Apgar Score

The Apgar score rates five traits of your baby:

• Appearance of skin colour: Skin colour is checked to look for signs of asphyxia - lack of oxygen to body organs. Birth asphyxia, if not treated on time, can affect the brain, lungs, kidneys and other body organs. It can lead to disability, organ failure and death. 
• Pulse or heart rate: The doctor uses a stethoscope to check if the baby has a normal heart rate. 
• Grimace or reflexes: Reflexes are considered as important health signals. Doctors normally pinch or gently slap the babies on their back to check their reflexes. 
• Activity or muscle tone: Muscle tone is checked to look for muscle activity in the baby. In the case of asphyxia, the baby may become flaccid  
• Respiratory function or breathing: Normal breathing at birth is important to maintain a healthy supply of oxygen to body organs. A distressed baby would have a low respiratory rate and shallow breathing.

Each trait is awarded points from zero to two - two being the best as per the condition observed. 

And finally, a combined health score is given out of 10. 

Normal results:

Usually, most of the babies score between 7 to 10. This score means that your baby is in pink of his health and he needs no extra medical help than routine medical care. 

Abnormal results:

A lower score (<7) does not imply that your newborn is unhealthy neither does it indicate a risk of health conditions later in life, it only signifies that he may need some immediate medical help either for better breathing or for any other health issue. 

Here is a break down of Apgars by individual traits

Breathing effort:

• A zero respiratory score means that the baby is not breathing at the time of birth

• A respiratory score of 1 is given in case of irregular breathing

• A two on breathing efforts indicates good respiratory function and is generally given if the baby cries well after the birth

Heart rate:

0 - for an inaudible or absent heartbeat

1 -  for a rate of 100 beats per minute 

2 - if the heart rate is more than 100 per minute

Skin Color:

A score of 0 is given if the infant is blue or pale blue at birth

A score of 1 is given if his extremities are blue but the rest of the body is pink. 

A score of 2 indicates that the newborn has a normal or pink skin colour.

Muscle tone:

0 - Indicates floppy muscles 

1 - Some muscle motion

2 - Active motion 

Reflexes:

0 indicates an unresponsive baby 

1 indicates that grimace during stimulation 

2 indicates that the grimacing was accompanied by sneezing, loud cries or cough 

It is common for premature babies, babies born through c-section or high-risk pregnancy babies to score below than the average in the 1-minute check-up. 

If the score doesn't improve in the 5 minutes check-up, doctors keep the baby under close observation so the required medical care can be given to improve his health. 

Babies with low Apgar scores are usually given breathing support or physical stimulation for normalising their heart rates and then evaluated for all the parameters.

Apgar score assesses for the distress levels of a newborn. It scores the baby on five important parameters including the heart rate, breathing, reflexes, skin colour and muscle tone. As a rule of thumb, the higher the score, the healthier the baby. Low apgar score point to a high level of distress though it does not indicate a future health condition.