Chapter 25: Newborn Growth and development Flashcards
Infancy
Birth to one year
Neonate or newborn is birth to 28 days
maturation
increase in functionality of various body systems or developmenal skills
adjusted age
Subtract the number of weeks the infant was premature, from the actual age. Use this age when assessing the growth and development.
weight
Birth 7.5 (loose 10% over first 5 days)
6 months doubles 16
1 year triples 23
Height
Birth 19-21 (increases about 1 per month)
6 months 25-27(about 1/2 per month)
1 year 28-30
Head Circumference
1 inch greater than chest
Birth 13-14
6 months 16.5-17.5
1 year 17.7-18.7
States of Consciousness
Deep sleep: lies quiet without movement
Light sleep: move a little while sleeping and may startle to noises
Drowsiness: Eyes may close, dozing
Quiet alert state: eyes are wide open and body is calm
Active alert state: Infants face and body move actively
Crying: cries or screams, body moves in disorganized fashion
Reflexes
Root-turn to side birth-3months
Suck- birth to 2-5 months
Moro - C abduct of arms Birth - 4 months
Asymmetric tonic neck -fencing, extremeties extend on side head is turned birth- 4 months
Palmar grasp birth -4 to 6 months
Plantar grasp birth - 9 months
Babinski birth to 12 months
Step birth to 4-8 weeks
Neck righting: keeps head upright 4-6 months - forever
Parachute: catch a fall 6 months - forever
backwards starts at 9-10 months
Respiratory
Rate slows From 30-60 to 20-30 at one year
Lacks IgA which contributes to infections
Maturity at 7 years
Cardiovascular
Heart doubles in size the first year
Pulse decreases from 120-140 to about 100
BP increases from 60/40 to 100/50
Thermoregulation improves
Stools
Of concern is red, white, or black. Mucuslike, frequent and watery, frothy or foul, hard, dry, formed, or pelletlike, or if baby is vomitting.
Iron
During the last trimester, the mom transfers iron stores to the fetus. Premature miss some of this increasing risk for iron deficiency anemia
Immune
IgG thru placena lasts for 3-6 months
IgG is made after that.
IgM reaches adult levels at 9 months
Erickson
1st year Trust vs Mistrust
Piaget
birth - 2 years Sensorimotor
substage 1: use of reflexes, to one month
substage 2: primary circular reactions 1-4, object
permanence starts
substage 3: 2nd circular reactions 4-8
substage 4: coordination of secondary schemes 8-12
object permanence developed by 8 months
Freud
Birth - 1 year Oral stage
Gross motor skills
Develop in cephalocaudal fashion. Starting with the head going towards the feet.
Warning signs include the child that cannot support head at 3 to 4 months, reaching with one hand only, cannot sit with help at six months, does not crawl at 12 months, cannot stand supported at 12 months
One month: lift and turn head in a prone position, head lag when pulled to sit, rounded back sitting
Two months: raises head and chest, improved head control
Three months: raises head to 45 in prone. Slight lag
Four months: lift head and looks around, rolls from stomach, head leads body pulled to sit
Five: rolls from back. Sits with support
Six: tripod sits
Seven: sits alone with some hand support
Eight: sit unsupported
Nine: crawls
10: pulls to stand, cruises
12: sits from standing, walks independently
Fine motor skills
Develops in a proximal distal fashion. From the center to the peripheral
One month: fist clenched, involuntary hand movements
Three: holds hand in front of face, hands open
four months: bats objects
five months: grasps rattle
six months: releases objects in hand to take another
seven months: transfers objects from hand-to-hand
eight months: gross pincer grasp/rakes
Nine-month bangs objects together
10 months: find pincer grasp, puts objects in out of container
11 months: offers objects to others
12 months: feed himself with cup and spoon, Mark on paper, pokes finger, feeds self, assist with dressings
Senses
Hearing developed at birth
Sight: 8-15 ft, color and tracking objects by 7 months,
Warning signs include no response to loud noises, no focusing on a near object, no sound by four months, does not turn to sound at four months, mostly cross eyed at six months
Communication warnings
No sounds at four months. No laughing by six months. No babble by eight months. No single word at 12 months.
Stranger and separation anxiety
Usually occurs around eight months.
temperament
The how of behavior. low or moderately active, regular, predictable to highly active, more intense, and less adaptable. Help the parents know how adaptable and flexible infant is.
Play and early learning
Play is the work of children. Reading aloud and sharing books during early infancy are critical to the development of neural networks for later tasks of reading and word recognition. Increases listening comprehension.
Nutrition
newborn: Fluid 140-160 ml/kg/day
calories 105-108 cal/kg/day
infant: fluid 100 ml/kg/day for first 10 kg
50 ml/kg/day for next 10 kg
calories: 1-6 months 108 cal/kg
6-12 months 98 cal/kg
contraindications for breast feeding
infants with glactosemia, Maternal use of illicit drugs and a few prescription medications, maternal untreated active TB, and maternal HIV infection.
Breastmilk
Includes lactose, lipids, polyunsaturated fatty acids, and amino acids. The highly concentration of fat of amino acids contribute to proper myelination of the nervous system. Iron is less than that of formula.
No supplementation is needed if there are 6 to 8 wet diapers per day
Formula feeding
Only use formula fortified with iron. Do not use cows milk. Always hold the baby in an semi upright position. Try not to overfeed. Burped 2 to 3 times per feeding. 1/2 to 1 oz initially up to 2-3. 6-10 times day. 3-4 months 6-7 oz 4-5 times day
ready-made can is good in the fridge for 48 hours. Concentrated in the fridge for 48 hours. Do not use unused portion.
Solid foods
Rice cereal at 4 to 6 months. At eight months soft, mashed table food and Cheerios are okay. 10 to 12 months you may include mashed meets. Introduce the cup at 6 to 8 months. No juice until six months and no more than 2 to 4 ounces per day.
Avoid honey, egg yolks, meat, choking foods. Common foods that cause allergies include citrus, strawberries, wheat, cows milk, egg whites, peanut butter
Sleep and rest
Newborns 20 hours.
Three months 7-8 at night, three naps.
Four months sleep through the night.
12 months 8 to 12 hours per night with two naps
Establish bedtime routine by four months, sooth themselves in night
Teeth and dentist
No fluoride or toothpaste needed during this stage. Visit the dentist by one year of age. The first teeth usually come in around 6 to 8 months of age. Occasionally they have natal teeth.
Colic
Inconsolable crying that last three hours or longer per day for which there is no physical cause. Usually ends by three months of age.
