Infant Growth & Development Slides

8/4/2019 Infant Growth & Development Slides

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I. Physical growth and development

A. Growth parameters

>The best indicator of good overall health in an

infant is steadily increasing size

>Growth and development is monitored byplotting measurement in a standardized

growth chart, from birth to 3 years, and from 3to 18 years


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Length:

A. From 0 to 6 months an infant grows 1 inchper month (2.5 cm)

B. average 6 month old infant is 25.5 inches

C. average 12 month old is 29 inches

Birth length increases by 50 % by 12 months

Weight: A. from 0 to 5 month old, child gains 1.5 lbs per

month


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B. weight doubles by 5 months

C. average 6 month weight is 16 lbs

D. birth weight triples by 12 months

E. average 12 month weight is 21.5 lbs > chest circumference is normally about 1 inch less

than HC; it is measured at level of the nipples

>Fontanel changes A. anterior: diamond shape; closes at 12 & 18

months

B. posterior: triangular, closes by 2 months


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NUTRITION

. Breast milk is the most desirable completefood source for the first 6 months

. Commercially prepared iron-fortified formulais an acceptable alternative

. Formula intake varies per infant but averages

4 oz 6 x a day for 1 month; 4.2 oz 5 x a day at 6months when solid foods are introduced

. Solid foods are not recommended before 4- 6months


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. Breast milk or formula is the primary sourceof nutrition for 6 to 12 months, although solidfoods should be added

. Infant cereals are usually the infants initialsolid foods; easy to digest, contains iron, andrarely causes allergic reaction

. Additional foods include other cereals, fruitsand meat

. Finger foods are introduced at 8-9 months


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. Weaning from breast or bottle to a cup shouldbe gradual. The infants desire to imitate(between 8-9) increases success of weaning

. Honey should be discouraged because it maybe a source of infant botulism

SLEEP PATTERRNS

< sleep patterns vary < during 1st month, most infants sleep when

not eating


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< between 3 and 4 months, most infants sleepbetween 9-11 hours at night

< by 12 month, most infants take morning and

afternoon naps < bedtime rituals should begin in infancy to

prepare the infant for sleep and prevent futuresleep problems


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DENTAL HEALTH

Fluoride supplements are needed forexclusively breast- fed infants, those receiving

ready to feed formula and where local water isinadequately fluorinated

Primary tooth eruption begins by 6 months

Teeth should be cleaned with damp cloth

Breast and bottle feeding should bediscouraged during sleep to prevent dentalcarries that result from prolonged contact withmilk


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II. Cognitive development

Overview ( Piaget)

> In the sensorimotor stage, between birth and18 months, intellect develops and the infantgains knowledge of the environment through

senses. Development progresses from reflexiveactivity to purposeful acts in 5 substages:


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A. Substage 1 ( birth 1 month): use of reflexes-characterized by innate and predictablesurvival reflexes ( such as sucking and grasp)

B. substage 2 ( 1- 4 months) primary circularreactions- marked by stereotyped repetitionand the focus on his/ her own body as center

of interest C. substage 3 (4-8 months) secondary circular

reactions- acquired adaptation and shifting ofattention to objects and environment


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D. substage 4 (8- 12 months) coordination ofsecondary schemes- consolidation of andcoordination of schemes ( searching for hidden)

E. substage 5 ( 12- 18 months) tertiary circularreactions- interest in creativity, and discoverythrough active experimentation; stagecompleted when infant achieves sense of

permanence

An emerging body image parallelssensorimotor development


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LANGUAGE Crying is the first means of communication Cooing begins between 1 and 2 months Babbling, laughing, and consonant sounds begin

between 3 and 4 months Imitative sound at 6 months Combined syllables (ma-ma) at 8 months Understands no-no by 9 months Infant says mama and dada in correct context

by 10 months Infant can say 4 and 10 words in correct context by

12


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III. Psychosocial development

A. Overview ( Erikson)

Erikson terms the crisis faced by the infanttrust vs mistrust

The sense of trust developed in the 1st year

forms the foundation for all futurepsychosocial tasks.


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In this stage, developing a sense of trust incaregivers and environment is the centralfocus.

