Produced by Gary Drevitch
MOST VIEWERS FOCUS ON THE SMILE. BUT WE'VE ALWAYS BEEN DRAWN TO HER GLOW
Researchers studying 3-D images of the “Mona Lisa” say she was probably either pregnant or had just given birth when she sat for Leonardo da Vinci’s 16th-century masterpiece. The clue was something she wore. Scans turned up evidence of a fine, gauzy veil around Mona Lisa’s shoulders — a garment women of the Italian Renaissance wore when they were expecting. . .
WE MAY HAVE TO WORK ON HARNESSING THE TECHNOLOGY THAT BROUGHT MOONLIGHT GRAHAM BACK FROM THE DEAD
America will start running out of family doctors in earnest by 2020, according to the American Academy of Family Physicians. The shortage will be most acute in Nevada, although that state is expected to retain its national lead in crime-scene investigators.
This article paints a bleak picture for the future of medical care in the Southwest and other growing states, but really, by 2020, won't most of our
primary-care physicians be imported from Mumbai and Tianjin anyway? So what's
SKINNY-BUT-DIETING MOMS THROUGHOUT THE UPPER EAST SIDE AND PARK SLOPE WILL BE TAKING PART IN AN "I TOLD YOU SO" RALLY AT CITY HALL PLAZA THIS AFTERNOON
Researchers from Harvard and the Swedish Institute of Misogyny are reporting that when a woman gains as little as seven pounds between pregnancies, she could be jeopardizing the health of her later fetus:
Researchers found that gaining weight during that interval — not during the pregnancy itself — raised the risk of such complications as diabetes and high blood pressure during the second pregnancy, and even stillbirth.
In the study, researchers including Sven Cnattingius (he won't be on the quiz, we just really dig the name) examined the body-mass index of more than 150,000 Swedish women who delivered two children between 1992 and 2001, and found that increases in BMI between pregnancies -- even when the woman's BMI remained in a healthy, non-overweight zone -- led to a sharp rise in the second fetus' risk of diabetes, high blood pressure, and stillbirth.
Follow-up research will be needed, but a variety of experts told the AP that women ought to start acting on this research today:
“For anyone who’s ever thought that gaining or losing 7 pounds didn’t make a difference, this should make them think twice,” [Dr. Daniel Herron, associate professor of surgery at Mount Sinai Hospital in New York] said.
Ladies, start your Zone diets.
AND YOU ALL KNOW WHAT THEY SAY ABOUT GIRLS WITH LONG FINGERS
Well, sure, they say they're potentially great athletes. In a British study,
. . . the largest study of its kind, hand measurements of 607 female twins aged 25-79 from the UK were compared with the women’s lifetime sporting achievements. The findings. . . found that women with ring fingers longer than their index fingers had performed better at running and associated running sports such as soccer and tennis.
We'll take a measure of Tiny Girl's fingers tonight, but we're not hopeful: We bought her a bright yellow 3-to-5-year-old baseball glove yesterday, and she wasn't exactly filling it out.
YES, OF COURSE WE FEEL BAD FOR THE TROUT, BUT FELLOW JUST WANTS TO KNOW WHEN THE STATE'S PLANNING TO SEND SLEEPY BEAR BACK TO US
A teddy bear has been implicated in 2,500 deaths. Of trout, that is. State officials say a teddy bear dropped into a pool at a Fish and Game Department hatchery earlier this month clogged a drain. The clog blocked the flow of oxygen to the pool and suffocated the fish.
SPEAKING OF WHICH, WE JUST CALLED OUR NANNY AND ASKED HER TO JUST GIVE FELLOW AND TINY BANANAS AND SLICES OF RAY'S PIZZA FOR DINNER. HEY, GET OFF OUR BACK, WE'RE EXHAUSTED
In today's Thursday Styles, Jodi Kantor writes about the (allegedly) high-pitched battles between nannies and their tightly-wound employers over stringent new parental demands that their kids eat only healthy, organic, low-fat, homemade meals. The parents in the article seem to have no intention of actually preparing, serving, or sharing any of the meals with the children themselves. But (allegedly) woe to any nanny who slips up and offers a preschooler a bottle of Yoo-Hoo under the new regime.
