Normal Newborn Transition

At birth, the newborn loses placental oxygen, glucose, and heat support and must establish these functions independently. The first assessment therefore has two linked purposes: support physiologic transition and decide whether each finding is expected adaptation or evidence of compromise. An experienced nurse looks first at breathing effort, heart rate, tone, colour, and temperature. A pink trunk with blue hands and feet may reflect normal peripheral vasoconstriction; a blue tongue or trunk does not. A quiet infant may be sleeping, or may be hypoglycemic, hypothermic, apneic, or depressed. The pattern and trend matter more than one isolated observation. Use the ACoRN Primary Survey—Airway, Breathing, Circulation, Disability, and Exposure—within the first minutes after birth. Apgar provides a standardized description of the newborn at a specified time, but it never replaces immediate clinical assessment or delays resuscitation.