We all know as children get older they are tested and scored in school. But did you know that their first ‘test’ is given within minutes of their birth? It’s true! At birth, your newborn will be scored on how he is transitioning to his surroundings outside the womb. He will be scored on 5 different areas, once at 1 minute after birth and again at 5 minutes after birth. This is the first “test” your baby will have and it is called the Apgar Score.

The 5 areas in which your baby will be scored are:

  • Skin Color
  • Heart Rate
  • Breathing
  • Muscle Tone
  • Reflex Response

For each area scored, your baby will be given a 2, 1, or 0 on each of the 5 responses. A score of 2 means that your baby has a healthy response to the area scored and a 0 means he is absent of a response. You may hear your nurse say, “Apgar score of 7 for first minute after birth and 9 for five minutes after birth.”

Apgar Score Chart

Area Scored

Score of 0

Score of 1

Score of 2

Skin Color

Blue in color

Body pink, feet/hands blue

Baby is pink

Heart Rate


Under 100 beats/minute

More than 100/minute



Slow or irregular

Good or crying

Muscle Tone


Some tone

Actively moving

Reflex Response



Sneezing or coughing

Some scores will be higher, some scores will be lower. This depends on how well your baby is adapting to his new environment. Your infant may need closer observation or his airway cleared. A score of less than 5 usually suggests that your baby may need oxygen, additional monitoring, or other special care. This may feel like a scary time, but once the healthcare team works with your baby you may see that score rise. A perfect score is a 10, but most babies score between 7 to 10.

The Apgar Score cannot determine how healthy a baby will be as he grows up. It will alert the healthcare team that a new baby may need extra care, observation, or medical management after birth. If your nurse doesn’t ‘announce’ the Apgar Score, you can ask what the score was. Most babies score high and only have points deducted for color, since most babies are born looking gray or purplish. Rest assured, as your baby grows they will continue to pass more tests with flying colors!

EIRMC is the region’s leading pediatric provider. To learn more about pediatric services at EIRMC, visit eirmcKids.com.

tags: baby , newborn