In cases where a newborn needs resuscitation, it should be initiated before the Apgar score is assigned at the 1-minute mark. Therefore, the Apgar score is not used to determine if initial resuscitation is needed, rather it is used to determine if resuscitation efforts should be continued. Variation between the 1-minute and 5-minute Apgar scores can be used to assess an infant's response to resuscitation. If the score is below 7 at the 5-minute mark, the Neonatal Resuscitation Program guidelines specify that the infant's Apgar score should be reassessed at 5-minute intervals for up to 20 minutes.