How to use it
- For each of the five signs, choose the description that matches what you see: 2, 1 or 0 points.
- Read the total from 0 to 10 and its band.
- Repeat for the 5-minute score; the two are recorded separately.
How the score works
Each sign gets 0, 1 or 2 points and the five are added:
| Sign | 0 | 1 | 2 |
|---|---|---|---|
| Appearance | blue or pale all over | body pink, hands and feet blue | pink all over |
| Pulse | absent | below 100 bpm | 100 bpm or more |
| Grimace | no response | grimace | cry, cough, sneeze, pulls away |
| Activity | limp | some flexion | active movement |
| Respiration | absent | slow, irregular, weak cry | good, strong cry |
The total is read in three bands: 7–10 reassuring, 4–6 moderately abnormal, 0–3 low.
Worked example
At one minute a baby has bluish hands and feet (1), a heart rate of 130 (2), grimaces when stimulated (1), some flexion (1) and a weak cry (1). Total: 1 + 2 + 1 + 1 + 1 = 6, moderately abnormal. At five minutes the baby cries and moves actively, the score rises to 9 and is reassuring.
Tips
- Score what you see at the time point, not what you expect.
- In babies with darker skin, color is judged on the lips, palms and soles.
- Premature babies often score lower on tone and reflexes simply because of their age.
- This tool is for learning and information. Care of a newborn is led by midwives and doctors and never waits for a score.