Infant Development

Infancy

Birth -12mo

Toddler

1-3 years old

Preschooler

3-6 years old

School Age

6-12 years old

Adolesence

11-20 years old

Elements of physical/biologic growth

height, weight, bone, teeth, organ changes

elements of motor/physical development

gross and fine motor skill

elements of cognitive development

thinking, learning, problem solving

elements of social/emotional development

attachment, temperament, self-concept

elements of language development

receptive and expressive communication

Jean Piaget

Cognitive development

Erik Erikson

Psychosocial development

Kohlberg

moral development

weeks of prematurity

40 - gestational age at birth

corrected age

chronological age - weeks of prematurity

catch-up period

number weeks premature x 10

When will birth weight double?

5 months

When will birth weight triple?

12 months

When will height increase by 50%?

1 year

What is the relationship between head and neck circumference at birth?

OFC = chest +2 cm

What is the relationship between head and chest circumference at 1 year?

head = chest

When does the anterior fontanel close?

12-18 months

When does the posterior fontanel close?

6-8 weeks

Infant refelxes

Involuntary, fade as voluntary motor control develops

Sucking reflex

suck when mouth stimulated (birth- 4mo)

Rooting reflexes

turns head and sucks when cheek stroked (birth- 4mo)

Extrusion reflexes

forces tounge outward when touched (birth- 4mo)

palmar grasp

grasps object when placed in palm (birth- 4mo)

Plantar grasp

toes curl when sole is touched (birth- 8mo)

Babinski

big toe up, toes flare (birth- 12mo)

Moro reflex

Startle, extends then pulls in legs and arms (birth- 4mo)

Neurologic maturation

brain growth, myelination of spinal cord, shift from involuntary to voluntary, crying to speaking

Respiratory maturation

fast and irregular to slow and regular, narrow nasal passages, larynx funnel-shaped, compliant trachea/chest wall, fewer alveoli

Cardiovascular maturation

HR slows, BP increases, respiratory sinus rhythm is common, capilaries near skin so poor thermoregulation

physiologic anemia of pregnancy

normal adaptation to extrauterine life

genitourinary maturation

higher percent (dehydration risk), frequent urination w/ low specific gravity, immature renal structures

GI maturation

immature digestion and liver, increasing stomach volume, teeth before solids,

Infant immunity

passive immunity from mom, colostrum is rich in antibodies, vulnerable to infection

Integumentary

mottling decreases over first few months

What are signs of teething?

drooling, sucking/biting fingers and objects, irritability, difficulty sleeping, low-grade fever, rubbing ears, decreased solid appetite

When do the first teeth erupt?

8mo (6-10 average)

By what age do infants have 6 to 8 teeth?

12 months

What age can infants move all extremities and raise head when prone?

2 mo

When can a baby roll from back to side and have no head lag?

4 mo

What age can babies roll prone to supine (both) and tripod sit?

6 mo

When will a baby be able to sit unsupported and get to siting alone?

9 months

At what age will a baby pull to stand and cruise?

12 mo

What age do babies have mostly fisted hands that briefly open?

2 mo

at what age will babies bat at objects and hold toy placed in hand?

4 mo

What age do babies start reaching for items?

6 mo

What age can infants rake, hold items with thumb and finger pads, and transfer objects hand to hand?

9 mo

what age can infants use a fine pincer grasp/finger tips?

12 mo

What is the sequence of cognitive development?

reflexes, repetition, initiation, cause and effect

When does separation anxiety emerge?

6-12 mo

When does a baby master object permenane?

8 mo

What piaget stage is an infant in?

Sensorimotor (birth to 2)

When can a baby cry then smile?

from birth

When does a baby coo and have differential cries?

2 mo

When can a baby form vowel sounds, vocalize to voices, and laugh?

4-5 mo

what age can a baby squeal?

6 mo

When can infants say dada/mama, lift arm, and respond to name?

9 mo

When can a baby say 1-3 words and follow simple commands?

12 mo

What is a baby’s concept of body image?

mouth is very exciting sensory (hands and feet suck), smiling, object permanence and separation awareness, growing interest in their own image (mirror)

Social and emotional development of infant

narcissism with limited frustration tolerance, learning that their behaviors manipulate their environment (reciprocal touch, reaching, smiling), temperment

What is a baby’s temperment?

Something they are born with, individual behavior style, shapes goodness of fit with caregivers

When does stranger anxiety emerge?

6-9 mo

what is reactive attatchment disorder?

results from maladaptive or absent parents

What erikson stage are infants in?

Trust vs mistrust

When is hearing fully developed?

at birth

What sight traits are present at birth?

eye crossing, nearsightedness

When does binocular vision form?

4 mo

When can babies see in full color, distance vision, full eye tracking?

7 mo

What senses are function from birth and develop rapidly?

Smell and tatse

What sense is most important in newborn communication?

Touch (holding, rocking, cuddling)

Wen do babies prefer onlooker play (watch faces and movement)?

0-3mo

When do infants exhibit solitary play (rattles, high contrast books)?

3-6mo

When do infants enjoy interactive games (peekaboo, pat a cake)?

6-10mo

When do infants begin purposeful play (stack, push, pull)?

10-12mo

What nutrition is prefered?

Breastmilk (healthy people wants to increase)

How often do newborns need fed?

q2-3hr, wake them until good weight gain

What supplement do babies need in first few days if breast fed?

Vit D at birth, iron at 4mo

what age do infants get solids?

6 mo (supplement for 1st year)

What age can infants have finger foods?

9-10mo (pincer grasp)

What age can infants have cows milk and honey?

1 yr

What are special feeding cocnerns?

hard, round, allergies

What should you avoid doing for dental health?

propping bottle, bottle in bed, fruit juice in bottles

What should you do to promote dental health?

flouride supplement after 6mo, first oral exam at 6mo, dentist established at 1yr, clean teeth 2x day when first tooth erupts (wet washcloth good)

What amount of toothpaste should children be using?

under 2 - rice, 2-5 - pea, always assist child brushing!

How much sleep should a young infant get?

10 to 20hrs

What age to infants start sleeping through the night?

6 mo

How many naps should an infant have by 12mo?

1 to 2 with full overnight sleep

What are the 3 causes of sudden unexpected infant death?

SIDS, ill defined causes, accidental suffocation

What are some sleep risk factors?

sleeping on stomach, overheating, secondhand smoke, soft mattress, beding, objects in bed, co-sleeping

What are some protective sleep factors?

sleep on back, breastfeeding, pacifier, room sharing, first and flat surface, no toys

What are the ABCs of sleep?

Alone, Back Crib

What are the biggest developmental concerns?

separation and stranger anxiety, colic, thumb sucking and security items, spitting up, teething

What is separation anxiety

normal and healthy with good attachment, use quick goodbyes, tell child they come back, transition objects, separation/return games, typically resolves by 3, can reoccur in new and stressful environments

What is stranger anxiety?

normal development, separate self from others, have new people approach slow and calm, keep parent in sight, prepare child ahead of time

What is colic?

inconsolable crying for over 3hrs per day with more in evening, resolves by 3 mo (GI, neuro, temperament, parenting style)

How to manage spitting up?

normal id gaining weight and wetting 6+ diapers, risk with overfeeding, feeding schedule and poor burping. Manage with small frequent feeds, burp 2-3 times per feeding, position upright for 30mins, avoid compressing the stomach