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Baby Report Card

At one minute and five minutes after birth, a nurse or doctor will do a quick sur--.our baby and then assign an Apgar score. This simple point system was by anesthesiologist Dr. Virginia Apgar during the early 1950s as a tool to which infants might need closer observation or more intense care after baby is given zero, one, or two points on each of five variables: appearance specifically color), pulse rate, response to stimulation, activity inc u in,_ tone), and respirations.

Few babies receive a perfect ten at five minutes because most have somedusky or bluish coloration of the hands and feet. (Note that references to pink orblue coloration in the table have nothing to do with the racial or ethnic origin ofthe baby.) If the score is one or less at five minutes, the baby will be given closerattention. It serves as a cue or a red flag for the level of care a baby may need im-mediately after birth Eventually the health-care staff will weigh and measure your baby, take foot-prints, apply an armband, and carry out a few other standard procedures. Thereis no reason your baby should be unceremoniously carted off to the nursery forthese details two minutes after birth. On the other hand, you don't need to be up-set if you are separated from the baby for a few minutes once you've had a comfortable time to get acquainted.

Soon after the baby is horn, the nurse will bathe her to remove the thick,whitish material called vernix, which served as a protective covering for her skinwhile she was in the womb. The baby will also receive three routine medical treatments:

• One dose of antibiotic eye ointment or drops. Eye infections caused bygonorrhea or chlamydia acquired during birth can be serious enough tocause blindness. These are effectively prevented by this treatment. Even if you feel certain that you could not possibly carry these organisms, allstates by law require this treatment.

• A shot of vitamin K. Newborn infants have a relatively low level of thisvitamin, which is necessary for normal blood clotting. Rarely, the levelis so low that the baby may be at risk for internal bleeding that cancause significant damage (a syndrome known as hemorrhagic diseaseof the newborn). A single injection of vitamin K prevents thisproblem.

• A plastic clip on the remnant of the umbilical cord. The clip will beremoved before discharge or will be left in place and removed at thedoctor's office during a follow-up visit.

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