U1L2: Development & Health Promotion

infancy age

birth to 12 months

- includes neonates & infants

neonate age

birth to 27-28 days

infant age

1 to 12 months

early childhood age

1 to 6 y/o

- includes toddler & preschool

toddler age

1 to 3 y/o

preschool age

3 to 6 y/o

school age

6 to 12 y/o

adolescence age

11 to 20 y/o

5 domains of growth & development

1. physical/biologic GROWTH

2. motor/physical DEVELOPMENT

3. cognitive development

4. social/emotional development

5. language development

physical/biologic growth domain

objective measurement -> height, weight, bone, teeth, organ changes

motor/physical grwoth domain

gross & fine motor skills

cognitive development domain

thinking, learning, & problem solving

social/emotional development domain

attachment, temperament, & self concept

language development domain

receptive & expressive communication

what percentage of children are milestones based on?

75% -> if a child misses one they should be referred to specialist

how do we correct age for premature babies referring to hitting milestones?

subtract weeks of prematurity from how many weeks old they are

how do we calculate catch up period for premature babies?

# of weeks premature X 10

how much should weight increase in the first 5 months of birth?

weight should double

how much should weight increase in the first 12 months of birth?

weight should triple

how much should height increase by the 1st yr?

+50% (1 in/month)

what is OFC?

occipital frontal circumference -> chest + 2 cm at birth

- should be checked until 3 y/o

what should the OFC be after 1 yr?

head = chest circumference

what are the 2 fontanels in newborns?

anterior & posterior fontanel

how long does it take the anterior fontanel to fully close?

12-18 months

how long does it take the posterior fontanel to fully close?

6-8 weeks

primitive infant reflexes (7)

- sucking

- rooting

- extrusion

- palmar grasp

- plantar grasp

- babinski sign

- moro (startle)

when should sucking stop?

4-6 months

whats rooting?

baby turns head when cheek is stroked

when should rooting stop?

4 months

whats extrusion?

forces tongue outward when touched

when should extrusion stop?

4 months

when should palmar grasp stop?

4 months

whats plantar grasp?

toes curl when sole is touched

when should plantar grasp stop?

8 months

whats babinski sign?

big toe up & other toes fan when sole is stroked

when should babinksi sign stop?

12 months

whats moro (startle)?

extends then pulls in arms/legs to noise

when should moro (startle) stop?

4 months

neurologic maturation in infancy

brain growth and myelination of spinal cord occur and should be completed by 2 years of age

examples of neurologic development in babies

- involuntary reflexes -> voluntary control

- crying ->speaking

respiratory maturation in infancy (4)

- fast RR -> slows

- irregular breathing -> more regular (should count to full min)

- narrow nasal passages & funnel-shaped larynx

- fewer alveoli

when do children reach adult capacity regarding respiratory?

7 y/o

cardiovascular maturation in infancy (3)

- HR slows, BP increases

- resp sinus arrhythmia -> not irreg.

- capillaries near skin -> limited thermoregulation

hematopoietic maturation in infancy

have high hemo at birth w shorter lifespans & stores start to decrease at 5 months old

where do newborns get their iron stores?

from mother at end of pregnancy

genitourinary differences in infancy (3)

- higher body water % -> dehydration risk

- frequent urination & low specific gravity

- immature renal structures

GI differences in infancy (4)

- immature digestion

- increased stomach volume

- teeth erupt to prepare for solids

- immature liver

whats meconium?

baby's first stool -> more hard & sticky

- should be passed within 24-48 hours of birth

what is breastfed baby's stools like?

less stench & less volume

what is formula fed babies stools like?

more peanut buttery consistency

immune differences in infancy (3)

- has passive immunity from mother -> lose around 3-4 months

- antibodies from colostrum in breast milk (extends immunity)

- vulnerable to inf

integumentary maturation in infancy

mottling decreases over first few months

what is the avg age of first tooth eruptions?

