The Apgar test is performed on all newborn babies to assess their health. Your newborn will be tested on five criteria immediately after birth, and checked a second time at five minutes old. The result of the test is known as the Apgar score.

Developed as a checklist by Dr. Virginia Apgar, the test quickly gives doctors and parents an assessment of baby health. Most babies score well on the test, and a lower score helps determine whether additional care is required for the newborn. Birth weight is not a health indicator on the Apgar score.

The Apgar Test Checklist

This test will assess your newborn for:

Appearance (baby's skin color)

• 0 is for pale coloring
• 1 is for pink color, and blue hands and feet 
• 2 is for pink coloring all over (the baby's mouth, palms and soles are checked on Asian or black babies)

Pulse (baby's heartbeat)

• 0 is if a heartbeat isn't found 
• 1 is < 100 beats/minute
• 2 is for > 100 beats/minute

Grimace (baby's stimulation response)

• 0 is for no response
• 1 is if the baby frowns 
• 2 is for a strong cry 

Activity (baby's muscle tone)

• 0 is if there is no, or weak, activity
• 1 is for limited movement
• 2 is for strong movements

Respiration (baby's breathing)

• 0 is for no breathing
• 1 is for slow, irregular breathing 
• 2 is for good strong breaths/crying

The highest possible score is ten, but very few newborns score that high. A normal range for an infant on the test is 7 to 9.

The Apgar Score And Baby Health

With the Apgar score, baby health can be quickly assessed so medical staff can act immediately if needed. Any baby with a score lower than 7 on the Apgar may need additional care and support.

• For babies who score under 4 points, additional tests, resuscitation and special care are almost certainly required.
• An infant that scores between 4 and 6 on the Apgar test may require help with clearing airways and extra oxygen to improve breathing.
• If your baby scores 7 or higher on the Apgar, their baby health is considered normal.

For most new moms, there's a lot to learn about caring for a newborn. If you ever have any concerns about the health of your new baby, call your doctor.