APGAR Scores: Baby’s First Pop Quiz
As pediatricians we are very judgy, even at the very beginning. But in a good way, I promise. The term APGAR or APGAR scores may be something you hear or have heard in the newborn nursery at the time of delivery or shortly after. From the get-go, your baby gets sort of a report card for their very first pop quiz of welcome to life 101. What the APGAR scores let pediatricians know in a very quick and standardized way is how the baby has done/is doing transitioning from the womb to the world. The score is on a scale from 0-10. And, just by saying what the APGAR score number is to a pediatrician, we know immediately how much extra support a baby may or may not need within the first few minutes to hours to days of life. The score is made up of 5 components and, as pediatricians love acronyms and being clever (in that order), we have been able to name these components in honor of the amazing Dr. Virginia Apgar, the rockstar pediatrician who invented the score. Here are the signs:
A – Appearance – this refers to the skin color of baby. Are they blue? Are they only blue at their hands and feet? Or are they pink or normal skin tone everywhere?
P – Pulse – What is baby’s heart rate? Is it 0 (not great), less than 100 (ok), or between 100-140 (normal)?
G – Grimace – no not the McDonalds Mascot, but what are baby’s reflexes to stimuli. Do they GRIMACE or react when we bug them by tickling their feet, rubbing their back or chest etc.?
A – Activity – This one should really be a “T” for Tone, but you know- acronyms. When we say activity or tone, we are checking if the baby is floppy when they come out or are they engaging their muscles from the get-go.
R – Respiration – Is baby breathing, or do they have slow breathing, or are they crying their cute little heads off letting us know those lungs are in good working order.
Each sign is rated from 0-2. So a perfect APGAR is a 10. And the lowest score is a 0. We give a baby an APGAR score at minute 1 of life and again at minute 5. If their score is still low, we keep testing at 10 minutes. A score of 7-10 is considered a very good sign that a baby will not need any extra help from us doctors in the delivery room. A score of 10 is super hard to get and is often reserved for babies of pediatricians or OB/Gyn docs because…. bragging rights. On average, most babies get a 7 or 8.
So, again, I speak for all pediatricians when I say sorry for being judgy and putting your baby on the spot like that, but it greatly helps pediatricians and nursing staff communicate quickly about how well a baby is doing and the appropriate next steps. And I mean c’mon pretty awesome acronym, right?!?