6-10 months then 1 tooth/month

how many teeth should a 12 month old baby have?

6-8 teeth

signs of teething (7)

- drooling

- irritability

- rubbing ears

- sucking

- difficulty sleeping

- decreased solid food appetite

- low grade fever (99)

how to gross motor milestones progress?

head to toe progression

2 month gross motor milestones

- raises head when prone

- moves all 4 extremities

4 month gross motor milestones

- no head lag

- rolls back to side

s6 month gross motor milestone

- rolls prone to supine

- tripod sits

9 month gross motor milestones

- sits unsupported

- gets to sitting

12 month gross motor milestones

- pulls to stand

- cruises -> walking while holding onto smt

how to fine motor milestones progess?

proximal to distal progression

2 month fine motor milestone

hands mostly fisted & briefly opens

4 month fine motor milestones

- bats at objects

- holds toy placed in hands

6 month fine motor milestone

reaches for items

9 month fine motor milestones

- rakes -> uses all fingers to grab smt

- pincer grasp -> pads of fingers

- transfers hand to hand

12 month fine motor milestone

fine pincer grasp -> finger tips

sensorimotor stages of cognitive development

reflexes -> repetitive behavior -> imitation -> cause & effect

when does seperation emerge?

4-6 months

object permanence

when a baby knows something exists when they can't see it

when does object permanence emerge?

emerges around 8 months

common communication & language development at birth

crying then smiling

common communication & language development at 2 months

coos & differential crying

- if not cooing its a sign of bad hearing

common communication & language development at 4-5 months

vowel sounds, vocalizes to voices, & laughs

common communication & language development at 6 months

squeals

common communication & language development at 9 months

say dada/mama, lifts arms to be picked up, responds to name

whats a sign of autism?

doesn't respond to name

common communication & language development at 12 months

1-3 words, follows simple commands, babbles w inflection

body image development

infants build sense of self through senses

body image development stages

- tactile experiences

- smile

- object permanence & separation awareness

- growing interest in their image

temperament

the infants individual behavioral style shaping goodness of it w caregivers

when does stranger anxiety emerge?

6-9 months

when separation anxiety emerge?

6-12 months

reactive attachment disorder

results from maladaptive or absent attachment

sensory development

senses mature at different rates

when is hearing developed?

fully developed at birth

how is sight at birth?

at birth eyes cross occasionally w nearsightedness, but should stop at 4 months old

when should sight be fully developed?

full color, distance vision, & tracking by 7 months

how is smell and taste at birth?

present and functional from birth & develops rapidly

- can smell moms breast milk and can differentiate ppls smell

how do newborns respond to touch?

responds to holding, stroking, rocking, & cuddling

- most important sense for communication

what kind of play do 0-3 month olds participate in?

onlooker -> watches faces & movement

what kind of play do 3-6 month olds participate in?

solitary -> rattles & high contrast books

- doesn't interact w others

what kind of play do 6-10 month olds participate in?

interactive -> plays peek-a-boo & pat-a-cake

what kind of play do 10-12 month olds participate in?

purposeful -> stacking, push & pull toys

infant nutrition characteristics (3)

- wake newborns to feed q 2-3 hrs

- vit D supplement within first few days

- iron supplement at 4 months if only breastfed

how should you introduce solids? (4)

- around 6 months old

- finger foods around 9-10 months

- wait 3 days before introducing new food

- high allergen foods should be introduced early

what foods should newborns not eat? (3)

- no cows milk, honey, juice until 1 yr

- no hard, round foods

- avoid added sugars

what should you do regarding dental health for newborns? (3)

- fluoride supplement after 6 months if needed

- first oral exam at 6 months & dentist at 1 y/o

- start cleaning teeth bid as first tooth erupts

how much toothpaste should you use for a

smear or rice sized amt

how much toothpaste should you use for a 2-5 y/o?

pea sized amt