The quality of caregiver- child relationship is acrucial factor in the development of trust

Consistent delay in needs gratificationdevelops sense of uncertainty, leading tomistrust


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B. Fears

> infant exhibits startle or Moro reflex inresponse to loud noises, falling, and sudden

movements in the environment > stranger anxiety typically begins in age 6

months

> caregiverss cuddling and warmth can easefears

>commonly seeks comfort from a securityobject during times of stress or uncertainties


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C. Socialization

Attachment to significant others begins at birthand very evident after 6 months

Age 2 months: social smileAge 3 months: familiar faces

Age 4 months: social interaction

Age 5 months: smiles at mirror image

Age 6 months: begins to fear strangers

Age 8 months: consistent stranger anxiety

Age 12 months: shows emotions (jealousy, etc)


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D. Play and toys

Play is the work of children

It reflects the development and awareness of

environment From age 1 month to 1 year, play is solitary

The infant develops sensory and motor skillsby manipulating toys and other objects

Toys stimulate psychological development Offers diversion

Means of communication and feelings


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Infant toys should be safe and appropriate:

No sharp parts and objects

No small or detachable parts

Examples of age appropriate toys: 1 to 3 months: mobile,, music box, rattle, etc

4 to 6 months: squeeze toys, busy boxes,, playgym

7 to 9 months: cloth- textured toys, splashingbath toys, large blocks and balls

10 to 12 months: books with large pictures


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E. Discipline

spoiling an infant with too much attention isdifficult; meeting the needs is precedence to

discipline Has no ability to accept delayed gratification.

Learning to wait progresses after infancydiscipline action is fruitless in infancy

Effective measures include negative voice,stern eye contact, time- out

Corporal punishment is not recommended


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IV. Motor development

Gross motor:

Infant can turn head side to side from prone

position unless if the surface is very soft whichmay lead to suffocation

About 3 months, head lag is almost not exhibited

5 months, rolls from front to back

7 months, sits leaning forward

8 months, sits unsupported

9 months, pulls up to stand


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10 months, infant cruises

12 months, walks holding someones hand

Fine motor:

1 month, strong grasp

3 months, infants grasp reflex fades and can

actively hold rattle 5 months, can grasp voluntarily

7 months, can make hand- to- hand transfer


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9 months, develop pincer grasp

12 months, attempt to build 2 tower block

Related safety concerns: Falling off beds and stairs

Aspiration, poisoning

Suffocation caused by inadvertently coveringof nose and mouth, or strangulation

Burns from hot liquids

Motor vehicle accident


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Nursing interventions:

Instruct parents to maintain safe environment(out of reach)

Alert parents of age- related potential injurysources and accident prevention strategies

Encourage parents to avoid repetitive negative

expressions for the sake of safety and to stresspositive behaviour such as playing withsuitable toys


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V. Psychosexual development

Overview ( Freud)

The oral stage of development extends from

birth to 18 months Infant sucks for enjoyment as well as

nourishment and gains gratification by

swallowing, chewing, and biting In this stage, infant meets the world orally by

crying, tasting, eating, and early vocalizing


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Biting is interpreted as a way to get hold on theenvironment and gain greater sense of control

Grasping and touching are used to explorevariations in the environment

VI. Illness and hospitalization

Young infants respond to pain by crying and facialexpression

Older infants respond with a generalized bodyresponses and deliberately withdraws fromstimulated area.


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Reactions to hospitalization:

Infants under age 3 months tolerate short termhospitalization if with nurturing person to

meet needs consistently Separation anxiety due to stranger anxiety

between 4 and 6 months


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Nursing considerations:

Spend time with parents within sight of infantso you are seen safe person

Allow parents to give care as much as possible Provide sensorimotor stimulation

Provide physical comfort and safety:

Keep baby warm and dry Meet hunger needs consistently; keep cribb

side rails up


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Cognitive interventions:

Provide variety off stimulating toys

Provide language development

Psychosocial and emotional interventions:

Maintain relationship with parents

Maintain consistent staffing

Promote sense of security (cuddle, holdinggently talking)

Infant Growth & Development Slides

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