Module 2: Fetal/Prenatal Development & Childbirth, Neonatal, Infant, & Toddlerhood

fertilization

sperm propel themselves through the female reproductive tract, where only one penetrates the ovum

Conception

happens once every 28 days

stages of fetal development

Germinal (pre-embryonic), embryonic. fetal

Germinal period 

a fertilized egg (zygote) rapidly divides into a cluster of cells called a blastocyst. This blastocyst then travels to the uterus and implants itself into the uterine wall

Embryonic period

• essentials are further developed 

• basic structures of all major body organs are formed 

• main external features are completed 

• most vulnerable to teratogenic substances

Embryonic period 

significant structural and physiological changes occur as the embryo transforms into a fetus

weeks 3-8 

fetal stage 

weeks 9- 40

3 weeks

neural tube forms, beginning brain, heart, and spinal cord

4 weeks

brain differentiates, limb bud

5 weeks

heart beats

6 weeks

fetal circulation established, eye forms, nasal cavity/ upper lip form

7 weeks 

palate formation nearly complete, fetal heartbeat can be seen on ultra sound

8 weeks

all body organs are formed, sense of touch, baby can move

weeks 9-12

Urine is produced & excreted, Natal genitalia recognizable, Ossification of bones begins, Respiratory-like movements begin

weeks 13-16

Placenta is distinct
Heart circulates, blood well, Quickening begins towards end

weeks 17-20

Quickening, Lanugo & vernix caseosa present, Continued primitive respiratory movements

weeks 21-24 

Wrinkled, pink, translucent skin, Surfactant production may begin, Grey area of viability

weeks 25-28

Eyelids open, Developing some subcutaneous fat Alveoli & surfactant

weeks 29-32

Testes may descend, May respond to sounds outside, More rhythmic breathing. movements

weeks 33-36

lanugo disappearing, Increased fat deposits, Surge of surfactant towards end

weeks 37-40

Vernix disappearing, Well-defined ears, Antibody transfer

Rubins developmental tasks of becoming a mother

ensuring safe passage

acceptance by others

binding into the child 

giving of oneself 

ensuring safe passage

engages in prenatal care, more protective of oneself and their health, seeks out role models and expert advice on best way to proceed through the pregnancy and delivery and on parenting 

ensuring acceptance of the child

assesses their partners/family’s receptivity of the infant, relationships redefined, creates new mothering/parenting identity

Binding into their unknown child 

Integrate the baby as an integral part of self but also as a separate being, Starts to think of what the child will be like fetal movement and nesting behaviors

Learning to give of oneself

explores the meaning of giving by putting baby’s needs above their own, develops their identity as a mother/ parent 

teratogen

any environmental agent that causes damage during the prenatal period

teratogenic influences

prescription/ non prescription drugs, Illegal drugs, Tobacco, Alcohol, Radiation, environmental pollutions 

thalidomide

used in 1960s for nausea, causes deformities of arms and legs

Congenital Malformations

malformation or physical anomaly present at birth, is acquired during the development of the fetus 

biophysical influences

health status of pregnant client, obstetrical history, microbiome, nutrition/activity

psychosocial influences

Adverse or diverse lifestyles, mental health disorders, emotional distress/ prenatal stress, disturbed interpersonal relationships 

sociodemographic influences

lack or prenatal care, lack of insurance, low income, lack of support, racial/ethnic disparities

environmental influences

hazards in the community, workplace, or in the home

approaches to childbirth

natural birth, medication assisted childbirth, medical interventions w

1st stage of labor

onset of regular contractions to fully dilated

2nd stage of labor

10cm dilated - birth of infant 

3rd stage of labor

birth of infant- delivery of the placenta

4th stage of labor

recovery and bonding/attachment

APGAR score

assigned 1-5 minutes after birth and rates the infants heart rate, respiratory effort, muscle tone, reflex irritability, color 

APGAR score 0-3

infant is in severe distress

APGAR score 4-6

infant is in moderate distress

APGAR score 7-10

infant is in minimal or no distress

family and childbirth

duvalls family lifestyle comes into play

Taking in phase 

need rest, dependent behavior 

taking- hold phase

begins to initiate care, still requires support, education and reassurance

letting go phase

confidence in behavior, embraces new role

Postpartum depression

A more severe and persistent form of depression that can develop any time within the first year after childbirth. 

