infant, toddler, preschooler Flashcards
how much does weight and length change during infancy (1 month to 12 months)
birth weight triples, length increases by 50%
why is teaching normal milestones important?
so parents can know what to expect! (roll over, oral stage, baby proof house!)
do all babies follow the same growth and development?
yes..first learn to small, babble, hold their heads up, then progress to rolling over, sitting up, crawling etc. in same sequence.
there are rare exceptions
why is it important for you to know the developmental milestones?
so you can recognize something that is not normal and take appropriate action. also help parents make realistic goals for their children (anticipatory guidance)
what does growth of the infant refer to?
physical size increase; weight, height, head circumference
weight gain weekly until 5-6 months?
150-200grams weekly
when does baby double birth weight?
at 4-6 months
average weight per lb/ per month for first 6 months, second 6 months
first 6 months= 2lb a month
second 5 months= 1 lb a month
average 1 year old male weight
10 kg/ 22 lb
average 1 year old female weight
9.5kg/ 21 lb
height increase in first 6 months
2.5cm a month, increases by 50%
average height at birth and 1 year
20 inches at birth, 30 inches at 1 year (50.5-76.2cm)
what grows first in infancy
trunk first, then legs
how much does the head increase in the first year?
33%, fontanelles close
head to tail pattern?
turns then lifts head first, to trunk, roll over, creeping, crawling to sitting and walking (cephalocaudal and proximodistal)
reflexes disappear
head growth per month up to 6 months
1.5cm per month
head growth in second 6 months
0.5cm, average is 45 cm at 1 year
by end of first year how close is head to adult size
2/3 the adult size
when does the posterior fontanelle close
6-8 weeks
when does the anterior fontanelle close
12-18 months
what happens to madible/lower jaw by 1st year
becomes more prominent
when does chest circumference become even with head
about 1 year old
when does the abdomen protrude until
until walking and abdominal muscle movement (2-4 years)
heart rate during infancy?
slows to 100-120
resp rate during infancy?
decreases to 20-30
BP during infancy?
increases slightly 100/60
infant may become anemic, when will it resolve by
5-6 months when adult HgB develops (add iron rich cereal to diet at 4 months)
are the liver and kidneys mature during infancy
no still immature, digestion and enzymes immature
when can baby shiver by
6 months
is an infant susceptible to dehydration
yes, still has 40% ECF compared to 20% in adults
when do lower incisor teeth come in
6-10 months
upper incisors?
8-12 months
lateral upper teeth?
9-13 months
lateral lower teeth
10-16 months
what does development of the infant refer to
refers to increase in skill or ability to function (qualitative)
when is baby cruising by?
11 months
when can baby transfer toy from hand to hand
7 months
when does baby have advanced hand-eye coordination
8 months
when does baby have pincer grasp
10 months
when can baby offer and release toys
12 months
grasp reflex-fisted at first to thumb opposition?
4 months
what language does infant use?
different cries
babbles and coos?
1 month
happy sounds
3 months
more purposeful sounds
5 months
imitate sounds, da-da
9 months
words with meaning
2-4 years old
when does baby have a social smile
1 month
when does baby laugh
3 months
when does stranger anxiety begin
8-9 months
when does baby turn their head to sound
3 months
when can baby play peek-a-boo and clap hands
10 months
eriksons theory and infancy
trust vs. mistrust
- needs are consistently met=safe world
- needs are not met= fearful & distrustful
piagets theory and infancy
cognitive development
- sensorimotor stage
- infants relate to world with senses and reflex behaviour
- self is separate entity (separation anxiety)
- permanence of objects, cause and reaction
what is primary circular reaction
by 3 months baby begins object exploration phase with hands and mouth, accidental reaction
what is secondary circular reaction
by 6 months baby is able to reach for objects and cause a purposeful reaction. 10 months understand object permanence, peak-a-boo
12 months love to throw things
kohlbergs theory and infancy
prereligious, little concept of any motivating force beyond that of their parents
-reinforce good behaviour
freuds theory and infancy
oral stage, interested in oral stimulation, relief of tension and nourishment
attachment and infancy?
dont make assumptions on attachment.
