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Growth and development of an infant in the various domains - physical, psychosocial, cognitive, psychosexual, spiritual and moral. Also discusses the special health concerns during infancy.

Growth and development of an infant in the various domains - physical, psychosocial, cognitive, psychosexual, spiritual and moral. Also discusses the special health concerns during infancy.

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  • 1. GROWTH & DEVELOPMENT
  • 2. Growth and Develo pment as a unit expresses th e sum of nu merou s changes that take p lace durin g the life c ycle of an indivi dual. The entire cour se is a dynamic p rocess that encom passes several int er-related d i mensions.
  • 3. WHY STUDY GROWTH & DEVELOPMENT?
    • Know what to expect of a child at any age
    • Know certain behaviours that are likely to emerge in mature forms
    • Assess the sequence and norms of G & D of a child
    • Know how to influence G & D favourably
    • Diagnose undernutrition, infectious and other diseases affecting G & D
    • Recognize the potential problems and strengths of individual children & their parents
    • Plan for comprehensive care of the child
    • Work with children effectively in health & disease
  • 4. STAGES OF GROWTH & DEVELOPMENT
    • Prenatal period (Conception to Birth)
    • Infancy ( Birth to 12 months of age )
    • Early Childhood ( 1 – 6 years)
    • Middle Childhood (6 – 12 years)
    • Late Childhood (12 – 19 years)
  • 5. PRENATAL GROWTH
    • Zygote – Increased cell organization and differentiation into three basic layers – Ectoderm, Mesoderm, Endoderm.
    • Embryo – Marked organization upto 8 weeks.
    • Fetal phase – 8 weeks to 40 weeks (birth).
    • - Increases in length and weight
    • - Linear growth with maximum velocity
    • at 4 months
  • 6. GROWTH & DEVELOPMENT IN INFANCY
  • 7. INFANCY
    • Neonate – Birth – 28 days ( Early and late neonatal period)
    • Infancy - 28 days – 12 months
    • - Rapid motor, cognitive, and social development
    • - Trust, physical adjustment to outside
    • - Psychological adjustment of parents
  • 8. GROWTH & PHYSICAL MATURATION
  • 9. WEIGHT
    • NBB – 2.7 – 3.9 Kg ( Av 2.5 Kg )
    • 0 – 7 days – 10% loss of Birth weight
    • 10 th day - Lost weight wt regained
    • 0 – 6/12 yr - > by 30 gms / day OR 150 gms / wk
    • 5 – 6/12 yr – Birth weight doubled
    • 7 – 12 “ - > by 15 gms / day OR 75 gms / wk
    • 1 year - Birth weight trebled
    • There after - > by 2.2 Kg / year
    • 2½ Year - Birth weight Quadrupled
  • 10. HEIGHT (LENGTH)
    • NBB – 50 cms (20”) + 2 cms
    • First 6 months - > by 2.5 cms / month
    • Later 6 months- > by 1.25 cms / month
    • 1 – 2 year - + 12.5 cms (5”)
    • 2 – 12 years - 6.25 – 7.5 cms / yr
    • 4 years - Birth height doubled
    • 13 years - Birth height trebled
  • 11. OCCIPITO-FRONTAL CIRCUMFERENCE (OFC)
      • NBB – 35 cms ( 1.25 – 2.5 cms > Chest Circumference)
      • 0 – 3 months - > by 2 cms / month
      • 3 – 12 months - > by 2 cms / 3 months
      • 1 – 3 years - > by 1 cm / 6 month (Equals chest
      • circumference 1 yr)
      • 3 – 5 years - > by 1 cm / year
      • 5 – 6 year - Adult head size
    • Thus, OFC at -
    • 1 year - 47 cms
    • 2 years - 49 cms
    • 3 years - 50 cms
    • 4 years - 50.4 cms
    • 5 years - 50.8 cms
