Peds Chapter 25 Newborn & Infant

Average newborn weight

3400 g (7.5 lb)

Birth weight loss in first week

Newborns normally lose 5-10% of birth weight in the first week.

When should birth weight be regained?

Within 7-10 days after birth.

Weight milestone at 6 months

Most infants double their birth weight by 6 months.

Weight milestone at 12 months

Most infants triple their birth weight by 12 months.

Average newborn length

50 cm (20 inches)

Length increase by 12 months

Infants typically increase length by 50% by 12 months.

Head circumference growth in first year

Usually increases by 10 cm from birth to 12 months.

Purpose of growth charts

Monitor weight, length, and head circumference over time.

Growth chart concern values

Less than 5th percentile or greater than 90th percentile.

How long can prepared formula be stored in refrigerator?

Up to 48 hours if tightly sealed and not previously heated.

Why should formula not be microwaved?

It can create hot spots that burn the infant's mouth.

Normal spit-up amount

Wet burps around a mouthful are normal.

Should cereal be added to bottles?

No, unless specifically ordered by a provider.

Why should nipples not be cut larger?

Increases choking risk.

Why is honey contraindicated before age 1?

Risk of infant botulism.

Neck righting reflex appears

4-6 months

Sideways parachute reflex appears

6 months

Forward parachute reflex appears

6-7 months

Step reflex disappears

4-8 weeks

Rooting reflex disappears

3 months

Startle reflex disappears

3-4 months

Sucking reflex disappears

2-5 months

Moro reflex disappears

4 months

Asymmetric tonic neck reflex disappears

4 months

Plantar grasp reflex disappears

9 months

Palmar grasp reflex disappears

4-6 months

Babinski reflex disappears

12 months

Definition of parachute reflex

Infant extends arms when tilted as if breaking a fall.

Six states of consciousness in infants

Deep sleep, light sleep, drowsy, quiet awake, active awake, crying.

Brain weight by 12 months

Approximately 2.5 times birth weight.

Anterior fontanel closure

Usually 9-18 months.

Posterior fontanel closure

Usually 2-3 months.

Myelination definition

Formation of myelin around axons to improve nerve impulse transmission.

Most important factor for brain growth

Adequate nutrition.

Normal newborn respiratory rate

30-60 breaths/minute.

Normal respiratory rate at 12 months

20-30 breaths/minute.

Definition of apnea

Pause in breathing longer than 10 seconds.

Definition of periodic breathing

Brief pauses less than 10 seconds between bursts of breathing.

Risk factors for SIDS

Prematurity, low birth weight, overheating, soft sleep surfaces, loose bedding, family history.

Infant respiratory anatomy risks

Narrow nasal passages, funnel-shaped larynx, compliant chest, narrow bronchioles, fewer alveoli.

When does respiratory system reach adult maturity?

Around 7 years old.

Why are infants at higher risk for respiratory infections?

Lack of IgA in upper respiratory tract during first year.

Acrocyanosis definition

Bluish hands and feet in newborns due to circulation changes.

Is acrocyanosis normal?

Yes, during newborn transition.

Desired newborn MAP

Equal to or greater than gestational age.

Low blood pressure in newborns may indicate

Hypovolemic shock or sepsis.

Why is thermoregulation difficult in infants?

They cannot effectively regulate body temperature.

How should infants be dressed?

Same number of layers as adults plus one additional layer.

Where does most infant heat loss occur?

The head.

Mottling definition

Web-like skin pattern caused by cold exposure.

Number of primary teeth

20 teeth.

Typical age of teething onset

Around 6 months.

Early signs of teething

Drooling, hand-to-mouth behavior, irritability, swollen gums.

Physiologic jaundice timeframe

First 2 weeks of life.

Meconium description

Dark green-black, sticky, tar-like stool.

Breastfed stool characteristics

Frequent, loose, seedy stools.

Formula-fed stool characteristics

Thicker and less frequent stools.

Normal stool frequency in newborns

Up to 8-10 stools daily.

Red, bloody, or white stool indicates

Need for further assessment.

Biliary atresia definition

Blockage of bile ducts causing pale stools and jaundice.

Signs of Hirschsprung disease

No bowel movement, vomiting, and abdominal distention.

Why do infants dehydrate easily?

Higher total body water percentage and immature kidneys.

Full renal maturity occurs at

Around 2 years of age.

Minimum acceptable urine output

1-2 mL/kg/hour.

Vernix definition

White creamy substance protecting fetal skin.

Lanugo definition

Soft fine hair helping vernix adhere to skin.

Which infants have more lanugo?

Premature infants.

Why do newborns have high hemoglobin and hematocrit?

Residual maternal blood and delayed cord clamping.

When are maternal iron stores transferred?

Mainly during weeks 36-40 of pregnancy.

Premature infants are at risk for

Iron deficiency anemia.

Maternal antibodies provide immunity for how long?

Approximately 3-6 months.

Major developmental theorists

Erikson, Piaget, and Freud.

Purposeful social smile develops at

2-3 months.

Babbling simple vowels develops at

4-5 months.

Infants begin saying mama/dada regularly

Around 6 months.

Peek-a-boo and patty-cake enjoyed

6-8 months.

Cephalocaudal development

Development progresses from head to toe.

Proximodistal development

Development progresses from center outward.

Late preterm infant gestation

35-37.6 weeks.

Newborn vision distance

8-15 inches.

What visual stimuli do newborns prefer?

Human faces and high-contrast colors.

When do infants recognize familiar faces?

Around 1 month.

When is full color vision achieved?

Around 7 months.

Best nutrition for infants

Breast milk.

When should solid foods be introduced?

Around 6 months while continuing breast milk or formula.

Breastfeeding frequency

Usually every 2-3 hours or on demand.

Should infants receive supplemental water?

No, not routinely.

When can cow's milk be introduced?

After 12 months.

Why should cow's milk be avoided before 12 months?

Inadequate nutrition and possible allergy risk.

What does "on-demand feeding" mean?

Feeding based on infant hunger cues.

First recommended solid food

Iron-fortified rice cereal mixed with breast milk or formula.

Requirements before starting solids

Good head control and ability to sit with support.

When should honey be introduced?

After 12 months.

When should peanut-containing foods be used cautiously?

Before 12 months due to allergy concerns.

Definition of colic

Crying more than 3 hours/day for more than 3 weeks in an otherwise healthy infant.

When does colic usually resolve?

Around 4 months.

Possible causes of colic

Overstimulation, gas, overfeeding, poor burping, constipation, reflux.

Ways to soothe a crying infant

Swaddle, hold, rock, dim lights, talk softly, burp, check diaper.

Who is responsible for car seat installation?

Parents or certified installers, not nurses.