Health promotion/milestones for Infants

Erikson (psychosocial)- Birth to 1 yr

Trust vs mistrust, trust developed by meeting comfort, feeding and caring needs.

Piaget-sensorimotor stage (Cognitive)- Birth to 1 yr

Infants use their senses and motor skills to learn about the world. (exploration=learning)

Growth milestone by month 6

Double the birth weight

Growth milestone by 12 months

Triple the birth weight.

Birth length

Increases by 50% by 12 months.

Posterior fontanel

Closed by 2 months of age `

Anterior fontanel

Closed between 12-18 months of age.

Gross motor skills develop via

Cephalocaudal fashion

Fine motor skills develop via

Proximodistal fashion

Examples of gross motor skills

Holding, keeping head up, using shoulders to roll, torso to sit up and knees to crawl.

Examples of fine motor skills

Reaching, swatting, using fingers to rake last.

Gross motor skill @ month 1

head lag, rounded back in sitting, turns head side to side

Gross motor skill @ month 2

Neck, control of neck, ability to lift head

Gross motor skill @ month 3

Raise head to 45 degrees, slight head lag

Gross motor skill @ month 4

Shoulder control- rolls front to back; push up on elbows/forearms when on.

Gross motor skill @ month 5

Rolls back to front & back again

Gross motor skill @ month 6

Waist- tripod sits

Gross motor skill @ month 7

Sits alone with some hands to support

Gross motor skill @ month 8

Hips- sits unsupported, pull to stand

Gross motor skill @ month 9

Crawls, some babies start to bear weight/stand up.

Gross motor skill @ month 10

Knees- pull to stand, "cruises"

Gross motor skill @ month 12

Feet- walks independently & sits from standing (not necessarily fully walking)

Fine motor skill @ month 1

Fists mostly clenched, involuntary hand movements

Fine motor skill @ month 3

Holds hand in front of face, hands open

Fine motor skill @ month 4

Bats at objects

Fine motor skill @ month 5

Grasps at rattle

Fine motor skill @ month 6

Releases object in hand to take another, holds bottle

Fine motor skill @ month 7

Transfers object from hand to hand

Fine motor skill @ month 8

Gross pincer grasp (rakes)

Fine motor skill @ month 9

Bangs objects together

Fine motor skill @ month 10

Fine pincer grasp, puts objects into container & takes them out

Fine motor skill @ month 11

Offers objects to others & releases them.

Fine motor skill @ month 12

Feeds self with cup & spoon, simple mark on paper, and pokes.

When does smiling develop?

6-8 weeks or 2 months is the gold standard, meaning infants are socially aware that smiling causes others to react.

Object permanence

the awareness that things continue to exist even when not perceived

What is the ability to recognize oneself in a mirror by 12 months called?

Self-recognition

At what age can children typically separate themselves from their parents?

By 12 months

What skill involves learning to distinguish oneself from other objects in the environment?

Separation

Crying

First verbal communicatio

3-5 words by when?

first year

When is further evaluation needed in language development?

An infant doesn't turn their head to sound. No babbling or imitating sounds by 7 months.

Receptive Language development: Birth to 6 months

turns head to sound, responds to NO, BYEBYE, and MAMA/DADDY

Receptive Language development: 9 to 10 months

Stops activity when No or name is said, responds with gestures to words like up/down, " and obeys simple commands.

Receptive Language development: @ 12 months

Recognizes names of body parts

Expressive Language development at 2-4 months

Coos and starts to add consonants. Gurgles and laughs.

Expressive Language development at 6 months

Babbles

Expressive Language development at 9 months

imitates sounds, adds more consonants, and combines syllables (dada), not meaning.

Expressive Language development at 12 months

says Mama and Dada with meaning, can say 3-5 words with meaning.

What is stranger anxiety?

A developmental stage where infants become anxious around unfamiliar people.

At what age does stranger anxiety typically develop?

Around 8 months of age.

What behavior might an infant exhibit during stranger anxiety?

The infant may become clingy and whiny when approached by unfamiliar people.

When does separation anxiety typically develop in infants?

Around 10 months

At what age can separation anxiety begin in infants?

As early as 4-8 months

What is a common reaction of an infant experiencing separation anxiety?

The infant becomes distressed when the parent leaves

Play importance

Infants practice their gross and fine motor skills through play and its critical to infant development.

Nursing role in infant growth and development

Encourage parent-infant attachment, promote nutrition, maximize development, and prevent injury.

Anticipatory guidance

educating parents and caregivers about what to expect in the next phase of development.

IMMUNIZATIONS pneumonic for infants.

B for given at Birth (HEP B)

Please (PCV), Don't (DTAP), Poke (IPV), Him (HIB), Her (Hep), Right now (Rotavirus).

What is recommended for infants during the first 6 months of life?

Breast milk

What supplements are recommended for exclusively breastfed infants after the age of 4 months?

Iron supplements

Should cows milk be given during the first year of life?

NO

When should an infant drink water?

Begin cup with water around 6-8 months, no juice as infants need protein & fat and not sugar.

Solids introduced

@ 6 months of age, assess readiness when tongue extrusion reflex is gone around 4-6 months.

How often are new foods introduced to infants?

Every 3-5 days

What should be monitored when introducing new foods to infants?

Allergies and intolerance

How many exposures to a new food may be needed before acceptance by infants?

Up to 20 exposures

Foods to avoid in infancy

Cow's milk

Honey

Excessive amounts of fruit juice

Foods likely to cause choking

Popcorn

Other small hard foods (e.g., raw carrot chunks)

Grapes and hot dog slices (must be cut in smaller pieces)

sleep and rest with infants

By 3-4 months, infants sleep 7-8 hours without waking. Encourage consistent routines by 4 months.

Safe sleep practices

Firm mattress, no pillows/blankets, no stuffed animals.

Dental hygiene in infants

First tooth 6 months to 1 year, dental care with the first tooth, clean with a washcloth/ gum brush.

Teething pain what to do?

Ice/cold teething rings, hard teething ring, over-the-counter gum remedies, and acetaminophen as needed for pain/irritability.

Safety in the car

Car seats should be rear-facing, secured in the center, and never unattended.

Safety in home

Safety crib at lowest position, safety gates at stairs, outlet covers, cabinet locks, and toilet locks, store meds and household cleaning supplies out of reach.

What is a key practice for feeding infants to prevent choking?

Hold infant for feeding, don't prop bottle.

What type of toys should be given to infants to prevent choking?

Age-appropriate toys.

What should be kept free of small items to prevent choking hazards?

Keep floor free of small items.

What types of small objects should be avoided when feeding infants?

Small objects like grapes, nuts, and carrots.