NUR4355 Infants 1 month to 1 Year

What age is the "WHO" growth chart used for?

children from birth to 2 years old

What age is the "CDC" growth chart used for?

children from age 2 to 20 years old

What is the typical increase in weight for an infant in their first year

they double their weight by 6 months and triple their birth weight by 12 months (1 year)

What is the typical increase in height for an infant in their first year

1 inch per month until 6 months and 1/2 per month from 6 to 12 months

How many pounds increase for an infant in their first 6-12 months

- Infants gain 1 to 2 lbs by 6 months (doubling their weight)

- Infants then gain 1lbs every months until 12 (tripling their weight)

Define gross motor skills

involve the large muscle groups and form the basis for developmental skills, such as rolling over, sitting up, crawling, and walking.

Gross motor: expect in a 1 month infants

- turn head in a supine position

- Chin up in prone position

Gross motor: expect in a 2 month old infants

- when prone, holds the chest up

- Bobs the head when sitting

Gross motor: expect in a 3 month old infants

Begin to roll to the side

When prone, props up on forearms

Gross motor: expect in a 4 month old infants

Roll front to back

No head lag when pulled up

Sits with trunk support

Props up on the wrists

Gross motor: expect in a 5 month old infants

Rolls over from back to front

When falling, puts arms out to the front

Able to sit with pelvic support

Able to sit witth arms out in front, supporting upper body

Gross motor: expect in a 6 month old infants

Think of pilot position:

Able to sit for a few moments propped (support) up on their hands

Bears weight on one hand in prone position

Pivots in prone position (lying on their tummy moving the arms in rotated and balancing leg up)

Gross motor: expect in a 7 month old infants

uses arms out to the sides to balance

Sits streadily without support

Bounces when held

Gross motor: expect in a 8 month old infants

Able to move into a sitting position

Crawls in a commando position

Able to pull to a sitting or kneeling position without assistance

Gross motor: expect in a 9 month old infants

Begins creeping

Pulls to stand

“stands” on feet and hands

Gross motor: expect in a 10 month old infants

Begin cruising (babies move sideways while holding onto furniture)

Able to stand of holding the hand of an adult

Able to walk if holding both hands of an adult

Gross motor: expect in a 11 month old infants

Able to move around furnitiure by holding on with one hand

Able to stand for a few seconds without support

Able to walk holding one hand of an adult

Pivot in sitting position

Gross motor: expect in a 12 month old infants

Able to stand up with arms upstretched and legs opened without falling

Able to walk indpendently without support

Define fine motor skills

involve small movements made by the hands and wrists, requiring coordination between the muscle groups and the brain

Fine motor: expect in a 1 month old infants

Hands in fist near face

Fine motor: expect in a 2 month old infants

50% of the time hands are open and unfisted

Able to hold a rattle if placed in the hand

Able to hold hands in the same spot together

Fine motor: expect in a 3 month old infants

Inspects fingers

Hits at objects close to body

Fine motor: expect in a 4 month old infants

Able to hold hands open most of the time

Grabs at objects close to the body, particularly clothes

Able to reach for objects tirelessly

Able to play with toys placed in hands

Fine motor: expect in a 5 month old infants

Grasps a cube with palm of hand (palmar grasp)

Transfers objects hand to mouth and then mouth to hand

Reaches/grasps things dangling in front of body

Fine motor: expect in a 6 month old infants

Transfers items from hand to hand

Can take a second object still holding on to a first

Reaches with one hand

Uses open and extended fingers to rake for things

Fine motor: expect in a 7 month old infants

Can hold an object between fingers and opposing thumb (radial palmar grasp)

Fine motor: expect in a 8 month old infants

Hits objects with other objects after demonstration

Able to grasp things using all the fingers and the thumb (scissors grasp)

Fine motor: expect in a 9 month old infants

Bangs two cubes together

Able to grab things with the thumb and pointer or middle finger (pincer grasp)

