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Immediately after birth your baby is given a "grade"—a reminder that your newborn is entering a quantitative world where humans are compared and scored from the moment of birth and throughout life. The Apgar score—devised by Dr. Virginia Apgar in 1952—is a quick appraisal of the initial health of your baby. This score, determined first at one minute and then five minutes after birth, assesses your newborn's heart rate, breathing effort, skin color, muscle tone and activity, and response to stimulation.

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 gets a 4 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 "non-worry" category. A baby who begins life with a one-minute Apgar of 5 and remains at 5 after five minutes would need more careful observation, possibly in a transitional nursery, and then would be allowed to room-in with the mother when her vital systems become stable.

There is seldom a perfect 10. Even tough 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 a 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."

The Apgar score should have a "For medical use only" label, but over the years this score has been given to parents who have perceived the number as a sort of infant IQ test—an unnecessary source of anxiety for parents of low-scoring babies. There is seldom a correlation between the Apgar score and the long-term development of babies. If your baby has pink lips and breaths normally, chances are he or she is a healthy newborn.