Baby blues

A mild, transient mood disorder that typically occurs within the first few days after giving birth

average birth weight 

7.5 lbs

average length 

20 in

what can be seen on the skin 

acrocyanosis

slate gray patches

lanugo and vernix

milia

Moro reflex

spreading out the arms and then pulling them in, in response to a stimuli 

tonic neck

if an infant is turned to one side they will extend the arm and leg on that side 

rooting

infant turns its head towards anything that brushes against its cheek in search for food 

Babinski 

Elicited by a firm stimulus on the sole of
the foot, which results in dorsiflexion of the
great toe and fanning of the smaller toe

grasp

object is placed in the infants hand and the infants wraps fingers around the object

stepping

when the soles of their feet touch a flat surface they will attempt to walk 

jaundice

impaired ability to rid the body of bilirubin

sensory capacity of a newborn

highly sensitive to pain

prefer mothers breast milk

hearing after first sneeze/ recognize moms voice

less acute than adults/ see best close up 

gross motor

actions that help with locomotion

gross motor @ 1 month 

chin up 

gross motor @ 2 months 

chest up, elevates self with arms

gross motor @ 4-6 months

rolls over

gross motor @ 6 months

sits alone steadily with arms in front for support

gross motor @ 8 months

pulls to standing

gross motor @ 9 months

creeps/ crawls

gross motor @ 10 months

walks when led

gross motor @ 11 months

stands alone, can sit from standing position

Gross motor @ 12 months

walks three steps 

fine motor less than 2 months 

hands are generally fisted

fine motor 3-4 months 

reaches for, grabs and shakes toy

fine motor 5-6 months

more accurate grasping with thumb on one side and fingers on the other

fine motor 8-9 months

transfers objects from one hand to another/ emergence of pincer grasp 

fine motor 9-10 months

can drink from a cup but not well

fine motor 11-12 months

feed self, may use a spoon but not well

reflexive schemes 

birth - 1 month, newborn schemes 

Primary circular reactions 

1- 4 months, repeating behaviors motivated by basic needs or accidental discovery

secondary circular reactions

4-8 months, imitation of familiar behaviors, sits up and reaches fro objects, searches for objects 

coordination of secondary circular reactions

8-12 months, object permanence

what does play look like @ 2-3 months

seat infant upright with view of environment, place in an interactive play gym activated by kicking, have them reach for objects, or put them in front of an unbreakable mirror

what does play look like @ 4-5 months

soft, bright colored toys, talk to or imitate sounds with them, jump or bounce them on your lap

what does play look like @ 6-9 months

squeaky toys, moveable parts, stuffed toys, play peakaboo, stroller rides, names body parts or items with them 

what does play look like @ 10-12 months

stack blocks, pull toys, scribble with a crayon, read books with animal pictures, play simple games with a ball 

language @ 2 months

cooing, crying, and smiling

language @ 4-6 months 

babbling, stringing sounds together 

language @ 7-8 months

syllables D,P, and B appear, more babbling

language @ 9-10 months

recognizes name, understands “no”, specific sounds used regularly 

language @ 12 months

can say 3-5 words, can follow simple directions

which one os Eriksons stages are infants in

trust vs mistrust

when do we see separation anxiety in infants

6 months

when do we see stranger anxiety in infants

9 months

best source of nutrition for infants

breastmilk or formula

when is the best time to start introducing solids 

around 6 months, when the baby can sit up on their own

when can infants start eating finger foods

9-10 months

when can infants start eating other foods like meat and eggs

11 months

hearing in toddlerhood

fully developed

necessary for speech

refined hearing help build language 

vision in toddlerhood

vision is improved but not 20/20 until 3 yrs

gross motor @ 12-15 months

learns to walk steadily

gross motor @ 18 months

runs clumsy, can go upstairs w/ hand being held