APGAR Scores

A system called APGAR Scores has been developed to check how well your baby is doing right after she’s born. A score is given at one minute and five minutes after birth, and is based on baby’s breathing, heart rate, skin color, muscle tone, and reflexes.

The scoring works as follows:
Breathing – Zero points for not breathing, one point for a weak cry and slow, irregular breathing, and two points for a strong cry with regular breathing.

Heart Rate – Zero points if there is no heart beat, one point for babies with less than 100 heart beats per minute, and two points for babies with a regular heart beat over 100 beats per minute.

Skin Color – Zero points for bluish, pale skin color, one point for babies with a pink body but bluish hands and feet, and two points for babies who are completely pink, including their hands and feet. For African American and Asian babies, the mouth, palms, and soles of the feet are checked, as their bodies will not be pink.

Muscle Tone – Zero points for babies with limp, flaccid muscles, one point for those who exhibit some flexing of extremities, fingers and toes, and two points for those with active movement of all extremities.

Reflexes – Zero points for babies who do not respond to stimuli, one point for babies who grimace in response to stimuli, and two points for those who cry in response to stimuli.

A normal score for a full term baby is between eight and ten points, with ten points being a perfect score. Most babies have a score of eight or nine at five minutes after birth.

Baby’s Physical Signs

0 Points

1 Point

2 Points

 

Breathing

 

None

A weak cry; slow, irregular breathing efforts

A strong cry; regular breathing

Heart Rate

None

Less than 100 beats per minute

Regular, over 100 beats per minute

 

Skin Color

(For African American and Asian babies, the mouth, palms, and soles of the feet are checked, as their bodies will not be pink.)

Blue, pale

Body is pink, hands and feet are bluish

Completely pink, including hands and feet

 

Muscle Tone

Limp, flaccid

Some flexing of extremities, fingers and toes

Active movement of all extremities

Reflexes (Response to Stimuli)

No response

Grimace

Cry