Newborn Assessments : What to expect

Tests and examinations that are done immediately after birth

When your precious little one enters their new environment, there are a few assessments that are done by your doctor or midwife. These tests are non-invasive and are done to assess the well-being of your newborn. 

An Apgar score is done immediately after birth and a newborn assessment is done before your baby is discharged. 

Other tests such as sugar tests and hearing tests may be offered too. 

What is an Apgar score? 

An Apgar score is the immediate assessment done on a newborn straight after birth and up to 10 minutes after. This determines whether your newborn needs emergency intervention or not. A score out of 10 is given based on the assessment. 

The apgar is done 1 minute after birth, and repeated at 5 and 10minutes.

What is assessed in an Apgar score? 

1. Heart Rate

The baby’s heart rate is assessed by listening to the baby’s heartbeat or by feeling the pulse in the umbilical area. A newborn’s heart rate is generally between 120 to 160 beats per minute,which is quite different to that of an adult. Generally the adult has a heart beat of 80 beats per minute. 

2. Breathing 

Baby’s breathing is monitored and assessed. This is to ensure that there is no difficulty in breathing or any need for oxygen. 

3. Muscle Tone 

This assesses the newborn’s head control, activity, movement and coordination. A newborn is strong enough to crawl to the breast straight after birth. This is called a breast crawl.

4. Reflexes

A variety of reflexes are assessed, including sucking and searching. If these reflexes are not present it makes it difficult for a baby to suck and feed. 

The curling of fingers and toes are assessed, to ensure that nerve endings are normal and that the baby reacts to stimulation. 

The startle reflex is assessed to be present on loud noises or when they feel that they have no support. 

The walking reflex assesses the stepping motion as the newborn’s feet touch the surface. It’s so cute when you see a baby trying to walk! 

5. Colour 

We assess circulation by looking at the newborn’s colour and overall appearance. When the baby takes their first breath, valves in the heart close as they no longer need their placenta but now use their lungs to breathe.

The opening (ductus arteriosus) is a normal part of a baby’s circulatory system in the uterus that usually closes shortly after birth. It may take up to 2 days for this valve to close.

The fingers and toes can generally take time to turn pink. This is also influenced by cold hands and feet which often take longer to turn pink. Skin to skin is the best method of heating a newborn.

The newborn assessment 

The newborn assessment is an assessment done from the baby’s head to their tiny toes. This assessment is done in great detail looking at the baby’s head, eyes, ears, mouth, neck, bones and alignment. The torso, back, arms, hands, legs, feet, genitals, sight and hearing are also assessed. 

A weight, length and head circumference is done and this serves as a baseline. 

Babies generally lose 200g within the first 3 days after birth. It is important to know what your baby weighs in order to do a comparison within the first week. 

Your baby’s hearing and sight are assessed, however, it is best to have an audio assessment with an audiologist within the first couple of weeks of life.

Your newborn’s genitals and rectum are assessed too. 

The rectum is assessed to ensure that there is no blockage. It is important to keep an eye out for the baby’s first stool and urine. Many care providers will monitor the baby until the first meconium and urine is passed. 

If you have any questions about the newborn assessments themselves or have questions about the results from your baby’s recent checks, please don’t hesitate to get in touch via my bloss profile.