Neonate to 6 months

3-7

length increases _____ to _____ inches in the first year

- boys > girls

lose; 2nd

babies will ____ a few pounds in the first few days of birth and then return to birth weight by the end of the ____ week

6; 1

birth weight should double by ____ months and triple by _____ year

higher; lower

babies have ____ HR and RR but _____ BP (SBP/DBP)

quiet alert

The infant is awake, relaxed, and quiet. In this state the infant is most responsive to testing and to bonding efforts.

- best for pediatric PT

secure attachment

distress on separation

seeks comfort from caregiver without hesitation when they return

insecure-avoidant

little distress on separation

little need for comfort or closeness upon reunion

insecure-ambivalent

intense distress on separation

responds poorly to caregiver's attempts to comfort (inconsolable)

insecure-disorganized

contradictory and bizarre behaviors upon reunion

ways to create attachment

meet needs and be predictable

caring physical contact

face to face interactions

communication and play (animation, reciprocity, mirroring feelings)

infant massage

benefits: bonding, improve sleep, positive effect on hormones that control stress, reduce crying

- wait at least 45 min after feeding

- observe mood and body language (steady gaze and calm movements means they are ready)

- use firm touch

- stroke/rub areas followed by flex/ext of extremities

flexion

neonates are born with physiologic _____

- symmetrical flexor tone in all postures

- no anti-gravity control

- auditory and olfactory recognition

- ability to seek maternal comfort

- remember prenatal experience

- long sleep states and bursts of energy

- rhythmical crying that is consolable

horizontal; T8

as a neonate the ribs are _____ with the diaphragm's dome at ____

- decreased reserve for breathing

varum

neonates legs are in genu ____

- tibias are IR due to intrauterine positioning

150

neonates have a femoral neck angle of ____ degrees

anteversion; antetorsion

neonates have femoral _____ of about 60 degrees with ____ of 30-40 degrees

- results in ER LE posture

elongate

the extensors _____ after birth due to gravity

head

neonates may appear to have head control but that is only due to physiologic flexion. the neonate will have a ____ lag during pull to sit due to this

kyphotic

neonates are extremely ____ in supported sitting

- no anti-gravity extension

- should be WB through ischial tuberosity's!!!

automatic

neonates have _____ stepping and bear partial weight on their LEs

head; flexed

in prone neonates can briefly lift their ____ and clear their face in prone

- hips and knees will be ____

UEs

in prone neonates should have their weight shifted onto their ____ and their arms adducted to side

- hands are normally fisted also

- BUT should have frequent spontaneous opening

voluntary

neonates will not have ____ release of objects

separate

neonates have monocular vision in that they are unable to _____ their eyes from their head when tracking

strong; nose

neonates have a ____ gag reflex, are obligatory ____ breathers, and have rooting and suck reflexes

preterm neonate

born lacking physiologic flexion (flat and extended)

- no anti-gravity control

- SEVERE head lag

due to: more space in utero, hormones exposed to in utero

increased; increased

at one month, we begin to see ____ spinal mobility and _____ extension of thoracic and upper lumbar areas

- also increased neck mobility

- ribs taking up 1/3 of thorax

increased

at 1 month, there is _____ head lag in pull to sit due to shoulders coming down

automatic

at one month _____ walking has disappeared

increased

- at one month there is ____ responsiveness to stimuli

- more kicking in supine

- momentary head in line with body in supported sitting

responds; monocular

at one month we notice these for fine motor and cognition:

- gross opening/closing of hand

- ____ to mother's voice

- attends to visual patterns of black/white/red

- primarily _____ vision and tracks from periphery to midline

rooting; drooling; more

at one month we notice these for oral motor/speech:

- may begin cooing around ____ months

- still using _____ reflex

- increased _____ (lack of seal)

- cries with ____ variation

flexion; asymmetrical; sagittal

at two months we notice these for gross motor:

- less physiologic ____, almost completely gone

- very ______ movements

- more consistent _____ plane movements

- increased ROM especially LE ER/ABD

- cease take weight on LE's in upright standing

less

at 2 months we notice these:

- in prone ____ weight on face with elbows in line with shoulders, working on near vision

- in supine working on midline and moving arms/legs

intentional; mouth; midline

at 2 months we notice these with fine motor/sensory

- holding objects becomes _____

- rotation of held objects (rattles)

- individual finger play in ____

- eye tracking past ____

- fixing to provide stability during task

- arm can extend and fingers can flex for voluntary grasp

cooing; drooling; cries

at 2 months we notice these for oral motor/speech:

- smiling and _____

- liquid loss especially with suckling

- increased ____

- differentiated ____ (hungry, wet, etc.)

red flags at 2 months

not performing:

- holding head in prone

- moving both UEs and LEs

- opening hands briefly

should be:

- calm with caregiver voice or being picked up

- tracking caregiver, looking at faces, smiling

- making sounds, reacting to loud noises

plagiocephaly

Flattening or asymmetry of the head

- common with torticollis

brachycephaly

short wide head

scaphocephaly

long narrow head

ribs

at 3 months the ____ begin to descend to give a more flat appearance

increased; decreased; some; closed

at 3 months we notice these with gross motor

- ____ asymmetry with extension

- increased symmetry with flexion (stability)

- _____ ATNR

- can hold head in midline in supine

- ____ head control in supported sitting

- sagittal plane movements (actively flex LEs against gravity)

- ____ chain activities in all positions

antigravity; extension; chin

in the first 3-4 months:

- developing _____ flexion control

- increased antigravity _____ in prone

- development of ____ tuck in prone and supine secures head in sitting by 4 months

roll

around 3 months babies may ____ from supine to side or from prone to side

- turn to look at something

open; mouth; convergence; 180

at 3 months we notice these about fine motor/sensory

- hands more ____

- palmar grip (grasp with scratching/clutching)

- reaches for an object while in prone and brings to _____

- eye ____ and development of binocular fixation (depth perception)

- follows object with eyes and head together through _____ degrees

gurgles; nasal

at 3 months we notice these with oral motor/speech

- ____ and sounds of contentment

- less dependent on ____ breathing, starting to breath through mouth