Believe it or not, your baby is given his first test when he’s just one minute old! It’s called the Apgar test, and it was designed in 1952 by an anesthesiologist named Virginia Apgar.

The Apgar test is performed by your doctor one minute and five minutes after your baby is born. The one-minute test measures how well your baby handled birth, and the five-minute test (or in some rare cases, ten minutes) measures how well your baby is adjusting to his new world.

According to the National Institutes of Health, the Apgar test measures five things: breathing, heart rate, muscle tone, reflexes and skin color. For each of these factors, your baby is given a score of 0, 1 or 2, with 2 indicating everything is normal and 0 indicating something might be wrong.

The scores for each item are added together, resulting in a score between 0 and 10. A score of 7 or higher is normal and means your baby is doing just fine. A score lower than 7 means he might need medical assistance adjusting to life outside the womb.

Let’s look at what doctors are assessing for each of the Apgar categories:

Breathing: The infant cries well and has regular, non-labored breathing.

Heart rate: A consistent heart rate. A heart rate greater than 100 scores a 2. A heart rate less than 100 scores a 1, while a 0 indicates no heart rate is detected.

Muscle tone: The infant has active motion and muscles are engaged. Floppy, loose muscles score a 0.

Reflexes (also called grimace response): Measures how well the infant responds to mild stimulation, like a pinch.

Skin color: Measures the infant’s color tone, ranging from pale blue to slightly blue to pink all over. Note, it’s incredibly uncommon for infants to score a 2 for skin color. Almost all babies are slightly blue at their extremities immediately after birth.

The most common causes of a low Apgar score are fluid in the baby’s airway, C-section or an otherwise difficult birth. Oftentimes, a low one-minute score becomes normal after five minutes.

If your baby’s score does not reach normal levels, he may be given oxygen to help him breathe or physical assistance to help his heart beat normally. It’s important to note that Apgar score has no correlation with the future health of your baby. It is purely a test designed to detect when an infant is having trouble adjusting to the outside world, so that proper medical attention can be given.

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Source: National Institutes of Health