Fine motor: expect in a 10 month old infants

Isolates index finger and points at things

Can use the pincer grasp to pick up small items clumsily

Fine motor: expect in a 11 month old infants

Throws objects

Can stir something with a spoon

Fine motor: expect in a 12 month old infants

Scribbles after a demonstration

Can use the pincer grasp to pick up small things without difficulty

Holds a crayon

Attempts to put blocks on top of each other

Psychosocial motor: expect in a 1 month old infants

Can discriminate parent’s voice

Cries out in distress

Psychosocial motor: expect in a 2 month old infants

Smiles in return

Responds to adult’s voice and smile

Psychosocial motor: expect in a 3 month old infants

Follows movement in a room

Can express dislike to taste or sound

Psychosocial motor: expect in a 4 month old infants

Smiles as a result of a sight or sound

Stops crying when parent speaks

Psychosocial motor: expect in a 5 month old infants

Can recognize parent and Bonds to parent

Psychosocial motor: expect in a 6 month old infants

Stranger danger and anxiety develop

Psychosocial motor: expect in a 7 month old infants

Looks back and forth from a parent to an object when wanting help

Psychosocial motor: expect in a 8 month old infants

Able to communicate emotions

Follows the gaze of a parent to look the same way

Psychosocial motor: expect in a 9 month old infants

Separation anxiety

Able to follow a point

Visually recognizes people

Vocal/makes sounds to get attention

Psychosocial motor: expect in a 10 month old infants

Has fears

Responds to name

Psychosocial motor: expect in a 11 month old infants

Seeks out help from an adult for an object

Psychosocial motor: expect in a 12 month old infants

Seeks parent’s interest in objects

Proto-imperative pointing (Represents pointing to an object to communicate that it is desired or requested.)

Separation anxiety

The fear and anxiety an infant feels when they are separated from familiar caregivers and places.

When does Separation anxiety become pathological

If it interferes with feeding playing or sleeping

What are some interventions for soothing separation anxiety?

Giving infants stuffed animals or blankets they're familiar with to remain with them

Parents should leave infant for short period of time with a caregiver

slowly increasing intervals of separation (come back 15 minutes then 30 minutes later , then up to an hour)

remaining in a familiar environment (home)

Stranger anxiety

The fear and anxiety an infant experiences when encountering someone they are not familiar with.

By what month does stranger anxiety develop

6 months

By what month does separation anxiety develop

9 months

Typically stops at 3 years

What occurs in an infant's cognitive development from 1 month to 2 months

optical focal length is 10 inches (newborns 8 to 12 inches)

prefer contrasts of shapes, colors, and faces

develop preferences for people, objects, and high-pitched voices

What occurs in an infant's cognitive development from 2 months to 6 months

explore the environment with a sense of touch

stare at their hands and touch parts of their body

self-understandment

beginning to grasp cause and effect

achieve visual binocularity

What occurs in an infant's cognitive development from 6 months to 12 months

object performance develops:

• reaching, inspecting, holding, putting objects in the mouth, and dropping objects becomes a part of sensory exploration

• infant learns to manipulate the environment around them by using objects for a purpose.

Infants will begin to play games such as peek-a-boo

stranger and separation anxiety develop

first words at 11 months

Cognitive developement that parents are concern about

Disorder such as Down syndrome, fragile X syndrome, and fetal alcohol syndrome

Language motor: expect in a 1 month old infants

Reacts or startles to sounds and voices

Begins to make noises (such as cooing)

Language motor: expect in a 2 month old infants

Aware of voices and sounds

Smiles socially and makes noises that sound like vowels

Language motor: expect in a 3 month old infants

Regards someone speaking

Begins to laugh

Responds with sounds when someone talks to them

Language motor: expect in a 4 month old infants

Turns their head towards a voice when heard

Ceases crying when they hear a comforting voice

Begins to laugh out loud

Makes sounds even when alone

Language motor: expect in a 5 month old infants

Responds when name is said

Makes an “ah-goo” noise

Squeaks and squeals with excitement

Able to express anger using sounds other than crying

Makes raspberries with lips

Language motor: expect in a 6 month old infants

Stops for a minute when told no

Holds hands up when wanting to be picked up

Uses consonants when babbling

Stops to listen to someone and then vocalizes in response when they stop

Smiles and speaks to themselves in a mirror

Language motor: expect in a 7 month old infants

Looks toward a familiar object when named

Listens attentively to songs and music

Uses an increasing number of syllables when making noise

Language motor: expect in a 8 month old infants

Responds when called

Able to look for family members when asked

Says “dada” nonspecifically

Engages in echolalia (repetition of words just spoken by another person)

Shakes head for “no”

Language motor: expect in a 9 month old infants

Enjoys games with arm movements

Responds to name well

Begins to say “mama” without regards to who it is being said to

Babbles in a manner that cannot be copied

Repeats heard sounds

Language motor: expect in a 10 month old infants

Actively engages and enjoys playing games (such as peek-a-boo)

Begins to wave in response to someone else waving

Says dada to the person recognized as the father

Language motor: expect in a 11 month old infants

Stops doing something when told no

Dances to music

Begins to say first word

Makes noises or sings when listening to music

Language motor: expect in a 12 month old infants

Able to follow a simple one-step direction with hand/arm movements

Can differentiate objects when two or more objects are named

When desiring something, points in the direction of the desired object

Uses hand and arm motions (such as grabbing or reaching) with vocalizing

What is echolalia

The often pathological repetition of what is said by other people, as if echoing them.

