5. Infancy Period MK (2)

8/2/2019 5. Infancy Period MK (2)

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INFANCY

Nur 346

Dr. Manal Kassab

25-3-2012


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The First Year of Life

Time of rapid growth anddevelopment.

Growth in the first year isextremely rapid.

It occurs in spurts, called saltatory

growth.


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Infant Weight

At birth: 2.7 4.0 kg At 5 months: 2X birth weight.

At 12 months: 3 X birth weight. At 2 years: 4 X birth weight.

At 3 years: 5 X birth weight.


At 7 years: 7 X birth weight. At 8 years: 8 X birth weight.




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Weight Gain (per day)

AGE WEIGHT GAIN

0-3 months: 30 g/day



9-12 months: 12 g/day 1-3 years: 8 g/day (2.8kg/yr)

3-6 years: 6 g/day (2 kg/yr)


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Weight Gain (per month)

AGE WEIGHT GAIN

0-3 months: 900 g

3-6 months: 600 g 6-9 months: 450 g

9-12 months: 360 g

1-3 years: 240 g/month(2.8 kg/yr) 4-6 years: 180 g/month (2 kg/yr)


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Formula For Weight

During Infancy

WT (Kg) = [ Age (months) +9] /2.

During 2-6 Years

WT (Kg) = Age (yrs) X 2+ 8.

During 7-12 YearsWT (Kg) = [Age (yrs) X 7-5] /2.


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Length/ Height Supine length is measured

for children ofless than 2years of age

After 2 years of age,standing height is taken asa measure of stature.


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LengthAt Birth:

At birth: 48 53 cm

At one year = 75 cm.

At two years = 87.5 cm.

At four years = 100 cm.


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Length Gain

AGE GAIN

0-3 months: 3.5 cm/ month

3-6 months: 2 cm / month


9-12 months: 1.2 cm/ month 1-3 years: 1 cm/month(12 cm/yr)

3-6 years: 0.25 cm/month (3 cm/yr)


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Gain In Length 1st year = 25 cm

2nd year = 12 cm

3rd year = 10 cm

4th year = 3 cm

At puberty: Girls = 6-11 cm

Boys= 7-12 cm


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Formula for Calculating HeightFrom 1- 6 Years

Height (cm) = Age (Yrs) X 6 + 77


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Head Circumference At birth: 35.3 1.2 cm

Increases by 6 cm duringthe first 3 months

Further increases byanother 6 cm during 3- 12months.


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Gain in head circumference During 1st year = 12 cm.

During 2nd year = 2 cm. During 3rd year = 1.5 cm.

From 3 to 14 years = 2.5 cm


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Changes in head circumference

AGE GAIN

0-3 months: 2 cm/ month

3-6 months: 1 cm / month


1-3 years: 0.25 cm/month 3-6 years: 1 cm/year


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VISION

An infants vision is at first, visual acuity20/100-20/400

Within a week they can focus on objects that are15-30 cm away

Binocularity: fixation of two ocular images into onecerebral picture begins to develop by 6 weeks andestablished by 4 months

Lack of binocular vision results in strabismus

Have visual preference for looking at the human face

http://www.youtube.com/watch?v=NNuiuqchHHw&feature=related

http://www.youtube.com/watch?v=uJxkcszgKzU
http://www.youtube.com/watch?v=NNuiuqchHHw&feature=relatedhttp://www.youtube.com/watch?v=NNuiuqchHHw&feature=relatedhttp://www.youtube.com/watch?v=NNuiuqchHHw&feature=relatedhttp://www.youtube.com/watch?v=NNuiuqchHHw&feature=related


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Vision

Stereopsis (three dimensions) begins in the 2nd 3rd month, welldeveloped by age 7 months

Depth Perception Incorrect term

What is Stereopsis?

Recognizing that an object is three-dimensional, not flat.

With this improved vision they develop hand-eye coordination

Why is the development of hand eye coordination important?

Important for skills such as eating, catching, coloring, tying shoes, etc


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Hearing

Birth: Responds to loud noise by startle or Moro

Responds to sound ofhuman voice more readily

than to any other sound 8-12 weeks:

Turns head to side when sound is made at level of ear

>12 weeks:

Locates sound by turning head to side and thenlooking up or down

24-32 weeks: Responds to own name


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Smell and Taste The sense ofsmell does not develop much before

birth because baby is surrounded by amniotic fluiduntil birth

Within 10 days they can distinguish the smell oftheir mother from another person.

