Infant Development Notes
Infant Stage of Development (1 Month to 1 Year)
Physical Growth
Newborns: Infants up to one month of age.
Infant Stage Focus: One month to one year of age.
Cephalocaudal Growth:
Literally means "head to tail" growth.
At birth, the head is about one-fourth of the total body length.
The head develops more rapidly than the lower part of the body.
Proximodistal Growth:
Means "near to far," from the center of the body outward.
Head, neck, and shoulder muscles develop before fine motor finger control.
Weight Growth:
Infants typically double their birth weight by six months.
They triple their birth weight by one year.
Height Growth:
Average height increases by one inch per month during the first six months, occurring in spurts.
Growth Charts:
Children between the 5th and 95th percentile are considered normal for growth and development.
Wellness Visits: Used to monitor child's growth.
Fontanelles
Infants are born with two fontanelles.
Anterior Fontanelle:
Located on the top of the head (front).
Diamond-shaped and larger.
Usually closes by 18 months of age.
Posterior Fontanelle:
Located on the back of the head.
Triangle-shaped.
Usually closes by eight weeks of age.
Dentition (Teeth)
The first tooth usually appears around six to eight months of age.
Dental Guide Formula:
Approximate number of teeth = Age in months - 6 (up to two years of age).
Example 1: 8-month-old infant: teeth (approximately).
Example 2: 14-month-old infant: teeth (approximately).
Typical Tooth Eruption:
Lower central incisors are usually the first to appear.
Upper central incisors follow.
By One Year: About four to six teeth are present, and the infant can eat table food.
Teeth Cleaning:
Clean teeth and gums with a damp cloth, even before teeth erupt.
Use a small, soft-bristle toothbrush once teeth start to appear.
Sleep Patterns
Sleep and wakefulness periods become longer and more regular as the infant ages.
Newborns:
Take around-the-clock naps totaling about 16.5 hours per day (80% of the time).
One Month:
Infants sleep about 15 hours per day.
Six Months:
Infants sleep about 14 hours per day.
Seven to Eight Months:
Many infants sleep through the night without awakening.
Twelve Months:
Most infants sleep at least eight hours a night.
Co-sleeping: Parent-infant co-sleeping is the norm for 90% of the world's population.
Fine Motor Skills
Involve movements with the fingers.
One to Three Months:
Hands clench on contact with a rattle.
Able to pull at blankets and clothes.
Four to Six Months:
Voluntarily grasp.
Reach with both hands.
Use the palmar grasp (scooping with fingers into the palm). For example, picking up and eating Cheerios out of the palm of the hand.
Seven to Nine Months:
Progression to the pincer grasp (using pointer finger and thumb).
Able to pick up a Cheerio at a time.
Transfer objects from one hand to another.
Good eye-hand and hand-mouth coordination.
Ten to Twelve Months:
Put one object after another into a container.
Turn many pages in a book at a time.
Assist with dressing.
Note: These are averages of when each skill is achieved.
Gross Motor Skills
Larger muscle movements.
One to Three Months:
Able to hold their head in a mid-position.
Lift their head and chest off the bed.
Roll from their side to their back.
Four to Six Months:
Sit up with support.
Roll over completely.
Bear almost all of their weight on their legs when held in a standing position.
Seven to Nine Months:
Sit independently.
Crawl.
Pull themselves to a standing position.
Ten to Twelve Months:
Stand alone.
Walk alone (many times).
Sit down from a standing position without help.
Toys
Toys should align with motor development at each stage.
One to Three Months:
Look and listen toys (e.g., a mobile with toys that spin and play music).
Four to Six Months:
Teething toys.
Rattles.
Musical toys.
Activity gyms where they can reach and kick toys.
Seven to Nine Months:
Cuddle toys.
Push and pull toys for crawling and standing.
Ten to Twelve Months:
Push and pull toys for walking.
Water toys (with supervision).
Toys for emptying and filling boxes.
Attachment
Definition: A strong tie with special people that leads to pleasure when interacting with them.
The primary relationship and foundation of future relationships.
It is imperative that the child bond with someone.
Four Types of Attachment:
Secure Attachment:
More than 65% of infants in the U.S.
Infant may cry when separated but prefers the caregiver over a stranger.
Upon return, the infant shows pleasure, smiles, and wants to be picked up.
Avoidant Attachment:
Infant is not distressed when a parent leaves.
Reacts to a stranger the same way as to the parent.
Slow to greet the parent upon reunion.
Fails to cling when picked up.
Child does not explore much, regardless of who is there.
Resistant Attachment:
Stay close or even cling to the caregiver rather than exploring toys.
When the caregiver leaves, the child is extremely distressed and is ambivalent when the caregiver returns.
The child may rush to the caregiver but then fails to be comforted when picked up.
The child may still be angry or even resist attempts to be soothed.
Disorganized/Disoriented Attachment:
Inconsistent way of coping with stress.
The child may cry during separation but avoid the mother when she returns.
The child may approach the mother but then freeze or fall to the floor.
Significance:
Secure attachments lead to a sense of well-being (Maslow), trust (Erikson), and are reflected in future emotional health (Freud).