Here's where our eye-rolling began, in case you're keeping score at home:
The issue is a trying one even for those gifted in the delicate art of parent-nanny diplomacy. The conflicts are partly a result of the educational and economic divide that leaves many nannies less knowledgeable (or neurotic, take your pick) about nutrition than their employers.
And here's where we stopped reading altogether:
To up the emotional ante, the current nutritional wisdom says that what children eat may set their tastes in place permanently. In this view, a hot dog is never just a single tube of meat, because it will lead to thousands of salty, processed, who-knows-what-filled lunches to come.
By the way, we rarely write about our own Child-Care Professional on this site, but she is in fact a consummate pro, and, as relates to the topic at hand, she does a far better job of serving healthy, balanced meals to the kids than we do. Maybe next week Thursday Styles can offer its readers the inspiring story of how she overcame our "educational and economic divide" and figured out all by herself how to give the children servings of fruits and vegetables with each of their lunches.
TWO PORTRAITS OF FELLOW
Many of you have asked how Fellow's adjustment to first grade at a new school is going, and the answer is about as well as can be expected. Two snapshots:
1. Fellow had been telling us how he was playing dodge ball in the school playground after school with "big boys" and how he "never got thrown out. For real, for real." Well, we took one of our paternity leave days a couple of weeks back, picked up Fellow, and watched him play after school. And he was indeed playing dodge ball with the big kids -- they just didn't know it. He lingered on the periphery of the game, and when a ball was thrown out of bounds, he raced to scoop it up, threw it back in the game, and went on being ignored. Meanwhile, some of his new first-grade classmates played together in a corner of the yard, but Fellow was too shy to join in. It was exactly like an episode of "Quantum Leap," if Fellow was the star, and he leaped back into our own body in 1975. Truly remarkable. And then -- a first-grade boy, small in stature but a giant to us, walked across the playground, tapped Fellow on the shoulder and invited him to join his classmates in their play. And he did.
2. So, socially, it's going to take a while. As we walked to school the other day, we encouraged Fellow to sign up for chess class at his school because, as we told him, if he became a better player, he could join the school chess team in third grade. At which point he looked up at us, calmly and matter-of-factly, and said, "Well, I don't really need to. I'm going back to Big City Elementary next year." He's mentioned this plan to us a few times, actually, in the middle of conversations in which he tells us, "First grade is fun," so we haven't been responding one way or the other. But there are reasons we've put him in the class he's in: His homework the other night was to copy a picture of a boy and label his body parts - a list of parts was provided, but the assignment said he could add more. As he worked, he looked up at us and said, "There's more body parts than this! What are they talking about?" And he bolted out of his chair and into his room, where he grabbed his "The Human Body" reference book, found a picture with callouts of body parts, and added lungs, kidneys, etc., to the page. And that's just what we were looking for.
HOW WILL YOUR TINY GIRL RATE?
As Manhattan readers probably already know, New York City has begun to unveil its plans for Gifted and Talented placement for the 2007-08 school year -- and Tiny Girl will be in the mix as a kindergarten applicant. For the third year in a row, the city's testing process has changed. The goal, according to administrators, is to standardize the process by requiring all districts to use the exact same measurements in the same way (give or take; see below). This year, the city will apparently not accept Stanford-Binet (IQ) test scores -- it remains to be seen if Hunter College Elementary applicants will be allowed to apply scores from the Hunter S-B tests to G&T applications, but it sure sounds like they won't -- and instead will employ the Otis-Lennon School Ability Test, or Olsat. (You can look at a brochure about the test here.)
The big news, and the bad news, is that the city will be using Otis-Lennon in combination with the wildly subjective Gifted Ratings Scale, a test in which individual teachers, public and private, evaluate children basically however they see fit. There were widespread reports a year ago that teachers in different locations, even within the same building, used widely varying standards to score the GRS, and complaints that the format of the test was fundamentally flawed. For example, a teacher could be asked to evaluate a child's creative aptitude by answering a questi0n like, Given a choice of different activities, how likely is the child to choose to create artwork? Well, the chances could be pretty slim if the kid loves going to the block area with his three best friends every day. Does that mean he lacks the fine motor skills to paint a delightful tree-sun-house-Mom-and-Dad scene? Not in the least. But he's going to get a very low score on creativity nevertheless. Most disturbingly, as the New York Sun reported earlier this year, there have been reports that the city has threatened (certain) nursery and preschools (for example, the JCC of Manhattan) not to send them a class full of kids with top GRS scores, as it could lead the Dept. of Ed. to punish all of the school's young applicants.
