Adobe Scan Feb 9, 2025

Physical Growth and Development in Infants

Sleep Patterns

• Average Sleep Duration: Infants sleep an average of 12.8 hours/day; this changes as they grow.

  • Newborns (0-3 months): Sleep 14-17 hours/day.

  • Sleep Cycle: Infants often start with REM sleep and move through cycles more quickly than adults.

• Sleep Studies Findings:

  • At 6 months, 62% of infants slept at least 6 hours at night, 43% at least 8 hours, 38% under 6 hours.

  • By 12 months, 28% still did not sleep at least 6 uninterrupted hours.

• Nighttime Waking: The most common reported issue by parents. Mothers lose about an hour of sleep nightly; fathers lose about 13 minutes.

• Evolution of Sleep Patterns:

  • By around 6 months, infants typically sleep 14-15 hours/day, with 3-4 hours of daytime napping.

  • Naps decrease to usually two per day between 9-18 months, and then often to one longer nap by 18 months.

  • Rapid weight gain and developmental milestones can alter sleep habits.

Sudden Unexpected Infant Deaths (SUID)

• Statistics: About 3,500 SUID cases occur in infants under one year annually in the U.S.

  • Types of SUID:

    • Sudden Infant Death Syndrome (SIDS):

      • Unexplained death of a previously healthy infant.

      • Leading cause of death in infants under 12 months; about 1,500 deaths in 2013.

      • Risk factors include low birth weight, siblings with SIDS, sleep apnea, ethnicity, low SES, and exposure to smoke.

    • Unexplained Cause: Death without a thorough investigation.

    • Accidental Suffocation and Strangulation: Risks include soft bedding and entrapment.

• Prevention Efforts:

  • Campaigns promoting "back to sleep" greatly reduced SIDS rates.

  • Remaining statistics on accidental suffocation have not declined significantly.

Co-Sleeping

• Cultural Variation: Where the infant sleeps varies by age and culture.

  • Studies show that bed-sharing increases SIDS risks, particularly for infants under 3 months.

  • Co-sleeping is part of attachment parenting practices; ongoing debates about safety exist.

  • Risk factors intensify with parental smoking or substance use.

Recommendations for Safe Infant Sleeping Environment (2016 AAP Guidelines)

• Place infants on their backs on a firm sleep surface (crib/bassinet).

• Avoid soft bedding: keep the crib bare—no bumpers, blankets, or pillows.

• Encourage breastfeeding as it offers protection against SIDS.

• Room-sharing is preferred, but do not share a bed; begin transitioning infant to separate sleep surfaces by 6 months.

• Avoid exposure to smoke, alcohol, and illicit drugs.

Immunizations

• Importance: Crucial for preventing communicable diseases from infancy.

  • Infants often mouth objects, increasing exposure to germs; sanitization is key.

• Vaccination Trends:

  • A significant number of children remain unvaccinated either for valid medical reasons or parental beliefs.

  • Herd immunity occurs when a high percentage (90%) are immunized, preventing disease spread.

  • California's stricter regulations on vaccination for children were implemented in 2017 to ensure community health.