Human Bio (Chapter 4)

ØLabor proceeds in 3 stages

1.Dilation of the cervix

2.Descent and emergence of the baby

3.Expulsion of the placenta

ØElectronic fetal monitoring

oMechanical monitoring of fetal heartbeat during labor and delivery

Ø Pain relief

Epidural

Cesarean Delivery

C-section

Indications for Cesarean

oFetal distress

o Breech birth

o Transverse position

o Head is too large

o Labor progresses slowly

o Vaginal bleeding

Childbirth Attendants

oObstetricians/physicians

o Midwife

o Doula

Approaches to childbirth

oSetting of the birth

oMedical attendants

Use of pain medication

average size

Neonate

Infant less than 4 weeks old

Distinguishing features of a newborn

o Large head

o Receding chin

o Fontanels

o Pinkish skin

o Neonatal jaundice

APGAR

A-Appearance

P-Pulse

G-Grimace

A-Activity

R-Respriration

Preterm/Premature Babies

Ø Infants born before completing the 37^th week of gestation

Ø Low birth weight (less than 5.5 lbs)

Ø Small-for-date infants

 2 important predictors of an infant’s survival

Risk factors for low birth weight

1.Demographics and socioeconomic factors

2.Medical factors

3.Prenatal behavioral and environmental factors

4.Medical conditions associated with pregnancy

Ø Outcomes for preterm babies

–Chilling

– Immature nervous system

– Vulnerability to infection

– Respiratory distress syndrome

Treatment

Ø Isolette (incubator)

Ø Massage

Ø Kangaroo Care

Preterm The child can also have issues later in life

o Slowed development

o Inability to reach developmental milestones

o Learning disabilities

o Behavior disorders

o Below average IQ scores

o Issues with physical coordination

Postmature babies

ØThese are classified as babies who are 2 weeks past their due date

 These are infants who are carried to full term, but show little to no indication that the birth process will begin

complications for postmature

oInsufficient blood supply provided by the placenta

Ø Use of medications to induce the labor process or performing a C-section

Infant Mortality Rate

2.5 million infants 28 days or younger died in 2017

Leading causes of neonatal death

oPreterm birth complications

o Childbirth complications

o Sepsis

Leading causes of infant death

o Birth defects and genetic abnormalities

o Premature or low birth weight

o Sudden infant death syndrome

o Maternal complications

o Accidents

Postpartum Depression

Ø Period of deep depression following the birth of a child

 Described as a long lasting, enduring feeling of deep sadness

Potential Causes of postpartum depression

Safe Haven Law (PA)

you may bring your newborn (up to 28 days old) to any Pennsylvania hospital or to a police officer at a police station

SIDS

ØSudden Infant Death Syndrome

Unexplained death of a seemingly healthy baby

SIDS Risk Factors

oBabies whose mothers are young

oAfrican Americans

oLow Birth Weight or preterm babies

oLow APGAR scores

oBaby whose mother smoked during pregnancy

o

Ø “Back – to – sleep” campaign

Death from Injuries

Ø Unintentional injuries are the 5^th leading cause of death in infancy in the US

o Infants have the 2^nd highest death rate from unintentional injuries

Ø ²/₃ of injury deaths in the 1^st year of life are by suffocation

Ø Traffic accidents are the leading cause of unintentional deaths in ages 1 to 4

o Drowning and burns

Ø Falls are the major cause of nonfatal injuries in infants and toddlers

Ø Boys > girls

Ø Shaken baby syndrome

Immunizations for Better Health

Ø Once familiar and fatal childhood illnesses are now largely preventable because of vaccines

Ø 85% of children worldwide are receiving routine vaccinations during their 1^st year of life

Ø No evidence that links vaccinations causing autism or other neurodevelopmental disorders

Ø Multiple vaccines fortify the immune system against a variety of bacteria and viruses and reduce related infections

Cephalocaudal

Growth follows the direction and pattern of the head and upper extremities and progress to the lower extremities. ( head to tail )

Proximodistal

Growth occurs from the center of the body first and then progresses outward. (From the center to out)

  Growth is governed by 2 main principles

1)Cephalocaudal

2 Proximodistal

Growth Patterns

Ø  Children grow faster during the first 3 years, especially during the first few months, then they ever will again

Weight

§Doubles within the first 5 months

§More than triples by 1 year

Height

§ Typically increases by: (boys)

•10 inches during the first year

•5 inches during the 2^nd year

•2 ½ inches during the 3^rd year

Nutrition of the Newborn

Ø Adequate nutrition is essential for physical development

o Most infants do a good job of regulating calorie intake on their own

Ø Malnutrition

o Condition of having an improper amount and balance of nutrients

o Can affect:

§Physical growth, IQ, and school performance

o Greatest occurrences in underdeveloped countries

Breastfeeding in Infancy

ØBreast milk is the best food for the first year of life

Ø Benefits include:

oNutritional completeness

oDegrees of immunity over certain childhood disease

oMore easily digested

oMay enhance cognitive growth

oEmotional benefits

Social factors that make breastfeeding difficult

oShort or absent maternity leave

o Inability to take frequent and extended breaks at work to pump

o Lack of privacy

Introducing Solid Foods

ØSolids can be started at 6 months but are not needed until 9 to 12 months

oRice cereal

ØTime of weaning varies greatly across developed and developing countries

Ø Neurons

oBasic cells of the nervous system

ØDendrites

Receive messages from other cells

ØAxon

oPart of the neuron that carries messages

ØMyelin

oFatty substance that helps insulate neurons

Nervous System Development

ØDuring the first 2 years of life, a babies brain will establish billions of new connections between neurons

The intricacy of neural connections continues to increase throughout life

ØSynaptic pruning

Elimination of neurons as the result of nonuse or lack of stimulation

ØPlasticity

oDegrees to which a developing structure or behavior is modifiable due to experience

Infant Reflexes

ØReflexes

oUnlearned, automatic response to simply help infants survive and protect themselves

Some reflexes remain with us our entire lives while others disappear

Rooting

Stimulus: Baby’s cheek is stroked with finger or nipple

Baby’s Behavior: head turns; mouth opens;sucking movenment begin

Age-birth to 3 months

Palmar Grasp

Stimulus: Pressure in palm of hand

Baby’s Behavior: flexion of the fingers causing a strong grip

Age: Birth to 4 months

Plantar Grasp

Stimulus: Pressure to the base of the toes

Baby’s reaction: Toe Flexion

Age: Birth to 9 months

Moro

Stimulus: Head dropping into extension suddenly

Baby’s behavior: Arms extend out to the side

Age: Birth to 5 months

Startle

Stimulus: Loud, sudden noise

Baby’s Reaction: Same response as Moro Reflex

Age: Birth to 5 Months

Positive Support

Stimulus: Weight placed on balls of feet when upright

Baby’s reaction: Stiffening of the legs and trunk into extension

Age: Birth to 2 months

Walking( Stepping )

Stimulus: Supported upright position with soles of feet on firm surface

Baby’s Reaction: Reciprocal flexion'/extension of legs, like walking

Age: Birth to 2 months

Asymmetrical tonic neck

Stimulus: head position, turned to one side

Baby’s reaction: Arm and leg on face side are extended, arm and leg on scalp side are flexed

Age: Birth to 6 months

Symmetrical tonic neck

Stimulus: Head position; flexion or extension

Baby’s reaction: When head id in flexion, arms are flexed, legs are extended. When head is in extenstion, arms are extended, legs are flex.

Age: 6 to 8 months

Tonic Labyrinthine

Stimulus: position of inner ear- reflected in head position

Baby’s reaction: In supine(when on back), body and extremities are held in extension in prone (when on belly), body and extremities are held in flexion.

Age: birth to 6 months

Babinski

Stimulus: Sole of the babys foot is stroked

Baby’s Reaction: Toes fan out; foot twist in

Age; Birth to 4 months

Touch and Pain

Ø Touch is the first sense to develop

Ø For the first several months, it is the most mature sensory system

Ø Infants can feel pain

Ø Infants show a decreased pain response when they are held or cuddled,

Smell and Taste

ØThese sense both begin to develop in the womb

Ø Flavors from foods are transmitted via breast milk

Ø Sweet > sour

Hearing

oAuditory discrimination develops rapidly after birth

o Hear before birth

o Are more sensitive to certain frequencies

o Can discriminate groups of different sounds

Sight

o Least developed sense at birth

o Neonate’s eyes focus best from about 1 foot away

o Ability to follow a moving target and color perception develop rapidly in the first months

o Reaches 20/20 level by about 8 months

o Infants show a preference for staring at faces

o Able to discriminate between individual faces within hours after birth

o Early screening is essential to detect problems that interfere with vision

Denver Developmental Screening Test

Ø Screening test given to children 1 month to 6 years old to determine whether they are developing normally

oMeasures:

§Gross motor skills

§Fine motor skills

§Language development

§Personality and social development

SIDS

Sudden Infant Death Syndrome

Safe sleeping methods

No sharing bed

have the baby on its back when sleeping

don’t overheat

baby sleeps in a crib