The Apgar Score

Not a perfect ten. What does the Apgar score really mean? Is a 10 healthier than an 8? Not necessarily! The Apgar score was devised primarily for nursery personnel to determine which babies need more careful observation. A baby who has a 5 needs more intense observation than a baby who receives a 7 to 10. It is sort of a which-baby-to-worry-about score. A baby who receives an Apgar of 5 to 6 at one minute but increases to 7 to 10 at five minutes would be in the nonworry category. A baby who begins life with a one-minute Apgar of 5 and remains 5 at five minutes would need more careful observation, possibly in a transitional nursery, and then would be allowed to room-in with mother when the vital systems become stable.

There is seldom a perfect 10. Even though there are infants who are pink all over, breathe normally, have normal heart rates, show strong muscular movement, and cry lustily, most normal, healthy newborns do not achieve perfect scores. Because it takes a few minutes for a newborn’s circulatory system to adjust to life outside of the womb, it is quite normal for newborn to have blue hands and feet for the first few hours. Also, some babies are naturally quiet immediately after birth. In fact, some of the healthiest newborns I have seen are in a state of quiet alertness at five minutes, but they would lose points on their Apgar for not “crying lustily”.

(Taken from “The Baby Book, by William Sears, M.D. & Martha Sears, R.N”; ISBN 0-316-77906-7 hc)