The Apgar

Just moments after birth, babies are administered their very first test. The APGAR score is an assessment tool used by doctors and nurses to determine whether a newborn requires any medical intervention. It tests five specific criteria of health, and the medical professional assigns a score of 0, 1, or 2 for each category. A perfect score of 10 is rare—most babies will show some minor deficits at the 1-minute mark, and many will still lose points at the 5-minute mark.

The five criteria of health used to calculate the APGAR score

GRIMACE RESPONSE OR REFLEXES

  1. Healthy babies indicate their displeasure when their airways are suctioned—they will grimace, pull away, cough, or sneeze.
  2. Baby grimaces during suctioning.
  3. Baby shows no response to being suctioned and requires immediate medical attention.

RESPIRATION

  1. A good, strong cry indicates a normal breathing rate.
  2. Baby has a weak cry or whimper, or slow/irregular breathing.
  3. Baby is not breathing and requires immediate medical intervention.

PULSE

  1. A pulse of 100 or more beats per minute is healthy for a newborn.
  2. Baby's pulse is less than 100 beats per minute.
  3. Baby has no heartbeat and requires immediate medical attention.

APPEARANCE OR COLOR

  1. Body and extremities show good color, with pink undertones indicating good circulation.
  2. Baby has some blueness in the palms and soles of the feet. Many babies exhibit some blueness at both the 1- and 5-minute marks; most warm up soon after.
  3. Baby’s entire body is blue, grey, or very pale and requires immediate medical intervention.

ACTIVITY AND MUSCLE TONE

  1. Baby exhibits active motion of arms, legs, and body.
  2. Baby shows some movement of arms and legs.
  3. Baby is limp and motionless and requires immediate medical attention.

REFLEXES IN INFANTS

Never underestimate the power of a reflex. For developmentalists, newborn reflexes are mechanisms for survival, indicators of brain maturation, and vestiges of evolutionary history. For parents, they are mostly delightful and sometimes amazing.

Three photos are shown at the bottom of the page demonstrating various reflexes in newborns.

THE SUCKING REFLEX

The first photo shows a newborn sucking at a finger. A newborn, just a few minutes old, demonstrates that he is ready to nurse by sucking on a doctor’s finger.

THE GRASPING REFLEX

The second photo shows a newborn holding on tight to a doctor’s thumbs. When the doctor places a finger on the palm of a healthy infant, he or she will grasp so tightly that the baby’s legs can dangle.

THE STEP REFLEX

The third photo shows a woman holding a newborn child who is raising one of her legs as if wanting to walk. A 1-day-old girl steps eagerly forward long on legs too tiny to support her body.