The Sun and the Times both reported on the announcement of the new G&T testing format yesterday, both acknowledging the concerns many parents and educators have with the GRS. So how important will those GRS scores be to your child's application package?
From the Times report (emphasis and brackets added):
City education officials said that Harcourt [its testing vendor] had proposed that schools give two-thirds weight to [Otis-Lennon] and one-third to [GRS] in admissions decisions, but that the details remained to be worked out.
Dona Matthews, the director of the Center for Gifted Studies and Education at Hunter College, called the Olsat “a good, tried and true test.”
“It has been around for a long time and has solid reliability and validity,” she said, “and it is tied to school success.”
But while she praised the city’s Education Department for using multiple criteria for admissions, Ms. Matthews said she had some reservations about the G.R.S. because of the possibility of inconsistency.
“Teachers vary tremendously in how good they are in making this sort of assessment,” she said. “A lot of highly gifted kids are not teacher pleasers. Teachers don’t like them, and they don’t necessarily give them good ratings on scales like that.” . . . .
City education officials said the new admissions process would have controls built in so that any large discrepancy between the test score and the classroom rating would generate additional examination.
The Dept. of Ed. has promised to reveal more when the application process begins later in October, but other critical questions have yet to be answered, such as: Will students living in a school's catchment (neighborhood) have preference in admissions to its G&T program? (From the sound of it, the answer appears to be no.) And, will siblings of students already in G&T programs have preference over other applicants? (Remains to be seen, although the Times article indicates that the city is inclined to rank all applicants in a district by their percentile scores, as they did a year ago, which would indicate that siblings will not get preference, although there was such outcry a year ago when the city dropped sibling preference that that may yet change.)
We'll keep you posted, and we welcome any updates from readers who have found out more than we have.
THIS IS HOW OUR PBS STATION ATTRACTS CONTRIBUTIONS FROM VIEWERS LIKE US
We haven't yet seen the new Sesame Street spokesMuppet, a colorful fairy named Abby Cadabby, but we were bemused by the lengthy feature in the Times about the nine-month corporate gestation period that led to the birth of this "suspiciously marketable" character. And of course, if the topic should come up at your new-parent cocktail party at Big City Nursery School later this month, the appropriate response is to note, huffily, that Jim Henson never focus-grouped Kermit, Ernie, or Cookie Monster, and they all turned out just fine.
In other Sesame Street news, belated thanks to PBS schedulers for re-airing the Natalie Portman episode from Season 35 on Labor Day morning, a day before the start of the school year. For those of you who may have missed it (or neglected to DVR it), the plot involves Queen Amidala filling in for the vacationing Alan at Hooper's Store. Highlights include Portman's inappropriately breathy and flirtatious line readings completely discombobulating Baby Bear's handler, and . . . she sings!
But we've seen relatively little of the Street since PBS premiered Curious George on Sept. 5. George airs the same time as Sesame Street on a competing PBS station, and it has quickly became the early-morning ratings leader here. (Find out what your kids should be learning from the show here.) We have just two quibbles: One, we get that the kids enjoy familiarity and repetition, but did PBS need to start rerunning episodes in the first-run AM slot on Day Three? And two, in the national premiere of a major new PBS show, was it the right decision to run the story of an Italian baker right out of central casting circa 1952, whose-a storyline is-a that he's-a so upset about-a his cat scratching his restaurant's booths that he-a cannot make anymore cannolis? Come on; why not debut with the episode that aired the next day, about the woman scientist?
"PAGING DR. ADAMS, DR. PATCH ADAMS, PLEASE REPORT TO THE FERTILITY CLINIC."
Israeli researchers have discovered that when women undergoing in-vitro fertilization are entertained by a clown immediately after a treatment, they are more likely to conceive than women whose experience is clown-free.
WELCOME TO OUR NIGHTMARE
Several months back, Loving Mother made an online purchase of some American Girl accessories for a relative's daughter, and had the items delivered to our home. Which means American Girl got our address, and so last night we came home to this scene: As soon as we opened the door to our apartment, Tiny Girl rushed up to us, with a newly-delivered American Girl catalog in hand, demanding, "Daddy, will you buy me this Emily doll for my birthday?" (Emily being the doll on the first page of the catalog.) "Well, Sweetie, your birthday is a few months away, but when it comes, if that's still what you really want, we can talk about it." "I AM still going to want it when my birthday comes! Daddy? Will you get it for me when it's my birthday?"