Cultural Comparisons:
Germany (values independence): Higher rates of avoidant attachment.
Japan (mothers typically by children's sides): Higher rates of resistant attachment.
These reflect cultural variations rather than true insecurity.
Temperament
Innate characteristics of an infant (mood, activity level, emotional reactivity).
Three Categories:
Easy Infants:
Quickly establish regular routines.
Generally happy and adapt easily.
Easy to comfort.
Usually in a positive mood.
Difficult Infants:
Slow to accept new experiences.
React negatively and intensely.
Cry frequently.
Slow-to-Warm-Up Infants:
Negative in mood.
Adjust slowly to new experiences.
Low activity level.
Parental Support: Parents of non-easy children need encouragement and support.
Psychosocial Development
Ages correspond with fine motor, gross motor, and toys discussed.
One to Three Months:
Social smiling.
Turn heads and listen to voices.
Recognize familiar faces and objects (e.g., a bottle).
Four to Six Months:
Enjoy social interaction.
May experience stranger and separation anxiety.
Seven to Nine Months:
Demonstrate oral aggressiveness and biting (related to teething).
Increase in attachment to parents and primary caregivers.
Ten to Twelve Months:
Obey simple commands.
Emotions become very evident.
Love an audience.
Discipline
Begins with consistent care through predictable routines.
Process of transmitting values from parent to child.
Consistent, predictable care in a calm, direct, and patient manner provides the foundation.
Leads to the child expecting that what a parent promises is delivered.
Beginning of the socialization process where norms of behavior become expected and routine.
Parents still need to teach and guide children for desired behaviors.
Theorists
Maslow:
Pyramid theorist.
Physiological needs (food, water, shelter) must be met first.
Primary caregiver needs to provide these.
Safety and security also important (consider fine and gross motor development).
Safety precautions (gates, safe toys, supervision) are essential.
Erikson:
Crisis: Trust vs. Mistrust.
Trust: Developed through intimate, consistent, and prompt care.
Addressing cries, routines, holding, and positive touches.
Mistrust: Occurs if infants are neglected or handled harshly.
Inconsistent care, not meeting needs, allowing child to cry without soothing.
Can lead to suspiciousness, anxiety, and difficulty negotiating life.
Freud:
Oral Stage.
Behaviors are motivated by the mouth (eating, sucking, chewing, tasting).
Provides a primary form of security.
Conflict: Weaning off the breast or bottle.
Piaget:
Sensorimotor Stage.
Infants think by acting on the world with their eyes, ears, hands, and mouth.
Invent ways of solving sensorimotor problems.
Consider motor developments and toys that appeal to various senses.
Communication
Crying: Primary form of communication for very young infants.
Caregivers learn to distinguish different cries.
Other forms of communication:
Cooing: Vowel-like noises (around two months).
Babbling: Consonants and vowels combined (mama, dada, baba).
Comprehension is better than production of words.
Play and Learning
Children learn to play and play to learn.
Solitary Play:
Infants play by themselves.
Don't understand giving, taking, and sharing.
Play side by side but alone.
Offer toys that stimulate multiple senses (colors, shapes, textures).
Recommendations: Safe, washable, and large enough not to be swallowed.
Nutrition
Breast or formula feeding (or a combination).
Cereal: Start around four to six months.
Fruits and vegetables: Start around six to eight months.
Introduce one new food at a time for several days to check for allergies.
Be careful of choking hazards (perfectly rounded foods).
Weaning
Gradual transition from breast or bottle to drinking from a cup and eating solid food.
Usually takes place around six to twelve months of age, but can be later.
Never put the baby to bed with a bottle of milk or juice (can lead to cavities or ear infections).
Readiness: Nurse for a shorter period, decrease interest in the bottle, offer more in a sippy cup.
Health Maintenance and Promotion Strategies
Protect from infection: Wash hands, keep the infant clean, wash toys.
Protect from accidents: Car seat, safety catches, gates on stairs.
Adequate nutrition in a clean environment.
Encourage well-baby checkups.
Caregiver education:
Shaken baby syndrome: Do not shake or throw the child.
SUID (sudden unexpected infant death) / SIDS (sudden infant death syndrome):
Lay baby on his or her back or side, not on their stomach.
Firm mattress.
Independent sleeping (crib or bassinet).
No extra pillows, blankets, or stuffed animals.
Smoking: Increases respiratory problems and ear infections.
Animal Safety: Educate on what types of animals are safe in the house.
Common Health Problems
Malnutrition: Contributes to one-third of worldwide infant and early childhood deaths; responsible for growth stunning.
Colic: Temporary situation causing cramping and pain.
Rule of three: Crying at least three hours per day, more than three days per week, for three weeks or more.
Possible causes: Adjusting to each other, infant temperament, oversensitivity to gas, milk allergy.
Vomiting and diarrhea: Intestinal conditions that can lead to rapid dehydration.
Respiratory conditions: RSV, bronchiolitis, croup.
Ear infections.
Leading causes of death: accidents (motor vehicle crashes, suffocation, drowning, poisoning, fires, and falls).