Normal Development Flashcards
How long is the neonate phase
first 4 weeks of life
What is normal gestation length?
40 weeks
What is full-term?
38-42 weeks
What is preterm?
before the end of the 37th week
What is post-term?
After the onset of the 42nd week
What is the range of normal birthweight? Average?
between 5.5-9.5 lbs, Avg: 7.5
What is the average length of a baby?
20 inches
AGA
appropriate for gestational age, weight between the 10th-90th percentiles for their age.
SGA
Small for gestational age, weight below the 10th percentile for their age.
LGA
Large for gestational age, weight above the 90th percentile for their age.
LBW
Low birth weight, born at less than 2500 g (5lb 8 oz)
VLBW
Very low birth weight, born at less than 1500 g (3lb 5 oz)
ELBW
Extremely low birth weight, born at less than 1000 g (2lb 3 oz)
IUGR
Intrauterine growth restriction. OBGYN measures the growth in utero. Less than 10th percentile = concern. Take measurements externally. May have to deliver early if it isn’t fixed.
Where are IUGR measurements taken?
Externally from the pubic bone to the top of the uterus.
What is the best nutrition for the baby? Second Best? How long should they be on these foods?
Breast milk is best, followed by formula. Exclusively these liquids for 1st 6 mo., 12 mo if possible is best.
If a baby is malnourished for the first ______ then their growth may be stunted.
3-4 years of life
How much of a role does heredity play in height?
A lot. 60-80% of height difference between people attributed to heredity.
How much should a baby grow at first?
1-1.5 inches per month
Is it typical for the baby to lose weight in the first few days?
Yes. 5-7% of body weight
When will the baby start gaining weight again? How much?
After 1-2 weeks. 4-8 oz per week.
How much should the baby weigh by the end of the 1st year?
2.5 - 3 x their birth weight.
Average head circumference at birth
13.5 inches
Microcephaly
Smaller head. Below the 10th percentile. Could be inadequate brain growth, genetic problem, etc.
Macrocephaly
Bigger head. Above the 90th percentile. Indicates hydrocephalus.
FTT
Failure to thrive. Weight falls below the third percentile. Can be intrinsic or extrinsic.
Intrinsic FTT
Problems with the liver, metabolic rate, etc. intrinsic to the childs processes.
Extrinsic FTT
Not being nourished, not enough social interaction, neglect, etc. Reasons out of their control.
Rules for back to sleep campaign
Alone, on my back, in a crib.
Why is tummy time important?
For development of back/neck extensors. Helps develop gross motor skills
What does the state of Ohio require newborn testing for?
Genetic, endocrine, & metabolic disorders
What do amino acid disorders cause? What does it result in?
The baby’s ability to break down proteins. Toxic build up that can result in intellectual disability and other problems.
What is Phenylketonuria (PKU)? How is it treated?
Amino acid disorder. Unable to break down phenylalanine, builds up, can result in brain damage. Treated with special diet.
What is Homocystinuria?
Amino acid disorder. Cant break down some amino acids and they build up in the blood, leads to blood clots. Treated with special diet.
What is hypothyroidism?
Endocrine disorder. Not enough thyroid hormone. Decreased growth, intellectual disability/learning delay. Treated with thyroid hormone replacement therapy.
What are fatty acid disorders?
Interfere with turning fats into energy. Can cause seizures, poor breathing, blood sugar, heart and muscle function problems. Treated with special diet and medications.
What are organic acid disorders?
Interfere with ability to remove certain waste products from the blood. Results in problems maintaining blood sugar, bouts of vomiting, coma. Treated with special diet.
What is galactosemia?
Body cannot break down galactose (in milk and other foods). Causes developmental delay, liver damage, cataracts. Treated with a special diet.
What is sickle cell disease?
A hemoglobinopathy. Autosomal recessive trait. Red blood cells don’t live as long or function as well. Cells only live 10-20 days vs 120 days. African Americans have higher incidence. decreased endurance, spleen prone to infection. Maybe treated with antibiotics.
What is cystic fibrosis?
Autosomal recessive trait. Body produces excessive mucous which is too thick because the Na++ Cl- channels arent working properly. Clogs up the lungs. pancreas is affected body can’t get proper nutrition.
