Babies of minority ethnic groups are being disadvantaged and even put at risk due to outdated score tests, researchers say.
A health inequalities board has probed the continued use of the Apgar score - a 1950s test on infants which checks whether they are "pink all over" - and whether paediatricians should continue to use it.
Experts believe the test, which scores babies overall general health upon birth, is too ethnocentric and should be replaced.
The NHS Race and Health Observatory has published a review carried out alongside researchers at Sheffield Hallam University questioning the relevance of the test and even give misleading results for non-white babies - potentially missing signs of illness and risking their health.
Black babies in particular already face higher health risks, with the stillbirth rate nearly twice as high for them as it is for white babies, according to the ONS, while Black women are four times more likely to die in childbirth.
Former chief midwife Prof Jacqueline Dunkley-Bent now co-chairs the Observatory, and says the outdated test is biased towards white babies.
"This biased assessment is exemplified by terms like 'pink' being used to describe a well-perfused baby [with good blood supply]," she said, "disregarding the diversity of skin colours within our population".
She added: "Consequently, it raises concerns about the clinical accuracy of such assessments when applied to ethnically diverse populations."
The Apgar test was devised using white European babies in 1952. It also assesses heart rate, muscle tone and the baby's breathing within minutes of birth.
The biased test could also be overlooking signs of jaundice - resulting in yellowed skin - and cyanosis which results in a bluish-purple tinge, researchers say.
Though a common condition, jaundice can cause severe health problems later in life if not treated right away. One mum said signs of her baby's jaundice were missed due to him being mixed-race.
Lauren Clarke's son Jaxson was born in 2019 and despite showing signs of the condition, was only diagnosed at six days old when he was admitted to hospital with an infection.
"I think if he had not been mixed-race the jaundice would have been picked up sooner," the mum told the BBC.
A Department of Health and Social Care spokesperson said: “We are absolutely clear that maternity care must be of the same high standard for everyone.
“NHS England has published guidance for local maternity systems, supported by £6.8m, focusing on actions to reduce disparities for women and babies from ethnic minorities and those living in the most deprived areas.
“We also set up the maternity disparities taskforce, which brings together experts from across the health system, government departments and the voluntary sector to explore and consider evidence-based interventions to tackle maternal disparities.”