    • 10 years - 53 cms
    • 15 years - 55 cms
    • Fontanelle closure –
    • Post - 6 – 8 wks
    • Ant – 12 – 18 months
    • Increase of brain weight –
    • By 2½ times in the first year
  • 12. CALCULATION OF ANTHROPOMETRICAL PARAMETERS
    • WEIGHT –
    • 3 – 12 MONTHS – Age ( months ) + 9 K g
    • 2
    • 1 – 6 YEARS - Age ( Years) x 2 + 8 Kg
    • 7 – 12 YEARS - Age (Years) x 7 + 5 Kg
    • 2
    • HEIGHT –
    • 2 – 12 YEARS – Age (Years) x 6 + 77 (cms)
    • Future (Adult) height – Girls – Ht at 2 yrs x 2
    • Boys – Ht at 2½ yrs x 2
    • OFC
    • Infant - Length (cm) + 9.5 cms
    • 2
  • 13. Mnemonic for Growth and Development 52 50 48 45 40 35 OFC 100 90 75 50 Ht (Cm) X 10 X 6 X 5 X 4 X 3 X 2 3 Wt (Kg) 10 7 5 4 3 2 1 5/12 3/12 0 Age (yrs)
  • 14. CHEST CIRCUMFERENCE & MUAC
    • Chest Circumference
    • - 33 cms at birth, barrel shaped
    • - At 1 year Transverse diameter > AP diameter by 25 %
    • - At 6 years transverse diameter > AP diameter by 33 %
    • 6 months – 39 cms
    • 1 year - 45 cms (Equals OFC)
    • 2 years - 49 cms
    • 5 years - 55 cms
    • 10 years - 64 cms
    • 15 years - 77 cms
    • MUAC (Mid upper arm circumference) – NBB – 14.5 cms
    • 1 year – 16 cms.
    • Then > by 0.25 cm / yr
  • 15. BODY PROPORTIONS
    • Big heads, large trunk, short
    • extremities upto 2 years
    • Mid point of body
    • - In infants - 1.8 cms above
    • umbilicus
    • - At 2 years - Just below umbilicus
    • - In adults - At symphysis pubis
    • Sitting Height
    • - At Birth – 70% of total length
    • - At 3 years – 57%
    • - At Puberty - 53%
  • 16. CARDIO-CASCULAR SYSTEM
    • Heart – Transversely placed, Apex beat at IV ICS
    • H R – NBB – 140/mt, 5 yrs – 100/mt, 10 yrs – 90/mt,
    • 12 yrs – 85/mt, 15 yrs – 80/mt
    • Sleeping Pulse Rate – 10 – 20 beats lower
    • BP – 80/50 …. 90/60 mm Hg
    • Systole rises in the 2 nd month
    • Diastole falls in the first 3 months, then gradually
    • rises
  • 17.
    • Hematological system
    • Hb F – The primary Hb for the first 2 -3 months
    • ( >>> Physiological Anemia )
    • then Hb A increases upto 6 months
    • Respiratory System
    • Resp rate – 50 – 35/ mt
    • Abdominal & diaphragmatic
    • Trachea close to bronchi, narrow lumen
    • Short straight eustachean tube
    • < IgA in mucosal lining
  • 18.
    • Lymphatic System – Hyperplastic in children. Resolves after puberty
    • Nervous System –
      • NBB – Brain wt – 10% of body weight
      • Infancy – Rapid brain growth. 80% achieved by 4
      • yrs
      • Myelination begins after 3 months, completed by 2
      • years
      • Primitive reflexes replaced by righting reflexes &
      • voluntary, purposeful movements
  • 19. GASTRO-INTESTINAL SYSTEM
    • Salivation begins at 3 months
    • Stomach capacity – 90 ml at birth, 360 ml at 1 yr
    • Enzyme amylase inadequate – Poor digestion of complex CHO
    • Liver immature throughout infancy
    • By 1 yr – 3 meals + 1 bed time feed
    • - 1 or 2 bowel movements
  • 20.
    • Immunologic System
    • - Maternal IgG upto 3 months
    • - Synthesizes IgG (40% of adult levels) by 1 year
    • - IgM produced at birth. Adult levels by 9 months
    • - IgA production gradual. Adult levels by puberty
    • Skin – Absent shivering and sweating at birth
    • - Accumulation of adipose tissue in 6 months
    • ( helps insulation)
  • 21.