What is the CFTR modulator?
Works with some mutations of CF, allows sodium chloride channels to work thinning the mucous.
What is hyperbilirubinemia?
Jaundice. Breakdown product from RBCs hemoglobin. Usually secreted in the bile. If mom if Rh (-) and baby is Rh (+) mom develops antibodies and can be bad for next pregnancy.
What is a normal APGAR score?
7-10. Done at 1-2 minutes and 5 minutes post-birth.
What is a baby’s respiratory pattern?
30-50 breaths per minute, obligate nose breathers.
Typical baby HR?
100-160 beats per minute
What’s a baby’s vision like?
Don’t see well far away. Least developed of all senses. Like human faces and high contrast images.
When is a babies hearing fully developed?
At birth.
What is cradle cap?
very common skin condition. Scaly patches on the scalp that go away within a few months.
What are hemangiomas?
a birthmark that most commonly appears as a rubbery, bright red nodule of extra blood vessels in the skin. Usually go away on their own in time.
What are milia?
Baby acne or milk rash
What are stork bites?
Common birthmark in newborns. Flat salmon colored build up of blood vessels. Often goes away on its own.
Erb’s Palsy
75% of injuries. C5-C6 upper brachial plexus injury. Head and shoulder stretched opposite ways. Shoulder can get caught under pubic bone during birth. Waiters tip.
Klumpke’s Palsy
C8-T1 Lower brachial plexus injury. Primarily ulnar nerve. Claw hand. less than 5% of brachial plexus injuries.
Erb-Klumpke’s
Entire brachial plexus. 20% of injuries.
What is DDH?
Developmental Dysplasia of the hip. May have unequal thigh creases or in the gluteal area or unequal knee height (lower knee often pathological)
Barlow Test
Test to assess for DDH. Only valid until 3 mo. Trying to see if the hip will displace. Hand under sacrum. Knee/hip bent to 90 degrees, Slight adduction, axial load through knee.
Ortolani Test
Test to assess for DDH. Only valid until 3 mo. Replaces the Barlow test. Flex hip to 90 degrees, abduct, apply anterior pressure at the greater trochanter. Will feel clunk if the hip relocates.
What is club foot?
Orthopedic condition. Foot adducted & PF. Can sometimes be treated with stretching protocol.
What things do doctors check for in a newborn?
Autonomic NS regulation, control of motor system, state regulation, social interaction.
State I
Very deep sleep, no movement, eyes are closed. ANS well regulated then they will enter deep sleep for extended period of time
State II
light sleep and the eyes are shut moving a little bit
State III
starting to wake up, opening eyes, closing eyes, dozing
State IV
Awake, eyes are open, moving a little bit. If ANS is regulated they should be able to stay this way for a time.
State V
Awake, moving kicking
State VI
The child is crying
What is physiologic flexion?
In utero the child is in flexion, when they are born they maintain that flexed position. Bear weight on the chest and head.
Should the heel be able to go all the way to the ear?
No. Should be able to go to level of the chest with normal tone.
What is the popliteal angle?
Flex the hip so the thigh is in contact with the abdomen, then start to extend the babies leg. 90-100 degrees is normal.
What is the scarf sign?
Moving the arm into HADd. full term baby you should feel resistance about at midline.
Should the baby have a lot of extension when you pick it up?
No. it should snuggle into you, but not be too floppy. Indicates ability to adjust to a new position.
What is the pull to sit test?
pull baby up by hands head will be corrected from “lag” close to the vertical position. If they don’t it indicates low muscle tone.
What’s the significance of spontaneous movements?
Looking for the baby to be symmetrical with their movements. All extremities moving to indicate good, balanced muscle tone.
When does sucking develop? Rooting?
Both at 28 weeks of gestation
Sensory systems to assess in baby.
Tactile, proprioception, visual, auditory (may startle, look toward sound), vestibular (respond well to slow linear movement)
HIP ROM at birth
Flexion contracture - 30 degrees
External rotation > IR (& ABducted)
Coxa valga (max 150 degrees)
Anteversion - exceeds 25 degrees
Knee ROM at birth
Flexion contracture - 30 degrees
genu varum
Talo-crural ROM at birth
70 degrees dorsiflexion
Vertebral column at birth
concave anteriorly