The sense oftaste develops rapidly.

During the 1st

year, babies learn about the worldthrough their mouth, putting everything in sight init.

Parents need to make sure the objects are clean, nottoo small, and without edges.


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Development During the First

YearTeeth

Development of the babys teeth usually beginabout the 6th week of pregnancy

6-7 Month

The 1st baby teeth appear (primary teeth).

Teething often causes pain and swelling and makesfor a cranky baby


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Language Acquisition

Cooing:

Repetition of vowel sounds by infants

Babbling:

Repetition of meaningless language sounds (e.g.,

babababa)

Single-Word Stage:The child says one word at a time

Telegraphic Speech:

Two word sentences that communicate a single idea

(e.g., Want yogurt, book table etc)


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Language development

12 weeks cooing, smiles when talked to

16 weeks turns head in response to

human voice

20 weeks makes vowels and consonantsounds (ah eee )

6 months babbling (all sounds)

8 months repeat certain syllables(ma-ma)

12 months understands and says some

words

http://www.youtube.com/watch?v=wxtLhgzntg8&feature=related


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Psychosocial development

Erik Erikson: FirstPsychosocial Stage:

Trust vs. Mistrust

Consistent loving care by amothering person isessential to build a trust

relationship.

Mistrust develops whenbasic needs areinconsistently met.

http://www.youtube.com/watch?v=PxwWr6T_O6s&feature=related (0.00- 0.30)
http://www.youtube.com/watch?v=PxwWr6T_O6s&feature=relatedhttp://www.youtube.com/watch?v=PxwWr6T_O6s&feature=relatedhttp://www.youtube.com/watch?v=PxwWr6T_O6s&feature=relatedhttp://www.youtube.com/watch?v=PxwWr6T_O6s&feature=related


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Piagets Cognitive Stages


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Sensorimotor Stage (0-2yrs)

Stage One (birth-1 mo.)

Reflexive stage Use of reflexes

Stage Two (1 - 4 mos.)

Primary circular reactions: child learns about cause and effect as aresult of reflexive sensorimotor patterns that are repeated for enjoyment(recognition of causality).

The interesting events are occurring within the body (plays withhands, fingers, feet)

Stage Three (4 - 8 mos.)

Secondary circular reactions: The interesting events in this case arelocated in the external world (Making Interesting Sights Last)

Beginning of object permanence: shows separation anxiety

Able to imitate selective activity

http://www.youtube.com/watch?v=ue8y-JVhjS0


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Sensorimotor Stage, Contd

Stage Four (8 - 12 mos)

Coordination of secondary schemata

New Adaptations and Anticipation (voluntarymovement in response to stimuli that can't be seen )

Intentionality occurs in interactions withthe environment and the infant is movingtowards goal directed behavior: works toget toy that is out of reach

Fully developed object permanence


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Stages of Sensorimotor Stage

1. Modification ofreflexes (0-1months)

Strengthens anddifferentiates reflexes

2. Primary CircularReaction (1-4 months)

Circular pattern ofhaving a stimulus andresponding

Focus is on own body

3. Secondary CircularReaction (4-8 months)

Focus is on the outsideworld

4. Coordination ofSecondary Schema (8-12

months) Goal oriented behavior

Apply ability to otherthings


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Moral development (Kohlberg) Level 1: Preconventional morality (0-9y) Stage 1: the punishment-and-obedience orientation.

Children determine the goodness or badness of anaction in terms of its consequences.

They avoid punishment and obey unquestioningly

those who have the power to determine andenforce the rules

They have no concept of the underlying moralorder


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Play Solitary Play:

When a child plays alone

even when with other

children


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Principles of Motor Development

Gross movements before finemovements

Pattern ofdevelopment is usually thesame, but the rate differs greatly from

child to child and from culture toculture.


