Apgar scoring question

[bryonyvaughn]

How do you score grimace/reflex response if a baby doesn't need and therefore isn't suctioned?

[mwherbs]

since routine suctioning is being dropped good question- but I have seen many babies sneeze or cough or other wise try to clear their own airway- or keep it clear- so a baby who spontaneously breathes and is pink all over with a good heartrate and good muscle tone at one minute is going to get a 10. many many babies have blue hands and feet- so it may be a 9 some have different degrees of muscle tone so maybe an 8... if you have a baby that isn't breathing and heart rate is below 100 you will suction that baby or clear their airways in some way before you give a puff of air --

[mothercat]

Baby's have many reflexes present at birth. The simplest is the Moro reflex. If baby exhibits a startle reflex or palmar grasping reflex then you are covered. Optical blink also counts. A little bit of light and baby blinks.

I'm a midwife and a neonatal resuscitation instructor.

[bryonyvaughn]

Thank you for your input, ladies. My last four births have been UC and I haven't really dealt with Apgars since my last MW attended birth almost 10 years ago. Since I didn't suction my babies, I didn't like they idea of Apgar scoring them less healthy than suctioned babies. Yes, I realize that is petty for taking others' standards personally and I accept my shallowness and give myself space to grow on.

I wrongly thought that rating was for grimace and/or gag response to suctioning. I didn't realize it was reflex responses generally with suctioning being the strongest stimulation given most newborns. That makes much more sense to me. Thank you. :-)

~BV