Immediately a baby is delivered, the major goal is to ensure the maximum care that can help survival and assimilation into a different environment.  Not only is the newborn physically examined, the baby may also be given certain medications to prevent underlying or serious health problems. The first 48 hours is an important time for the baby, as there will be evaluations done at least every hour to ensure that there are no developing situations.

After a baby is delivered, the Apgar Test is performed. The Apgar test is based on five evaluations and is done one minute after the baby is done and five minutes later.

The Apgar Test is scored, based on the following:

  • Heart rate
  • Muscle tone
  • Color
  • Respiratory rate
  • Reflect irritability

If a baby scores between 7 and 10 in the Apgar Test, the baby will most likely not require extra care. This means that the baby has adequate unassisted breathing, good muscle tone, spontaneous crying, full or almost full-term and a normal color. If a baby has a score lower than 7, then the baby may require additional routine care.

After a baby is born, certain changes are expected within the first 4 to 6 hours. Some of these changes may occur in the baby’s breathing as more blood begins to flow to the lungs or as more oxygen gets to the lungs, clearing out the fluids.

Based on the Apgar Test, these are checks or parameters to evaluate:

  • Checking the baby’s airway to clear fluid or mucous that may have been inhaled during the delivery. A tube is usually inserted into the baby’s nose, mouth and throat to clear foreign materials.
  • Measurement of the baby’s size, weight and crown.
  • Administering of Vitamin K to the baby either as an injection or drops. This is necessary for blood clotting and to prevent the brain from bleeding.
  • Clamping and cutting of the umbilical cord. The umbilical cord is checked to eliminate chances of a secondary infection and also to ensure that the umbilical grip is properly in place.
  • Checking of the heart rate to ensure it is normal. A normal heart rate for a baby should be about 120-160 beats a minute. If it’s too high or low, it could be an indication of a heart or lung problem.
  • Assessment of the muscle tone to ensure that they are solid muscle movements. A weak muscle tone is an indication of a possible future problem.
  • Evaluation of the baby’s activity, motor function, reflexes and reactions to cardinal points
  • Evaluation of the baby’s color. The normal baby color is pink, though there might be a slight blue coloration of the hands and feet after birth which will eventually give way. A complete blue or purple coloration could be a sign of a heart or respiratory disease.
  • Checking to ensure that the respiratory rate is normal. This should be at least 40 to 60 breaths a minute. A respiratory rate lower or more rapid than this signals a problem.
  • Temperature assessment to ensure that the baby’s temperature is between 97.7 and 99.5 normal degrees. An elevated temperature could signal an infection.
  • Checks for the two cartilaginous spaces in the cranium, at the back and front of the skull.


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