starts at 8 months

What is the first sign of play in an infant

the social smile

appears at 4-6 weeks of age

By 3-6, the infant will look for others to interact or play with

Which milk is the most common that children exhibit allergic reactions to

protein in cows milk

How does early introduction of foods affect hypersensitivity

Research shows that early introduction decreases the development of hypersensitivity reactions

- should be introduced before 1 years

- foods such as eggs, peanuts

when should Iron drops be introdcued to infant

4 months

when should Vitamin D supplementation for breastfed infants be introduced

2 months

Risks for sudden unknown infant death

maternal age of 20 or younger

maternal smoking

lack of prenatal care

secondhand smoke

low premature birth weight

infant of male sex

overheating

At what month does the palmar grasp occur

5 months

baby closes their finger around in the palm of their hand

At what month does the radial palmar grasp occur

7 months

holds the object between all of the fingers and the opposing thumb

At what month does the scissor grasp occur

8 months

Objects are held between the thumb and the side the of index finger

At what month does the pincer grasp occur

9 months, becomes "fine at 12 months"

grabs things with the thumb and the pointer or middle finger

At what month can the toddler scribble after the demonstration

12 months

At what month does the head lag stop?

4 months

infant is able to hold their head up without flopping around or lagging behind upper body

At what month does creeping movement begin

9 months

crawling movement with the stomach elevated off the floor

also starts pulling up to stand

At what month does cruising begin

10 months

able to cruise or move around furniture by holding on with both hands

When is the infant able to roll to the side versus the back to the front, and get into sitting position

3 months: roll over onto the side

4 months: rolls from front to back

5 months: roll from back to front

8 months: sitting position

When can the infant discriminate parents' voices

1 month

what is Proto-imperative pointing

represents infant pointing at an object to communicate desire or request of it

occured at 12 months

Breastfeeding decreases the risk of

• Ear infection

• Respiratory infections

• Asthma

• Development of SUID

Formula fed increases the risk of

Chronic disorders such as

• Asthma

• Diabetes mellitus

• Respiratory

• Ear infection

Preterm infant should be fed using what

both colostrum and breast milk

Educate mother based on feeding with bottle

- Position bottle at angle to prevent aspiration and choking when feeding

- Never prop the bottle UP this will increase risk for ear infection, tooth decays, and choking

- Never place infant in bed with bottle or leave it when sleeping

- Leftover formula after feeding should be discarded (increased risk for bacterial growth)

How does breastfeeding prevent infection

provides IgA

Until what age should cows milk be avoided

do not introduce until after 12 months

infant is unable to digest properly

Until when should bottles continously be sterilized

until after 4 months of age

when is the first meal used to introduce solid foods in what month?

After 6 months, Iron fortified cereal mixed with breast or formula milk

• Add new food every 3 to 5 days

• Introduce vegetable, fruit, then meat

• Solid food once a day then progress to two/three times daily

What kind of food is unsafe for the infant

HONEY 🍯 🐝 (source of bacteria clostridium botulinum)

What should be introduced first, fruits or veggies?

veggies first before fruits (introduce taste for veggies rather than sweet tooth)

What kind of mothers shouldn’t breastfeed their infants?

Mothers with

• HIV and AIDS due to because virus can be passed down to the infant through breast milk

• untreated tuberculosis

• severe malnutrition

• active herpes sores on breast/nipples

(alcohol substances and certain medication can also be passed down to infant)

What foods are known to cause food hypersensitivity commonly

• peanuts

• soy

• milk

• wheat

Why Infant is at risk for iron deficiency anemia?

Breastmilk contain a very small amount of iron in them. This is why Iron drops are recommended at 4 months of age

What month that AAP recommends these infants to receive vitamin D

Within the first 2 months of life

What vitamin suppment mother are require to take if they are vegan

vitamin-B12 deficient mothers require supplementation of vitamin B12

Sleep issues

Infants 3 months and younger get 16 to 17 hours of sleep

Infants 4 months to one year should get 13 to 14 hours of sleep per day

Encourage parents to establish sleep schedule for infant to calm down and sleep

What is Failure to thrive

• Inability to convert calories to energy or not properly intaking calories

• weight for age that Less than 5th PERCENTILE on CDC growth chart

• Neglect and lack of parent education can result in lack of feeding and failure to thrive

(think you fail your baby)