Score of 0

Complexion

Pulse rate

blue or pale
all over

absent

Reflex irritability

no response

grimace

to stimulation

Score of 1

Score of 2

blue at extremities

no cyanosis

body pink

body and

(acrocyanosis)

extremities pink

< 100 beats per

> 100 beats per

minute

minute

Component of
acronym

Appearance

Pulse

grimace on suction or
aggressive

cry on stimulation

Grimace

stimulation

flexed arms and

Activity

none

some flexion

legs that resist

Activity

extension

Respiratory effort

absent

weak, irregular,
gasping

strong, lusty cry

Respiration

The APGAR Scoring System

(developed by Dr. Virginia Apgar)

*** 0-3 Severely Depressed

4-6 Moderately Depressed, needs airway clearance
7-10 Excellent Condition

Immediate Care of the Newborn

Goals:
1.
2.
3.
4.

To establish, maintain and support respiration.

To provide warmth and prevent hypothermia.
To ensure safety and prevent injury and infection.
To identify actual or potential problems that may require immediate attention.

To establish and maintain respiration

1. Wipe mouth and nose of secretions after delivery of the head.
2. Suction secretion s from mouth and nose;
**Compress bulb syringe before inserting
Suction mouth first, then, the nose
Insert bulb syringe in one side of the mouth
3. A crying infant is a breathing infant. Stimulate baby to cry if baby does not cry
spontaneously or if cry is weak.
**Do not slap the buttocks but rub the soles of the feet.
Stimulate to cry only after secretions are removed
The normal infant cry is loud and lusty. Observe for the following abnormal cry:
High pitched cry indicates hypoglycemia, increased intracranial pressure
Weak cry- prematurity
Hoarse cry laryngeal stridor
4. Oral mucous may cause the newborn, to choke, cough or gag during the first 12
to 18 hours of life. Place infant in a position that would promote drainage of
secretions.
Trendelenburg position head lower than the body.
Side lying position if Trendelenburg positions is contraindicated, place
infant in sidelying position to permit drainage of mucus from the mouth, pale a small
pillow or rolled towel at the back to prevent newborn from rolling back to supine position.
5. keep the nares patent. Remove mucus and other particles that may be cause
obstruction. Newborns are obligatory nose breathers until they are about 3 weeks
old.
Characteristics of Newborn Temperature:

1. newborns loss about 2 to 3 degree centigrade of heat at birth because the

external environment is much cooler than the temperature inside the mothers
womb.
2. Newborns loss heat easily because:
They have immature temperature regulating system
Of very little amount of subcutaneous fat to provide heat in their body
They have a larger body surface
3. They also tend to take on the temperature of their environment.
4. The average newborn temperature at birth is around 37.2 C. It is not unusual
for its temperature to fluctuate during the first few hours after birth but is
should stabilize within 10 hours at a range of 36.5 to 37C.