-at 6 months will show a preference in parents
how is play until 3 months
undifferentiated from birth until 3 months
how is play from 3-6 months
rattle, stuffy, caregiver
play from 6 months to 1 year?
more active and verbal, no strangers, want parents attention
when do babies ascribe meaning to words
around 10-11 months
temperament during infancy?
depends on parents perceptions and expectations of infant/child
thumb-sucking and infancy?
try not to make a big deal out of it, in school age try a pacifier
how much head banging is normal
less than 15 minutes
sleep concerns and infancy
very individual and normal unless day and nights get mixed up
colic babies?
cramping, abdominal pain. drawing legs up. endless crying- usually infants less than 1 year. exhausting!
diaper dermatitis
very common! change frequently, mind detergents
milaria
heat rash, bath and dry infant well, baking soda in bath, reduce clothing
obesity is more common in which babies
bottle fed
sleep from 1-6 months
individual, around 16 hours, 3-4 hour intervals, 3 naps
sleep from 6months-1 year
14 hours, 2 naps`
development of senses in infancy
binocular vision, hand regard
- 4 months recognize familiar objects
- 6 months tracking and deep perception
- 10 months object permanence
when can baby recognize name, hone to sound
hone to sound at 4 months
recognize name at 10 months
turn head to sound at 3 months
when can baby start to smell
1-2 hours after birth
aspiration prevention in infancy
No powder in baby’s face, no bottle propping, recommend parents take CPR training (choking baby); remember button battery!! Clean floors, lock up medications, lock doors & cupboards, food in bite size (no popcorn or peanuts), small parts toys, balloons etc. Burns – smoke detectors, don’t microwave formula, EBM, foods, check bath water temp, keep coffee/tea etc. away from infant, cigarette ashes, sunburn, hot car in summer, fireplace guards, table clothes out of reach.
when is baby ready for adult bathtub
when they can sit up on their own and develop good back support- never alone!
what is shaken baby syndrome
caused by violent shaking of the baby, often due to prolonged crying and frustrated caregiver; large head & shearing forces cause injury (neurological damage); often see no external signs but may present with vomiting, poor feeding, irritability or listlessness; more severe are seizures, LOC, apnea etc.
sudden infant death syndrome?
younger than 1 year, unexplained, peak age 2-3m. “Back to sleep”, non-smoking environment & breast feeding help prevent.
positional plagiocephaly?
asymmetrical head – increased incident since the “back to sleep” campaign.
failure to thrive syndrome?
infant falls below 5th percentile for height and weight – organic or inorganic causes
who is the expert when dealing with parents and infant?
the parents! educate non-judgementally
order or assessment with infant
least invasive to most invasive
weight gain during toddler
slows to 1.8-2.7 kg/year
height during toddler
slows to 7.5cm a year, stretch out and lose “baby fat”
head growth during toddler
grows 2.5 cm a year, by 2 years chest circumference is greater than head. chest and head is equal in about 6 months to a year
body proportions during toddler?
abdomen still protrudes
sensory changes during toddler?
explore world through all senses
-taste preferences developed
how many teeth during toddler?
20 deciduous teeth by 30-36 months
completed myelination of spinal cords?
18 to 24 months
brain develops during toddler to about what of its adult size?
90% of adult size
heart rate during toddler
80-120
resp rate during toddler
still slow around 20-30, but still abdominally
walking development in toddler
walks 12-13 months, creeps up stairs at 15 months
- one stair at a time at 18 months
- run/jump, stand on one foot 30 months
when can toddler usually spoon feed themselves
18 months
eriksons stage during toddler?
autonomy vs shame and doubtdevelop a sense of independence but safety without over protection; begin to see self as separate from parent, able to tolerate being separated from parent, able to delay gratification, and do not always have to do as they are told! Doing things independently “I do it”! “NO!” Control over bodily functions. Negativism, ritualism, mood swings, temper tantrums, regression.
