Growth and Development of Infats

age range on an infant

birth to 1 year

erikson’s theory

trust vs mistrust

psychosocial

serves as a foundation for future psychosocial tasks

developed with caregivers

care vs abandonment

when they cry and their needs are met they learn to trust; they learn to mistrust when their needs are not met when crying

paiget’s theory

sensorimotor

cognitive

characterized by use of the five senses to explore their world

freud’s theory

oral

psychosexual

pleasure (and control) is derived from oral stimulation

they explore the world through their mouths

kohlberg’s theory

good vs bad

conscience

relates to moral development

moral reasoning is not yet developed

reflexes in infancy

primitive reflexes

root: birth to 3 months; when their cheek is touched they turn towards it

suck: birth to 2-5 months; reflexive sucking

moro: birth to 4 months; startle reflex

babinski: birth to 12 months; toes fan out

cognitive development

sensorimotor stage: 5 senses

guided by cause and effect

object permanence: develops between 4-7 months; solidified at 8 months —> they know that something is still there even if they can’t see it

sensory development

all senses except hearing develop as the infant matures

hearing: fully developed at birth

sight: newborn is nearsighted; binocularity develops at 6 weeks

smell: by 7 days they can differentiate smells

taste: initially sweet tastes are preferred; develops over several months

touch: prefer soft sensations; infants communicate and understand moods by how they are touched

language development

1 to 3 months: coo

4 to 5 months: vocalize in response to voices

6 months: squealing and yelling

10 months: babbling strings

12 months: 2-3 recognizable words

gross motor skills development

larger muscles

4 months: raises head, rolls from prone to supine

6 months: sits up with assistance

8 months: sits unsupported

9 months: crawls

10 months: pulls to stand

12 months: sits from standing position, walks independently

fine motor skills development

smaller muscles

1 month: fist clenched

4 months: bats at objects

5 months: grasps at rattle

7 months: transfers objects from one hand to another

8 months: gross pincer grasp

10 months: fine pincer grasp

12 months: feeds self

weight growth in infants

newborns are on overage 7.5 pounds

doubles by 4-5 months

triples by 1 year

a baby who was born 1 pound will not be the same weight as a baby born at 8 pounds when they are 1 year old

length development in infants

newborns are on average 20 inches long

grows more quickly over first 6 months

increases by 50% in first year

vitals in infants

respirations: newborns 30-60; 12 months 20-30

heart rate: newborn 120-140; 12 months 100

infant nutrition

breastfeeding is best

iron fortified formula

breast milk or formula only for the first 6 months

6 months- solid foods: begin with iron fortified rice cereal, introduce one new food every 3-5 days, limit fruit juice to 2-4 oz/day, 6-8 months introduce cup

8 months- soft smashed table foods, finger foods

10-12 months- may introduce strained, pureed or mashed meats

iron fortified is important to prevent iron deficiency anemia

food avoidance

peanuts- potential for severe, life threatening reactions—→ anaphylaxis

whole milk: immature GI tract, unable to properly digest, results in GI bleeding and iron deficiency anemia

honey: should not be consumed prior to age 2, potential for contracting botulism

eggs: salmonella and/or allergic reactions

spitting up

occurs in all infants

may be overfed or burp poorly

feed smaller amounts more frequently

burp baby at least 2-3 times per feeding

keep baby upright for 30 minutes after feeding

baby’s stomach can only hold about 30mL —> needs to be burped to keep out air

colic

inconsolable crying lasting at least 3 hours per day for which there is no physical cause

typically resolves by 3 months

may be caused by immature GI or neuro system

possible treatments: gas drops, rhythmic soothing (car ride, swing)

rule out allergies

tnumb sucking and pacifiers

infants have a need for non nutritive sucking

helps to self soothe

pacifiers associated with increased incidence of otitis media

try to wean by 1 year of age

wean by 2-3 years of age to limit adverse effects

teething and dental health

infant may drool, bit on hard objects, increase finger sucking, refuse to eat, not sleep well

may apply cold to gums

mild fever

no bottle propping

clean teeth and gums with soft damp cloth

no toothpaste

no bottles to bed

wean from bottle by 12 months

play and sleep

interaction is the best play for infants

engage in solitary play

4 months: show preference for certain toys

6 months to 1 year: develop sensory motor skills (peek-a-boo and pat-a-cake)

6-8 months (7 months): shows fear and pulls away from strangers; stranger anxiety

newborns sleep 10-19 hours a day

by 3 months: sleep 7-8 hours at night without waking; 3 naps per day

by 12 months: sleep 9-12 hours a night; 2 naps per day

discuss safe sleep practices

discipline

punishment: a penalty as retribution for an offense

discipline: teaching obedience to rules, socialization of acceptable behavior

limit setting by confining to safe environments

stern negative voice: NO!

stern eye contact: child knows and understands that behavior is not acceptable

time out in playpen, crib, blocked area

when discipline is started early in life and maintained appropriately at each stage of development, the child will learn and develop self discipline

vaccine schedule for infants

Dtap: 2, 4, and 6 months

Hib: depending on vaccine type as to how many does; 2 and 4 months (if 3rd dose needed its given at 6 months)

rotavirus: depending on vaccine type as to how many doses; 2 and 4 months (if 3rd dose needed its given at 6 months)

leading causes of injury and death in the infant

falls

MVAs

drowning

electrocution

suffocation

choking

burns

poisoning

safety related nursing interventions in the hospital for infants

side rails up on cribs/beds at all times even if parent keeps lowering them

check temperature of foods, water, drinks to ensure no burns will occur (avoid microwaves due to undetected heated center especially with liquids)

never leave thermometer unattended in mouth, under arm, or rectally

prepare all bathing equipment and drying area in one location; do not transport wet infant across room to avoid slipping or dropping baby

continuous surveillance of room to remove needles, needle covers, small objects that are potential choking hazards and check sheets and under child for same objects to prevent skin breakdown from lying on thse objects

caregiver home safety teaching for infants

medical checkups and immunizations at 2, 4, 6, 9, and 12 months

back to sleep positioning (decreases incidence of SIDS)

no bumper pads and slats no greater than 2 3/8 in apart

never leave child in car alone due to dramatic temperature changes

buckets, pet dishes, tubs, toilet bowls are all potential sources of drowning

reduce water temp in heater to less than 120 degrees to decrease chance of burns

do not put pacifier on a cord, string, or necklace

keep all forms of plastic bags away from infants; no disposable diapers should be stacked in crib

choking hazards with even more deadly consequences —> batteries, magnets, balloons

shorten or remove pull cords from blinds and curtains

keep infants out of direct sunlight and use sunscreen after the age of 6 months