infants

What are the major components of a newborn health history?

Family concerns, prenatal history, neonatal course, feeding, medical history, family/social history, safety, sleep, and health-promotion needs.

What should be assessed about the prenatal course?

Pregnancy complications, prenatal diagnoses, maternal health, medications or drug exposure, and other pregnancy concerns.

What should be assessed about labor and delivery?

Type/course of delivery and any labor or delivery complications.

What feeding information should be obtained at the newborn visit?

Whether the infant is breast/chestfeeding, bottle feeding, or both, plus feeding frequency and any feeding problems.

What social factors should be assessed during the newborn health history?

Living situation, food/housing concerns, family support, relationships, substance exposure, childcare, and other social stressors.

What safety topics should be discussed with caregivers of newborns?

Car seat use, safe sleep, smoke and carbon monoxide detectors, firearms, environmental hazards, and injury prevention.

What does developmental surveillance evaluate?

Physical, cognitive/language, and social-emotional development over time.

What three major developmental areas should be monitored in infants?

Physical/motor, cognitive/language, and social-emotional development.

What should the clinician observe between the infant and caregiver?

Interaction, bonding, attachment, responsiveness, and caregiver-infant communication.

What should happen if developmental milestones are delayed or skills plateau?

Further evaluation should be performed and early intervention considered.

What is developmental regression?

Loss of a developmental skill that the child previously acquired.

Is developmental regression concerning?

Yes. Loss of previously acquired skills requires further evaluation.

What is habituation?

The ability to gradually stop responding to a repeated stimulus.

What is attachment?

A reciprocal, dynamic process of interaction and bonding between an infant and caregiver.

What is state regulation?

The ability to regulate or modulate arousal in response to different levels of stimulation.

What is perception in newborn behavior?

The ability to recognize familiar sensory stimuli such as voices, touch, and scents.

What are examples of complex newborn behaviors?

Habituation, attachment, state regulation, and perception.

Around 2 months, what gross motor milestone is expected?

Holds the head up when lying on the stomach.

Around 2 months, what fine motor finding is expected?

Opens the hands briefly.

Around 2 months, what social milestone is expected?

Looks at faces and smiles responsively.

Around 2 months, how does an infant respond socially to a caregiver?

The infant may calm when spoken to or picked up and look at the caregiver's face.

Around 2 months, what auditory/cognitive response is expected?

Reacts to loud sounds and watches the caregiver.

Around 4 months, what happens to head control?

The infant should hold the head steady without significant support/head lag.

Around 4 months, what hand behavior is expected?

Hands are predominantly open and the infant can hold a toy placed in the hand.

Around 4 months, what social behavior is expected?

Smiles to gain attention and may chuckle.

Around 4 months, what language milestone is expected?

Coos and makes sounds back when spoken to.

Around 4 months, how does an infant respond to sound?

Turns the head toward the sound of a caregiver's voice.

Around 6 months, what rolling milestone is expected?

Rolls from front to back.

Around 6 months, what prone motor milestone is expected?

Pushes up with straight arms while on the stomach.

Around 6 months, what reaching milestone is expected?

Reaches to grab a desired toy.

Around 6 months, what social recognition is expected?

Knows familiar people.

Around 6 months, what mirror behavior may be seen?

Likes looking at themself in a mirror.

Around 6 months, what vocal behaviors are expected?

Laughing, taking turns making sounds, blowing raspberries, and squealing.

Around 9 months, what sitting milestone is expected?

Gets into a sitting position and sits without support.

Around 9 months, what hand-transfer milestone is expected?

Moves objects from one hand to the other.

Around 9 months, what type of grasp may be seen?

Uses the fingers to rake food or small objects toward them.

Around 9 months, what response to strangers may occur?

The infant may be fearful around strangers.

Around 9 months, what happens when a caregiver leaves?

The infant may look, reach, or react when the caregiver leaves.

Around 9 months, what social game is commonly enjoyed?

Peek-a-boo.

Around 9 months, what name response is expected?

Looks when their name is called.

Around 9 months, what object-permanence behavior develops?

Looks for objects that are dropped or disappear from view.

Around 12 months, what standing milestone is expected?

Pulls to stand.

Around 12 months, what walking-related milestone may occur?

Walks while holding onto furniture, also called cruising.

Around 12 months, what type of grasp should develop?

Pincer grasp using the thumb and index finger.

Around 12 months, what drinking skill develops?

Drinks from a cup without a lid with caregiver assistance.

Around 12 months, what social games may the child play?

Simple interactive games such as pat-a-cake.

Around 12 months, what gesture is commonly expected?

Waves bye-bye.

Around 12 months, what early language behavior is expected?

Calls a parent or caregiver a special name such as mama or dada.

Around 12 months, what simple word should the infant begin to understand?

No.

Around 12 months, what object-use cognitive skill develops?

Puts an object into a container.