when does imitation begin
19-24 months, look for an object, remember it, imitate it
end of toddlerhood begins which thoughts?
preoperational thought and assimilation
- beginning of problem solving
- rational judgement, intellectual reasoning
spirituality during toddler
parallels cognitive development, family and environment influences childs perception of world in all aspects
when can toddler recognize self in mirror, recognize gender
mirror- 2 years
gender- 3 years
when does parallel play happen
18 months to 24 months, playing side by side
what is the biggest task for the toddler usually?
toilet training! usually around 18 months to 24 months when anal sphincters are under control
temper tantrums?
very challenging to deal with for any parent! Is child getting enough attention? Are they not getting their need met due to inability to express it? 18m can tolerate a time out. Best to be consistent in how one handles the tantrum. Best to ignore behaviour as long as they are in no danger or harm to self (walk away works as kids don’t like being left alone) and reinforce better behaviour positively. Best to try to avoid triggering behaviours (i.e. don’t go shopping when your kid is hungry, tired, frustrated etc.). Ensure not seizure activity.
negativism?
“NO” period.All about gaining independence and autonomy! This is normal behaviour. They are not being “bad”, just exercising their independence and autonomy, boundaries. They really don’t have the cognitive capacity to do this on purpose. Give simple choices of which you can live with either answer.
regression?
usually brought on by stress, normal,
seperation anxiety?
try to have consistent caregivers or favoured caregiver (Granny?!). Give a bit of warning before leaving and what child can expect. Best not to sneak out as may cause increased fear and abandonment issues.
nutrition and toddlers?
- 12-18m growth rate slows & so does appetite but still need protein for muscle growth & high activity level
Ritualistic behaviour – use same cup, plate etc. one food touches another – yikes!
Encourage independence building by letting child feed self rather than parent, also may help with appetite and amount eaten (gaining sense of independence). Difficult for toddlers to sit still for a whole meal. Kids may like same food again and again, go with it! Offer finger foods. Eat about the same foods as family by 12 months, just cut smaller or mashed? Look at food consumption over 24 hours or even a week rather than meal to meal and generally should be OK for food groups! Appetite will vary as will food preferences. Avoid using food as a reward or to pacify a child. Beware of choking foods! Grazing is a good way to ensure proper nutrition.
activity and sleep and toddles?
very active but concerns re: too much screen time leading to obesity! Get outdoors and off the couch! Sleep 12 hours a day, 1-2 naps and often by end of toddlerhood don’t nap. Sleep problems common, getting settled to bed and fears (separation, monsters (transitional objects help, routines, etc. help), and waking up during the night. Safe sleeping environment, bed for sleep and not play time. Avoid all this by establishing a consistent sleep routine early.
when can eyes be tested?
aged 2 to 2.5 or when they can ID object .on eye chart
when can hearing be tested
at 18 months
approaches to the toddler
similar to infant- engage parent
- allow child to touch equipment
- praise positive behaviour
- distraction, playful
- limit choice to two * no yes or no questions1
vital signs of preschooler
HR 60-110 average 85
RR 18-25
BP 96/57 -+ 10
when does right or left handedness develop
5 years old
height per year during preschooler
7-7.5cm per year
what stage of fowlers are toddlers in
initiative-projective
how much screen time should kiddies have
less than an hour a day
4 words one sentence=
1 year
300 words, multiword sentence=
2 year
best approach to regression
ignore it and praise existing patterns of appropriate behaviour
when can autism be diagnosed
18 months or 2 years
are sleep problems common in toddlers?
yes! due to fears and separation
- may be scared of monsters
should food be used as a reward?
no! encourages over eating and obesity
serving size for toddlers?
15ml of solid food per year of age or 25% of adult portion
vitamin D in food
fish, fish oils, egg yolks prevents rickets
how much fruit and veggies a day in todders
4 servings
leading cause of 1-4 year old deaths
drownings then: burns, vehicle accident, threats to breathing
when should booster seats be used
18-36 kg (recommend until 8 years old)
