Okay, so today I wanted to figure out how to actually use the Ballard Score Sheet. I’d heard about it, you know, for checking how old a baby is, gestation-wise, but I’d never actually done it myself.
First, I grabbed a copy of the score sheet. Found one online pretty easily, just a simple form, really. It’s broken down into two main sections: neuromuscular maturity and physical maturity.
Neuromuscular Maturity
I started working through the neuromuscular part. Basically, you’re looking at how the baby responds to certain movements.
- Posture: How does the baby hold their arms and legs when they’re just lying there? Are they all curled up, or kinda floppy? I watched the baby for a bit to observe this.
- Square Window: This one’s about wrist flexibility. You gently bend the baby’s hand towards their forearm and see how much of an angle you can get.
- Arm Recoil: I extended the baby’s arm and then let it go to see how quickly and strongly it snapped back.
- Popliteal Angle: This involves bending the baby’s knee and seeing how far you can straighten their leg. It’s a measure of leg flexibility.
- Scarf Sign: Trying to wrap the baby’s arm across their chest, like a scarf, to observe the resistance.
- Heel to Ear: Gently bring the baby’s foot up toward head and see how close it can reach.
Physical Maturity
Next up was the physical maturity section. This is more about what the baby looks like.
- Skin: Is it sticky and transparent, smooth, or peeling and cracked?
- Lanugo: That’s the fine hair on the baby. Is there a lot, a little, or is it mostly gone?
- Plantar Surface: Checking the creases on the soles of the baby’s feet. The more creases, the more mature.
- Breast: I looked at the breast bud size and development.
- Eye/Ear: This one checks how well-formed the ear cartilage is and if the eyelids are fused or open.
- Genitals (Male or Female): This checks the development of the baby’s genitalia, it looks a little different for boys and girls.
For each of these things, the score sheet gives you little pictures and descriptions to help you figure out what score to give. Each item gets a score, usually from -1 to 5.
After I went through all the items, I added up the scores from both sections. That total score then corresponds to a gestational age in weeks. There’s usually a little chart on the sheet, or you can find one online, that tells you the gestational age based on the total Ballard score.
It felt a bit awkward at first, handling the baby and trying to figure out the scores, but after a couple of tries, I got the hang of it. The hardest part was honestly just making sure I was being gentle and not making the baby uncomfortable.
