2.2 Infant Growth and Development Flashcards
Infant Growth/Development (Age 0-1)
Growth - Increase in size
Development - Growth in ability/functioning
- Milestones are usually measured until age 6 (measures averages)
Optimal Growth/Development (Infants)
- Weight gain 5-7 ounces per week
- By 6 months they will double their birth weight
- By 1 year they will triple their birth weight
- Height increases around 1 inch per month for the first 6 months
- 50% increase in length by age 1
- Growth is not gradual, they occur in spurts
Infant Body System Development
Respiratory - RR slows down and becomes more stable. High risk of respiratory illness due to immaturity.
Cardiovascular - HR decreases. Sinus Arrhythmias (abnormal pattern that increases with inspiration and decreases with expiration).
Hematologic - Fetal hemoglobin gets replaced with mature RBC’s. Maternal iron stores decrease at around age 4-6 months (which may lead to iron deficiency anemia).
Digestive Tract - Breastfed infants digest milk better, stools may be much more loose
Immune System - Maternal IgG is replaced with own bodies IgG.
Thermoregulation - Increases ability with thermoregulation. Skin will learn to contract and baby will learn to shiver
Renal Function - Kidneys are not fully mature until age 2 so they are at risk for dehydration/electrolyte imbalance.
- NORMAL OUTPUT IS 2 mL/kg/hour
Stool Patterns in Newborns
Meconium - Occurs 24-48 hours after birth (green-black in color)
Transitional Stools - Appears by 3 days (green-yellow in color)
Milk Stools - Appears by 4 days
Breastmilk Stool - Yellow, Seedy, Loose
Formula Stool - Darker and thicker stool
Infant Nutrition
FEEDINGS
- Breastmilk exclusive until 6 months
- Vitamin D supplements during first few days of life to prevent rickets
- Maternal iron stores last until 4-6 months. Iron supplements (iron fortified cereal) needed in breastfed children (formula already has iron)
- Fluoride supplements at 6 months of age
- Formula/Breast Milk - 20 kcal/oz
Do not feed baby cow’s milk or honey before 1 years old
(Cows milk has high solute load which is hard for immature GI tract to digest)
(Honey is not given to prevent Botulism)
BABY FOOD
- Solid food is usually started around 4-6 months to 12 months
- Start with vegetables first than fruit (if baby has fruit first they may not want vegetables due to sweetness of fruit) - This is done until 8 months then protein (meat) puree is started around 8-10 months
- Baby food is introduced 1 at a time. Give first food for 4-7 days to test for allergies or food intolerances (rash, constipation). If they do well then move onto next food
- General Guideline - 1 Tablespoon of food per year of age
Baby Teeth
- Teach parents to wipe teeth with gauze or small toothbrush
- Baby teeth start erupting around 12 months of age (6-8 teeth). Can start seeing them around 8 months.
- BMI TRACKING STARTS AT AGE 2 DUE TO INCREASED CHILDHOOD OBESITY AND DIABETES
Infant Primitive Reflexes
- Reflexes babies are born with (present for first few months of life)
Birth - 3-4 Months
- Rooting
- Sucking
- Palmar Grasp
- Moro “Startle”
- Tonic Neck “Fencer”
Parachute Reflex - 7-9 Months - Horizontal prone position infant extends hands and fingers to protect their fall
Landau Reflex - 6-8 Months and persists until 12-24 months. Horizontal prone position infant raises head and extends leg and spine.
Birth - 8 Months
- Plantar Grasp
Birth - 1 Year
- Babinski Reflex
Fine Motor Development
1-3 Month – Grasping Reflex (Strong Grasp)
2 Months – Grasp reflex starts to fade
3 Months – Grasp reflex absent
4 Months – Tries to reach objects but overshoots and grabs objects with both hands
5 Months – Grasp objects voluntarily (able to hold 1 cube at a time for a short period)
6 Months – Drops objects when another object is given. Grasp and manipulate small objects
7 Months – Transfer objects from one hand to the other
8 Months – Begins pincer grasp or releasing an object
9 Months – Crude pincer grasp
10 Months – Grasp handles
11 Months – Neat pincer grasp (Proximal distal)
12 Months – 2 block tower and can turn pages in a book many times
Gross Motor Development
2 Months - Head Lag (little neck muscles to baby cannot hold their neck up on their own)
3 Months - Baby can hold head more erect but still bobs forward
4 Months - Head Control (neck muscles are developed to hold their head) (Sit with support)
5 Months - Head Lag should be absent
6 Months - Infants can maintain sitting position if propped)
5-6 Months - Abdomen to back (5), Back to abdomen (6)
7-9 Months - Parachute Reflex (protective extension of arms forward)
8 Months - Sit erect without support
10 Months - Move from Prone to Sitting
Locomotion
- Cephalocaudal Direction
4 Months - Coordination of extremities (Can sit with support)
6-7 Months - Crawling (usually backwards)
8 Months - Sit steadily unsupported
9 Months - Creeping
11-12 Months - Pull to standing position
11 Months - Walking with both hands held or walk while holding furniture
12 Months - Walking with 1 hand held
Standing or sitting without assistance or taking steps is considered cephalocaudal
Psychosocial Development
Erikson - Psychosocial Development
Piaget - Cognitive Development
Erikson Psychosocial Development
Trust VS Mistrust (with caregivers during 1st year of life)
- It is very important for infants to feel their needs are being met during infancy
- Importance of consistency of care
Piaget Cognitive Development
Sensorimotor Phase (6 stages from birth to 24 months)
Birth-1 y/o - Reflex Stage (Children use reflexes to express themselves. They learn associations such as crying will get them fed or if they cry they get changed)
1-4 Months - Primary Circular Reactions (Replacement of reflexes with voluntary reflexes)
4-8 Months - Secondary Circular Reactions (Reasons for actions become very defined)
- Imitation, Play, Affect (emotions)
8-12 Months - Coordination of Secondary Schema (Increased motor skills to allow exploration of environment, Object Permanence - Infants understand if an object disappears the object is still there just not in front of them, they develop intellectual reasoning)
Social Development
Infants - Need connection and attachments
2 Months - Responds to sound by turning his head to side when sound is at ear level (also smile)
3 Months - Infants can recognize familiar faces and objects such as their own hand or feeding bottle
4-8 Months - Separation Anxiety (separation from parent)
6-8 Months - Stranger Anxiety
6-9 Months - Turn their head in a curving arc
- Parents are encouraged to room-in at the hospital overnight to reduce separation/stranger anxiety.
1 Years Old - Children start acting out when they know their parents will leave.
Language Development
- Crying is the first verbal form of communication
6 Weeks - Vocalizations
2 Months - Demonstrates social smiles and vocalizes to familiar voices
3-4 Months - Coo, Laugh, Gurgle
6 Months - Combine syllables such as dada
6 Months - Imitate Sounds, Add Consonants
9-10 Months - Comprehend “No”
10-11 Months - Ascribe Meaning to Words
1 Years Old - 3-5 Words with Meanings
Promoting Sleep for Infants
First 3-4 Months - 9-11 Hours
Total Daily Sleep - 15 Hours