IS THIS THE END OF THE ROCKET SHIP REVUE AS WE KNOW IT?
Dan Zanes' slinky sidewoman Barbara Brousal has delivered her baby, and taken a leave from the band. She's being replaced - as if that were even possible - by singer/guitarist Charlie Faye, at left, and that's just one of several lineup changes in the Zanes band as it prepares to go on tour this fall. Singer/accordion player Cynthia Hopkins is out as well, devoting herself full-time to her downtown music-and-performance projects. Even Yoshi the bass player is taking off. What gives, Dan? The group not happy with how you're divvying up that new Disney money?
UM, WE'RE NOT SURE, BUT WE'VE SPENT A LOT OF TIME WITH PREGNANT LADIES LATELY, AND WE THINK THESE IMAGES MIGHT BE PHOTOSHOPPED
Gawker this week posted several of the images, which were presumably designed to attract Brazil's beer-loving-pregnant-gal niche market.
And that's not as crazy as it sounds: Loving Mother rarely drinks beer, but has regularly enjoyed non-alcoholic beer during her pregnancies. Still,not sure this is the ad approach that would sell her. Ourselves, on the other hand, we can't turn away.
YOU'RE NOT GOING TO BELIEVE US, BUT NOVA SCHINN ISN'T EVEN THE MOST EVIL MATERNAL MARKETER OF THE WEEK. IN FACT, IT'S NOT EVEN CLOSE.
No, that prize goes to Donna Charlton-Perrin, creative director on the Suave account at Oglivy, who was interviewed in the Times the other day for a roundup of new national ad campaigns taking new approaches to targeting moms "who, they are certain, are dying to spend more time on themselves, but feel too guilty to do so."
We'll sign off today with her quote, italics added:
[Charlton-Perrin] said Ogilvy was looking for ways to “interrupt moms when they are not thinking about themselves’’— say, by putting Suave stickers on food shelves in supermarkets, or running pop-up ads on Internet sites that sell children’s clothes.
“There seems to be this feeling in the culture that moms must be martyrs, that their lives have to be all about their kids,’’ Ms. Charlton-Perrin said. “But the beautiful woman inside that mom is still dying to get out. So we’re saying, ‘A pretty mommy is a better mommy.’ ’’
AND THEY'RE SO CUTE, TOO
Maybe it's the postpartum hormones, maybe it's the rush of nostalgia since we haven't done it in three-and-a-half years, but we just had the best time buying some Newborn Huggies. After years of paying $14 for maybe two dozen size 3, 4, or 5 diapers, one forgets what a massive bargain a pack of Newborns is (same size package with the same volume of material, but since the diapers are so much smaller, many more fit inside). We just paid $19.98 for 96 - that's under 21 cents each! Sadly, the poop still stinks . . .
LIVING LIKE THE OTHER HALF -- TEMPORARILY
Little Guy is our third child and we really are old hands at this, but as the body ages, so does the spirit, and lack of sleep becomes less of a badge of honor, and more like a pair of big lead badges hanging from our eyelids. So last week, for the first time ever, we had a baby nurse come over - overnight only, and just for two nights - and she'll probably return for about two nights each this week and next as well. And we have to confess - it's awesome! Little Guy slept much better, and Loving Mother slept, period, which she hadn't done the two nights previous to the nurse's arrival. And there's really nothing like watching a pro swaddle, because, yes, we're three kids in, but if there was a swaddling immunity challenge on Survivor: Parents Island, we'd sadly be on the first motorboat home. Houdini would have loved our swaddles.
HEY, MAN, WE'RE ALL A LITTLE WORRIED ABOUT THE NEW FIRST GRADE
It's the first day of school here in Manhattan, as Tiny Girl
joyously reported to Big City Elementary for her first day of public
pre-K, and First-Grade Fellow started his first day of school in a
public gifted program at a different school a little bit up the street.
