Growth/Development Infant

are children small adults

no

principles of growth and development

individual pace, skills build, genetics/environment influences

cephalocaudal development order

head, neck, trunk, legs, feet

cephalocaudal development examples

2 months hold head up, 4-6 months rolls, 6-9 months sits, 9-12 months, pulls to stand, 12 months walks

proximodistal development

center of body outwards, shoulders/arms/heands/fingers

proximodistal development examples

reaching, grasping, object transfer, pincer grasp

infant growth

weight: double by 5-6 mo/triples by 12 mo, length: increases 50%, head cirumference: rapid brain growth

expected development at 2 months: gross motor

holds head up when prone

expected development at 2 months: fine motor

hands begin to open, briegy holds a rattle

expected development at 2 months: language

coos, different cries for different needs

expected development at 2 months: social

social smile, visually tracks faces/objects

expected development at 2 months: nursing assessment

assess head control, observe visual tracking, ask parents about feeding/sleeping

expected development at 4 months: gross motor

good head control, pushes up on forearms when prone

expected development at 4 months: fine motor

bats at objects, brings toys to mouth, grasps toys

expected development at 4 months: language

laughs, squeals

expected development at 4 months: social

enjoys interaction, smiles spontaneously

expected development at 4 months: nursing priorities

observe symmetry of movement, assess head control, encourage tummy time

expected development at 6 months: gross motor

tripod sits, rolls front to back

expected development at 6 months: fine motor

reaches for desired objects

expected development at 6 months: language

babbles

expected development at 6 months: cognitive

explores object by mouthing

expected development at 6 months: nutrition

begin complementary foods, continue breastmilk/formula, no honey, begin cup practice

expected development at 9 months: gross motor

sits unsupported (gets to sitting on own), crawls

expected development at 9 months: fine motor

rakes, immature pincer grasp, transfer objects from one hand to the other

expected development at 9 months: language

understands "no", says "mama/dada" nonspecifically

expected development at 9 months: cognitive

object permanence, searches for hidden toys

expected development at 9 months: social

stranger anxiety, separation anxiety (cannot happen if object permanence isnt there)

expected development at 12 months: gross motor

cruises along furniture, pulls to stands, may begin taking independent steps

expected development at 12 months: fine motor

mature pincer grasp, finger feeds

expected development at 12 months: language

1-3 meaningful words, follows simple commands

expected development at 12 months: social

waves bye-bye, plays peek-a-boo

expected development at 12 months: nutrition

transition from bottle to cup, transition from formula to whole milk, encourage self feeding

motor development red flags

persistent head lag/poor head control by 4 months, not rolling by 6 months, not sitting independently by 9 months, abnormal muscle tone

communication/sensory development red flags

no social smile by 2 months, poor visual tracking or response to sound by 4 months, no babbling or failure to respond to name by 12 months

always abnormal development red flags

developmental regression (loss of previous milestones)

inadequate physical growth resulting from insufficient caloric intake, malabsorption, increased metabolic demands, or psychosocial factors

failure to thrive

failure to thrive findings

poor wt gain, wt percentile crossing, delayed growth, developmental delay, loss of subcutaneous fat, feeding difficulty, lethargy/irritability

erikson's psychosocial theory

trust vs mistrust, promoted by (consistent caregiving, feeding, comfort, responsive parenting)

what to teach caregivers: safety

back to sleep, rear facing car seat, childproof home, prevent falls/choking

what to teach caregivers: nutrition

breastmilk/formula 1st yr, no honey before age 1, introduce solids around 6 months, transisiton to cup

what to teach caregivers: development

tummy time, read/talk daily, encourage exploration

what to teach caregivers: health promotion

immunizations, well child visits, oral hygiene

safety promotion prevention: infant safe sleep

firm mattress, back is best, no pillows/loose blankets, move cribs away from windows with blind cords

safety promotion prevention: infant transportation

rear facing car seat, back seat only LATCH system

safety promotion prevention: infant injury prevention

never leave unattended, prevent falls, choking hazards, smoke detectors, water heater (

safety promotion prevention: toddler common hazards

falls, poisoning, drowning, burns, choking, firearms, motor vehicle injuries

safety promotion prevention: toddler parent teaching

childproof home, lock meds/cleaning products, never leave child unattended near water, fence pools, window guards

SIDS prevention

back to sleep "back is best", firm mattress, no loose bedding, smoke free environment, room sharing w/o bed sharing