From the moment that your baby is born, she’ll be routinely checked and examined to ensure that she’s developing well. Here’s our guide to the tests that she’ll undergo.
The first tests that your baby has to undergo are performed both straight after birth and within the first 36 hours.
The Agpar Test
As soon as your baby is born, the midwife will assess her overall health at one minute and then at five or ten minutes after birth. This test – the Agpar Test, as it is known, has five categories, which are assessed:
Skin colour: A newborn baby’s skin is tinged with blue, but it will become pink quickly after the birth, especially after they’ve had a good cry! In non-white babies, the inside of the mouth, whites of the eyes, soles of the feet and palms are also checked.
Heart rate: Newborns should have a heart rate of over 100 beats per minute.
Breathing: This should be strong and regular.
Muscle tone: Your baby should be able to actively move her arms and legs.
Response/reflex: When stimulated, baby should respond.
Each category is given a score from nought to two, giving a total score of between zero and ten. A healthy baby will have a score of seven or higher, while a baby with a lower score may need time to recover from the birth. A baby, who registers a very low score, many need medical attention.
Scores below seven are relatively rare, and usually happen if your baby has had a traumatic birth. Even if your baby does score low, she may just need careful monitoring immediately after birth. Often babies with low scores will experience no further problems.
You may not even be aware that any tests are taking place, as experienced midwives can often carry out the Agpar Test just by assessing your baby while she’s in your arms.
Weight and size
Your baby’s weight, length and head circumference will be recorded. These details are important, as the measurements provide the basis to monitor how she’s doing in the following months – steady growth and weight gain are indicators that all is well.
As babies acclimatise to life outside the womb, most will lose some weight in the first few days after birth. After the first week or so, however, this should level out and you can then expect your baby to gain weight steadily.
Within 36 hours of the birth a midwife or paediatrician will carry out further checks.
Your baby’s head and neck: the skull and fontanelle (soft spot) will be checked, as well as the roof of your baby’s mouth, to ensure her palate is properly formed. The eyes, ears and nose will also be examined.
Heart sounds and breathing: Your baby’s heartbeat should be around 120 beats per minute. It’s fairly common for the doctor to pick up an innocent heart murmur as a baby’s circulatory system adjusts. Nearly half of all newborns have a heart murmur, but most are harmless and disappear within weeks.
Hands, feet, arms and legs: The doctor will examine your baby’s feet to see if there is any sign that they turn in excessively. The tone and strength of baby’s limbs will also be observed.
Hips: The doctor will very gently rotate baby’s hips to check joints for dislocation or clicking. Hip dislocation affects about one in 500 babies and partial dislocation (or ‘clicky hips’ as they’re known) affect slightly more babies. Treatment usually involves wearing a special plaster splint for six to twelve weeks.
Bowel movements: The doctor will ask you if your baby has opened her bowels (ie, ‘done a poo’). This will indicate that baby’s back passage is open. The first poo will be sticky and of a greenish black colour, so don’t panic! It’s called meconium and is perfectly normal.
Spine: The doctor will run his hands down the bones in baby’s back to check for any obvious abnormalities.
Hearing: This is checked by the insertion of a special instrument into your baby’s ear.
So there you go! Just knowing that your baby is receiving an excellent standard of care – and attention – should give even the most nervous new mum some comfort!