We understand that there are lots of parents with actual problems out
there, but the decision to switch schools on Fellow was the most
harrowing one we've yet made for him, and we tossed and turned through
anxiety dreams for hours last night. Fellow loved Big City Elementary
so much, made so many friends, and was so reluctant to be in a new
school for the second year in a row -- but on the other hand, he's
excited about the new school's chess club, he likes the playground, and
he'll have some old friends from nursery school there, so we'll see.
But, boy, did we feel the pangs when we saw his old kindergarten
teacher and some of his old friends at Big City this morning.
On the bus this morning, as we rode from Fellow's new school down the street to Tiny's new school, a pair of women struck up a conversation with us about the first day of school. When we confessed that we had switched schools on Fellow, one mom, about to deliver her youngest daughter to kindergarten at Big City Elementary, lashed into us for moving him out of a school he loved, and jeopardizing his emotional state. She later told us that her older kids went to the Anderson Program (an ultra-elite public magnet program), so -- easy for her to say. Then a grandmotherly type behind us asked, "How old is your son?" "Five and a half." "OK, then don't listen to her. I was a teacher and principal for 30 years. He's young. He'll be fine."
And he probably will -- after all, it's not like we're sending him to Clemmons Elementary School outside of Winston-Salem. As Newsweek reports in "The NEW First Grade," its anxiety-mongering back-to-school cover story this week, Clemmons is symptomatic of schools where parents are so eager to push their kids onto the Ivy League track that they hold kids back from kindergarten for a year or more, demand that first-grade teachers produce class ranks, and rush their kids into tutoring if they haven't mastered reading by mid-first grade. In other words, they act a lot like Manhattan parents trying to get their kids into nursery school.
The Newsweek piece really breaks no new ground, but is a decent roundup of years-old trends toward a more academic first-grade curriculum, a shift that, as the article concedes, is in fact based on a new understanding of younger children's ability to learn. It's not quite a chicken-and-egg situation, but the parental push for more academics in first-grade does correspond to new research proving that most 5-to-7-year-olds can, in fact, take it. Are the schools responding to the parents or the research? Depends on who you ask and how many magazines you're trying to sell.
And yet. As we read the section about Clemmons parents holding kids back and creating giant six-and-a-half-year-old kindergarteners, we thought how enlightened New York City admission rules are -- the city allows parents to start kids in grade K at six years old, but not in gifted or special magnet programs. If you're six, you have to apply for first-grade admissions. But then again, it now occurs to us, when it comes time to apply to special high schools like Stuyvesant and Bronx Science years from now, those older kids may very well have a distinct advantage over Fellow and Tiny, December kids who'll both start K before they turn five. And so the anxiety builds anew.
MORE BAD NEWS FOR OLD DADS
The results aren't new, but they're notable for the breadth and focus of the study they come from: Men who become fathers in their 40s are six times more likely to produce autistic children than fathers under 30. The study tracked 130,000 Israeli Jews born in the 1980s, and was "based on biographical information on. . . boys and girls who at age 17 were being assessed for eligibility to serve in the Israeli military." The mothers' age at childbirth appeared to have little impact on autism, but as for the dads:
"It's a strong effect in a carefully designed study," said Dr. Edwin Cook, an autism researcher at University of Illinois-Chicago.
WITH AMBIVALENCE, WE OFFER THE LATEST EVIDENCE THAT TV MAY BE GOOD FOR TODDLERS
But the producers of "Blue's Clues" will certainly trumpet these results: In a new study of how children under three interact with TV, Vanderbilt researchers found that the beloved show was "on the right track" in its "realistic, child-centered conversations" -- when Steve or Joe turn to the screen to ask kids a question, and then wait for an answer, which many young viewers shout from their couches. The study tested how well children performed activities based they had seen in a video "if they considered the onscreen actors to be. . . 'social partners,'" as they do when watching the show.
Earlier studies already found that three-to-five-year-old "Blue's Clues" viewers perform better on problem-solving tests than peers who have never seen the show. This new proof that the show -- and presumably "Dora the Explorer," which has similar interactivity -- may be beneficial for even younger kids is more good news for the pro-TV set.
However, the Vanderbilt study did nothing to disprove the so-called "video deficit," in which "toddlers who have no trouble understanding a task demonstrated in real life often stumble when the same task is shown onscreen." For toddlers, real-life interactions remain superior to video demonstrations, but Fellow and Tiny will have to make do with a steady diet of the latter until Little Guy starts sleeping through the night.
