is 10 points and after the immediate initial assessment, the tests are repeated about five minutes after birth. You will probably not even notice Apgar scoring being done, as the doctor or midwife carries out the assessment while they observe and/or busy themselves with the baby.

The five criteria are as follows:

Function criterion score
Heart rate Above 100 beats per minute 2
Fewer than 100 beats per minute 1
No heartbeat 0

Breathing regular and easy 2
Irregular, strained 1
Not breathing spontaneously 0

Movements active with good muscle tone 2
Some movement but not ideal 1
Limp and flaccid 0

Skin colour normal colour, no extreme pallor or blueness 2
Extremities bluish 1
Poor blue skin all over 0

Reflex response Strong reflexes 2
Compromised reaction 1
Reflex response absent 0

By Sister Lilian

Newborn Care: Breastfeeding

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