Each newborn baby is carefully checked at birth for signs of problems or complications. A complete physical assessment will be performed that includes every body system. Throughout the hospital stay, physicians, nurses, and other healthcare providers continually assess a baby for changes in health and for signs of problems or illness. Assessment may include:
Each area can have a score of zero, one, or two, with ten points as the maximum. A total score of ten means a baby is in the best possible condition. Nearly all babies score between eight and ten, with one or two points taken off for blue hands and feet because of immature circulation. If a baby has a difficult time during delivery, this can lower the oxygen levels in the blood, which can lower the Apgar score. Apgar scores of three or less often mean a baby needs immediate attention and care. However, only 1.4 percent of babies have Apgar scores less than seven at five minutes after birth.
|Sign||Score = 0||Score = 1||Score = 2|
|Heart Rate||Absent||Below 100 per minute||Above 100 per minute|
|Respiratory Effort||Absent||Weak, irregular, or gasping||Good, crying|
|Muscle Tone||Flaccid||Some flexion of arms and legs||Well flexed, or active movements of extremities|
|Reflex/Irritability||No response||Grimace or weak cry||Good cry|
|Color||Blue all over, or pale||Body pink, hands and feet blue||Pink all over|
Most hospitals use the metric system for weighing babies. This chart will help you convert grams to pounds.
1 lb. = 453.59237 grams; 1 oz. = 28.349523 grams; 1000 grams = 1 Kg.
An examination called The Dubowitz/Ballard Examination for Gestational Age is often used. A baby's gestational age often can be closely estimated using this examination. The Dubowitz/Ballard Examination evaluates a baby's appearance, skin texture, motor function, and reflexes. The physical maturity part of the examination is done in the first two hours of birth. The neuromuscular maturity examination is completed within 24 hours after delivery. Information often used to help estimate babies' physical and neuromuscular maturity are shown below.
Points are given for each area of assessment, with a low of -1 or -2 for extreme immaturity to as much as 4 or 5 for postmaturity. Areas of assessment include the following:
A score is assigned to each assessment area. Typically, the more neurologically mature the baby, the higher the score.
When the physical assessment score and the neuromuscular score are added together, the gestational age can be estimated. Scores range from very low for immature babies (less than 26 to 28 weeks) to very high scores for mature and postmature babies.
All of these examinations are important ways to learn about your baby's well-being at birth. By identifying any problems, your baby's physician can plan the best possible care.
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