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2-3 months


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First Month Turns head to clear nose from bed

Keeps hands fisted or slightly open

Head lag when pulled from lying to sitting

Second month Holds head up while on tummy almost 45

degrees

Third month Lift head and chest of the bed

Turns head to sounds

Reaches for objects with both hands

Gross Motor Development


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Fourth month

Rolls from back to side

Able to raise head and chest off surface to angle of 90

degrees

Fifth month

Rolls from abdomen to back

May sit if supported

When supine, puts feet to mouthSixth month

Transfer toy from one hand to next

army crawl on tummy

Rolls from back to abdomen


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Seventh month

Pushes up on hands and knees

Sits w/ little support When held in standing position

bounces actively

Eighth month

Sit without support Creeps

Stands leaning against something

Ninth month

May crawl upstairs


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Tenth month

Stands w/ little support

Cruises the room.

Eleventh month

Stands alone

Twelfth month

Walks


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At 4 month: brings handstogether and shake rattle

At 6 month: palmer grasp

At 7 month: pass object fromhand to another

At 8 month: advanced eye-

hand coordination

At 10 month: pincer grasp

At 12 month: holds cup orspoon

Fine Motor Behavior


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Hematologic System

Hgb A production

largely replaces Hgb F

by 4 months

(physiologic anemia

due to fetal RBCsdestruction)


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Respiratory System

RR slows 3060

Upper respiratory infections tend to bemore severe due to

small lumen of respiratory tract

inefficient mucus production.


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Become functioningat 2 months.

Produce both IgG &IgM antibodies by

the 1st year.

Immune System


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Emotional

At 6 weeks: social smile

At 4 months: recognize his primarycaregiver.

At 7-8 months: stranger anxiety,continue until 12 months.

At 8 months: separation anxiety,continue until preschool period.

Both are related to infants ability todiscriminate between familiar and

nonfamiliar people


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Dentation

First tooth erupt 5-7 months

Has 6-8 deciduous teeth by the 1st yearof age.

The sequence of eruption is:At 6 months: lower central incisors.

At 7 months: lower lateral incisors.

At 8 months: upper central incisors.

At 9 months: upper lateral incisors.


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GI System

Can digest protein at birth

Amylase deficiency until 3rd month of age(cannot digest complex CHO)

Lipase deficiency during entire 1st year

Infant needs frequent feedings

Extrusion reflex exists until 3-4 months

Introduction of solid food 4-6 months.


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Energy Requirement

Age Energy requirement

< 6 months Wt (kg) x 108/ day

6mo-1 year Wt (kg) x 98/ day


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Water requirements = amountfoods + fluids

Age Amount

3 days 80-100 ml/kg/day

10 days 125-150 ml/kg/day 3 mo 140-160 ml/kg/day

6 mo 130/155 ml/kg/day

9 mo 125-145 ml/kg/day

With BF and formula: none additionally needed infirst 4 to 6 months


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Infant Nutrition

Birth through 4-6

months

Breast milk

OR

Iron-Fortified infantformula


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Breast- Versus Bottle-Feeding

Debate focused on whether breast-feeding is better forthe infant than bottle-feeding

American Pediatric Association strongly endorses breast-

feeding throughout the first year of life Benefits

Appropriate weight gain

Fewer allergies

Fewer illnesses Reduced childhood cancer and reduced incidence of breast

cancer in mothers and their female offspring

Lower incidence of SIDS

Stronger attachment bond


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4 through 7 months

Breast milk

OR

Iron-Fortified infant formula

Iron-Fortified infant cereal

Vegetables

Fruit

Infant Nutrition


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8 through 11 months

Same as 4 through 7 monthsPLUS

Meat

Egg yolks

Infant Nutrition


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11 months

Finger foods Cup

Infant Nutrition


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Tips for Introduction of

Solid Foods

Start slowly

Only 1 new food every 4-5 days

Hold baby during feeding

First food: Iron-Fortified infantrice cereal


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Tips for Introduction of

Solid Foods

Use single-ingredient foods

Read food labels

Avoid desserts

Avoid foods that can chokeinfants


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Feeding Problems

Colic (


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Common Health Concerns

Teething: gum sore, tender can lead todecreased intake and cry.

Thumb sucking: does not deform the jaw aslong as it stops by school-age.

Diaper dermatitis: prolong contact with urine orfeces.

Constipation: increased with formula fed.

Sleep problems: as a result of colic or otherhealth problems.


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Documents

5. Infancy Period MK (2)