objective 7 Flashcards
Period of time from 4 weeks to 1yr
Milestones (norms) vary with each child
infancy
Effective feeding patterns
Predictable sleep/wake cycles
Bonding
neonatal phase
Wt doubled by 2 mos
Wt tripped by 1 yr
Head growth rapid: 1-2cm/month x6 months
physical development
present until 3 months
grasp reflex
grasps objects between fingers and thumb
8mos
prehension
infant extends arms when thrust downward in prone position
8mos
parachute reflex
coordinates index finger and thumb
1 yr
pincer grasp
Eriksons trust vs mistrust table 13.4
Love & security vital: healthy personality
Social
Stimulated by change in env
Sensory stimulation
Parents taught to talk, sing, and touch infants
Essential for thought processes and perception
emotional development
makes small throaty noises, cries when hungry or uncomfortable, sleeps 20-24 hrs
1 month (S)
smiles to mothers voice. Knows crying brings attention
2 months (S)`
cries loudly when irrupted from play, babbles and squeals, sucks from spoon
6 months (S)
plays pat-a-cake, amuses self longer, reserved with strangers
8 months (S)
recognizes “no”, shows emotion, verbalization slows b/c of increased concentration about ambulation
12 months (S)
1st teeth- lower contral incisors
6-10 months
6 teeth (4 above and 2 below)
1 yr
Posterior fontanels closes
Tears appear
Can hold head erect in mid position
Follows moving light with eyes
Legs active
Holds rattle briefly
2 months (M)
Sits alone for a moment with hands forward for support
Solid food introduced
Turns over completely
Sees parent & self as one
Separation anxiety begins
6 months (M)
Sits alone steadily
Uses index fingers and thumb as pincers
Can distinguish happy from fearful face
Can transfer from one hand to another
Begins to crawl, moves forward, using chest, head and arms, legs drag
8 months (M)
Can rise self to sitting position
Creeps and crawls
Cruise furniture
Holds bottle
Complies with simple command
Fear of being left alone
Fears strangers
Waves “bye-bye”
9 months (M)
Clings to mother in unfamiliar situation
Demonstrates emotions (affection)
Stands alone for short periods, may want
Attempts to feed self
Babinski reflex disappears before infant walks
12 months (M)
how do we prevent accidents?
Safety locks
Drowning
Suffocation
Falls
Poisoning major cause of death
Toy safety
Car safety
Black and white contrasting mobiles
0-2 mos play
Hold and chew toys, unbreakable mirrors
3-9 mos play
Push-pull toys, lrg pic books, soft blocks, nested boxes
1yr play
fed at 3-4 hr intervals
bottle-fed infants
fed at 2-3 hr intervals
breastfeed infants
what are the DOs of introducing new foods?
Introduce slowly & one food at a time in small amounts.
Rice cereal recommended as first food since it is less allergenic
Introduce new solids after milk feeding (as solid food increases , formula/milk should decrease)
what are the DO NOTs of introducing new foods?
Introduce new food if infant ill (adverse effects such as allergic reaction may not be identified)
Mix cereal or baby food in bottle
Introduce whole milk before 1 year of age
Introduce low fat milk until 2 years of age
child begins to reach for spoon
7 months (D)
Begins to use spoon independently , although not able to keep food on it
9 months (D)
what are the physical factors affecting the parent and infant readiness for feeding?
mom well, infant well, anomalies
Much more skillful at self feeding & has the ability to both rotate wrist and to elevate the elbow to keep food on the spoon
2 years (D)
what are the psychological factors affecting parent and infant readiness for feeding?
Discomfort
Restlessness
Restlessness
Crying
Extrusion reflex
what are the benefits of breastfeeding?
Faster involution
All right nutrients; right proportion
Changes to meet baby’s needs
Easily digested
risk contamination
Feeling closeness
Always right temp
Brain development
Enhances mother-infant bonding
what are the contraindications of BF?
Mother has contagious disease i.e. HIV
Mother has herpes lesions on both breasts, active varicella zoster virus & untreated infectious tuberculosis
Use of illicit drugs or undergoing treatment
Galactosemia in infant
what are the 4 stages of lactations?
secretory differentiation
secretory activation
galactopo
involution
Lactogensis in response to pregnancy hormones = colostrum
1st milk secreted
Yellowish fluid, rich in protective antibodies
Provides protein, vit A&E and essential minerals
Lower calories
secretory differentiation
Occurs in response to placenta delivery
Decrease in progesterone, increase prolactin
The milk comes in day 2-3 until day 8
secretory activation
9 days after birth
Driven by autocrine, driven by milk removal
Establishment of adequate milk-supply dependent on continual production and removal of breast milk
galactopo
Occurs 40 days after last feed
Milk secretion ceases
involution
what are the positions for BF?
Laid back
Cradle
Football
Side lying
how do we prevent problems in BF?
frequency and duration of feedings
flat/inverted nipples
nipple confusion
breast engorgement
nipple trauma
Feed at least 8-12X/day
Feed Q 1.5-3 hrs early weeks
Cluster feeds
Flexible 1st weeks; wake after 3 hrs
Feed at least 15 mins on 1st breast, switch, then til satisfied (approx 15 min each breast)
Begin next feed with last breast
frequency and duration of feedings
Roll between finger & thumb
Consult lactation consultatnt
flat/inverted nipples
Breast feed & bottle feed
Avoid supplementation 1st 3-4 wks
min each breast
Pacifiers- neg effect on supply, and impact on latc
nipple confusion
Pump
Cold application between feeding & heat prior
Manual massage
breast engorgement
Cracks, blisters, redness & bleeding
Correct positioning
Expressed milk on nipples, warm compress
min each breast
nipple trauma
what are the 3 forms of formula feeding?
ready to feed
concentrated liquid
powdered
how do we prep for bottle feeding?
Bottles/nipples sterilized by boiling for 2 mins
Ready to feed
No dilution, wash top can, pour bottle
Concentrated liquid formula
Half formula, half water
Powdered formula
Water with recommended scoops
how do we observe for dehydration?
< 6 wet diapers/day
Dry, hard stool
Skin turgor
Dry MM
Low grade fever
Sunken fontanels
