Growth & Development

Question 1

Benefits of breastfeeding

Answer 1

-Decreases illnesses
-Provides maternal antibodies to the babies
-Decreases GI problems
-Decreases allergies (breastmilk has anti-inflammatory agents)
-Decreases risk of obesity
Provides analgesia to mothers for procedures

Question 2

Breastfeeding pain

Answer 2

-Lanolin!
-Ensure proper latching
-Check for milk blebs (blocked nipple pores)

Question 3

Treatment for mothers with mastitis

Answer 3

-Augmentin
-If PCN allergy, Cephalexin

Question 4

How often do babies feed if they are exclusively breastfed?

Answer 4

On demand

Question 5

Vitamins for breastfed babies

Answer 5

-Vitamin D 400U, begin a few days after birth
-Vegan mothers who breastfeed must take vitamin B12 to prevent neurological problems with the baby
-Iron: give starting at age 6 months until they are able to take 2 servings of iron-fortified cereals (1 mg/kg/day)
-Fluoride: check local fluoride water supply. If low, start supplementing at 6 months

Question 6

Normal weight gain for children (Newborn-School-age)

Answer 6

-Within the first week, 7-10% loss
-Regained lost weight by weeks 10-14
-Doubles by 6 months
-Triples by 1 year
-Quadruples by 2 years
-3-5 years old, gain about 4-6 lbs/year
-School age (6-12 years old), gain about 5-7 lbs/year

Question 7

Tooth eruption - primary teeth

Answer 7

-First to erupt: central incisors (8-12 months)
-Last to erupt: second molar (25-33 months)

Question 8

Tooth eruption - permanent teeth

Answer 8

-First to erupt: first molars and central incisors (6-7 years)
-Last to erupt: second molars (11-13 years)

Question 9

Signs of teething baby?

Answer 9

Drooling and fever

Question 10

Cognitive domain theorist & theories? (Birth-Adolescence)

Answer 10

Jean Piaget:

-Sensorimotor (birth-2 years)
-Learn about senses
-Reflexes
-Object permanence
-Simple problem solving

-Preoperational/preconceptional (2-7 years)
-“Me”… egocentrism
-Magical thinking
-Animism (“make food for my bear too, he is hungry like me”)
-Imaginary friends

-Concrete operational (7-11 years)
-Logical thinkers
-Solving

-Formal operational (>12 years)
-Middle-high school
-Abstract problems
-Complex problem solving

Question 11

Psychosocial domain theorist & theories? (Birth-Adolescence)

Answer 11

Erik Erikson

-Trust vs. Mistrust = Infancy (birth-1 year)
-Baby learns that if they cry, parents will feed, change it, tend to it

-Autonomy vs. Shame and Doubt = Toddler (1-3 years)
-They want to become more independent, don’t want anyone changing their diaper, start wanting to potty train

-Initiative vs. Guilt = Preschool (3-6 years)
-“I do”, “I take care of”, “I will do myself”.
-Take initiative in tasks

-Industry vs. Inferiority = School-age (6-11 years)
-Like working hard in school

-Identity vs. Role Confusion = Adolescence (12-18 years)
-“Who am I?”, “I want to know who I am”

Question 12

Psychosexual domain theorist & theories? (Birth-Adolescence)

Answer 12

Sigmund Freud

Principles:
-Id = pleasure
-Ego = reality, self-interest
-Superego = morality or conscience

Stages:
-Infancy = Oral stage - Id
-Birth-6 months = Orally passive (drinking milk from mom, sucking bottles, sucking thumb)
-7-18 months = Orally aggressive (Teething, biting, putting everything in their mouths)

-Toddler = Anal stage
-1-3 years = Potty training, control of bladder and bowel

-Preschool = Phallic stage - Ego
-3-6 years = Discover their genitals, attached to the parent of the opposite sex, Oedipus complex

-Schoolage = Latency stage - Superego
-6-12 years = puberty, recognize sexuality, boy vs. girls, recognize the difference between the 2 genders

-Adolescence = Genital stage
-12-18 years = Identify who they are, interest in the opposite sex

Question 13

Corrected Gestational Age

Answer 13

-Premature babies need to have corrected gestational age. For example, a baby born at 32 weeks, during a 4 month old checkup, will only be doing what a 2 month old baby is doing. This is normal, no need for concern.
-They catch up by 2 years old.

Question 14

Measurement Landmarks (Birth-2 years)

Answer 14

-Measure height, weight, and head circumference until about 2 years old
-After 2 years, measure BMI = weight in kg divided by height in m squared

Question 15

Milestones = 2-5 months

Answer 15

-Smiles and coos
-Lifts head/chest when on stomach
-Holds head steady when pulled to sit
-Startles to loud noises
-Reaches for objects

Question 16

Milestones = 6-9 months

Answer 16

-Turns to sounds
-Responds to name
-Rolls over
-Sits alone
-Supports weight on feet
-Uses thumb and fingers to pick up objects (Pincer grasp)
-Crawls
-Hand to hand transfers objects
-Says “Mama” or “Dada”
-Waves goodbye

Question 17

Milestones = 10-12 months

Answer 17

-Pulls to standing/cruises furniture
-Recognizes people
-Simple pretend play
-Cries when parents leave
-Clings to familiar faces (starts getting stranger anxiety)

Question 18

Milestones = 13-18 months

Answer 18

-Walks alone
-Points to body parts

Question 19

Milestones = 19-24 months

Answer 19

-Two-word sentences
-Walks up and down stairs
-Jumps with both feet
-Completes simple puzzles

Question 20

Well-check Visits (Birth-Adolescence)

Answer 20

-Start attempting BP readings by age 3. If by age 4, cannot get a reading, refer.
-From 6 months-6 years, babies need periodic lead screenings.
-Adolescents: provide time with provider alone, parents outside of the room, to ask private questions

Question 21

Standard of Care - Safety (Birth-4 years)

Answer 21

Car seats:
-Up to 1 year = rear-facing
-Up to 4 years or 40 lbs = use seatbelts with booster seats

Question 22

Body Considerations for Children

Answer 22

-Higher BSA to mass ratio = may absorb pollutants faster than adults
-Less fat and less elastic tissue
-Large head in comparison to their bodies
-Smaller circulating blood volume - bleed out faster
-Bones are more susceptible to fractures because they are more elastic. At higher risk for greenstick fractures because the bone bends first before it breaks
-Cartilaginous cervical vertebrae, slowly get replaced by bone
-Smaller and shorter trachea, smaller lung volumes, and more compliant chest wall - higher risk for respiratory infections
-Higher risk for evaporative heat loss and hypothermia, also due to decreased subcutaneous tissue
-Increased caloric and energy expenditure - faster growing - need more energy
-Larger tongue - careful with children when having seizures, that they tongue does not obstruct airway
-Epiglottis is more anterior and superior than in adults
-Limited stores of glycogen and higher relative metabolism - higher risk for hypoglycemia
-Immature immune system - higher risk for infections