SCENES FROM A BRIS
Friday afternoon, the extended FD.com family gathered for hummus, brownies, and a little ritual circumcision. All went well, except FD's own prepared remarks. As we began speaking, we heard a crying baby in the background, and the noise just wouldn't stop. We looked over to where our in-laws were standing once, twice, three times, and wondered, with some annoyance, why they hadn't handed their toddlers off to someone else so the bris could proceed in peace. Then it dawned on us: Little Guy was the one crying. Fully flustered, we cut our remarks short and let the professionals get on with reshaping our new family member's. . . member.
[Photo note: Our mohel asked us which New York baseball-themed yarmulke we'd prefer for his little keppe, and so, yes, Little Guy is wearing a Mets skullcap at left. Had we had more foresight, we'd have brought a Red Sox head-covering to the procedure, but so it goes. For more new photos of Little Guy, click here and scroll to the bottom of the screen.]
IN HER NAME
Little Guy, as we did manage to stammer to the assembled crowd the other day, is named for his Freelance Grandmother, our own mother, who passed away about 10 months ago. We can report that he is so far about as loud as she was, so it may in fact be a good match.
Since he'll never get to meet his namesake, however, we plan to roll
out several of her parenting catch phrases as he gets older, so he'll
at least get a taste of life with her. For example, when he comes home
from a play date covered in mud, we'll scream, "Oy Gottenyu!"
When we start catching him in lies, we'll tell him, "You're full of old
shoes!" and when his teenage behavior inevitably turns strange, we'll
wail, "It would take a Philadelphia lawyer to figure you out!"
TINY TAKES THE LEAD
We know many longtime readers have been placing their bets, and so we're prepared to tell you that Tiny Girl has taken a significant early lead in the race to be Little Guy's favorite big sibling. She's read "Benny's Baby Brother" to him at least a dozen times already, and it quiets him down every time. She's also Johnny-on-the-spot when Loving Mother calls for new diapers. Still, Fellow has become adept at placing Little Guy's mirror next to his blanket to attract his attention, and he's constantly offering up fingers for the baby to pull on.
LADIES, DON'T LET THIS HAPPEN TO YOU
NOW, THAT'S WHAT WE CALL ECONOMICS!
Habitual hot-button-pusher Caitlin Flanagan recently described the purported explosion in teen oral sex this way (from the Atlantic, via Slate):
The moms in my set are convinced—they're certain; they know for a fact—that all over the city, in the very best schools, in the nicest families, in the leafiest neighborhoods, 12- and 13-year-old girls are performing oral sex on as many boys as they can.
That's right, inattentive working moms -- in the leafiest neighborhoods! Just like yours! Bet you're wishing you'd stayed at home now!
Anyway, Flanagan notwithstanding, Slate reports on how the Freakonomics approach gets to the bottom of the teen oral sex boom, specifically one study that shows the trend to be basic economics: As the costs/risks of unprotected sex rise for teens -- AIDS, gonorrhea, the price of the Pill, and especially, it turns out, new state abortion-notification laws -- they become less likely to do it; in fact, the percentage of teen virgins seems actually to have risen more than 15% in recent years:
[Jonathan] Klick and [Thomas] Stratmann claim to have found evidence [that w]herever and whenever abortion-notification laws have been passed, gonorrhea rates in the teenage and adult populations start to diverge. When it becomes more troublesome to get an abortion, teenagers seem to cut back on unprotected sex.
And so the shift to (unprotected) oral sex. Slate's conclusion: "On the one hand, good news: Teenagers are finding safer ways to get their kicks. On the other, it suggests that teenagers believe one of the most serious consequences of an unwanted pregnancy is that their parents will find out. If teenagers are avoiding unsafe sex, it may not be for the best reasons."
IN OTHER WORDS, MOMS-TO-BE, YOU CAN FEEL FREE TO STAY UP LATE
WORRYING ABOUT HOW MUCH ORAL SEX YOUR FUTURE TEENAGE DAUGHTER MIGHT
Women who feel particularly anxious or stressed during pregnancy apparently cause no harm to their babies, according to a Sam Houston State University study:
Anxiety was not associated with any of the negative pregnancy outcomes examined: length of labor; birth weight; use of analgesia during labor, which can indicate great pain; gestational age at birth; or the Apgar score that rates the general health of a newborn.