    • Fluid & Electrolytes
    • NBB – 75% of total body wt is water
    • - ECF vol is 40% which <es to 20% in adulthood
    • Renal System – Immature at birth
    • Complete maturity in 18 to 24 months
    • Urine Sp.Gr – 1000 – 1010
    • Dentition – Begins at 6 – 12 months
    • By 3 yrs – all 20 teeth
    • Rule – Age (months) -6 = No of teeth
    • Permanent teeth by 6 – 12 years
  • 22. SPECIAL SENSES
    • Hearing – Acuity at adult levels at infancy
    • 6 months – can differentiate familiar voices
    • 7 months – vestibular function begins
    • Short ext auditory meatus & Eustachian canal
    • Visual – Low acuity. Hypermetropic
    • 6 wks – 4 months – Binocularity well estd.
    • 7 -12 months – Stereopsis ( depth perception) begins to develop
  • 23. MOTOR DEVELOPMENT
  • 24. GROSS MOTOR (Devt.al maturation in posture) General movements Head balance (3/12) Rolling over (5/12) Sitting with support (4/12) Crawling & Creeping (8/12) Standing (10/12) Walking (1 yr)
  • 25. Sitting without support…
  • 26. Standing with support Coo, that’s How it looks to Ma and Pa!
  • 27. FINE MOTOR
    • Use of hands and fingers in prehension
    • Grasp reflex at 0 – 3months
    • Palmar grasp
    • Crude pincer grasp – 8-9 months
    • Neat pincer grasp – 11 months
    • Builds a tower of 2 blocks by 1 year
  • 28. PSYCHOLOGICAL DEVELOPMENT
  • 29. Psychosocial Development
    • Reflex behaviour – parent, peer response
    • 1 month – Social smile, 4 months – laughs aloud
    • Play helps socialize
    • Attachment- Indiscriminate response. cry, smile
    • Vocalize more to mother, distinct preferences
    • 6 months – ‘peekaboo’, asks to be carried
    • - Stranger anxiety & separation anxiety
    • Eric Erickson- Trust Vs Mistrust
    • - 3-4 months – Oral phase (pri narcissism)
    • - 5-12 months – Social phase
  • 30.
    • Language
    • Cry – for displeasure and pleasure
    • 2 months – ah, eh, uh….
    • 3 months – coos, gurg;es, laughs (n,k p, g)
    • 8 months – Imitates sounds t,d,w
    • 9-10 months – Understands ‘NO’, obeys simple commands
    • 1 yr – 3-5 words with meaning
    • Play – Sensorimotor, narcissistic, dependant, solitary
    • - Laughs, peekaboo, pat-a-cake, repetition, imitation
    • - Selective after 6-8 months ( No strangers!)
    • Sleep – 0-6 months – 18-20 hrs /day
    • - 6-12 months – 16-18 hrs/day
    • - 2-4 yrs - 12-16 hrs/ day
    • - 5-10 yrs - 10-12 hrs/ day
    IMPORTANT – Not only ‘to play’, but to be ‘played with’.
  • 31.
    • Psycho- sexual development
    • Sigmund Freud – Oral phase
    • Cognitive ( Intellectual) development
    • Jean Piaget – Sensorimotor Phase ( 0-2 yrs)
    • - Use of reflexes, deliberate acts, repetitive acts(4-8 months), object permanence(10 months), develops self image by 1 yr
  • 32. SUMMARY OF MILESTONES OF DEVELOPMENT
    • 1 Month - Social Smile
    • 2 Months - ah, eh, uh sounds
    • 3 months - Head holding
    • 4 Months - Grasps objects, sits with support
    • 5 Months - Rolls over
    • 6 months - Sits without support
    • 7 Months - Crawls & creeps
    • 8 Months - Thumb- finger prehension
    • 9 months - Pulls up to sit, stands with support
    • 10 Months - Walks with support
    • 11 Months - Stands with support
    • 12 months - Takes a few steps by self
  • 33. NEEDS & SPECIAL CONCERNS IN INFANCY
    • Love & security ( warmth, support to head & neck)
    • Nutritional needs – 120 Cal/Kg (0-6 month), 100 Cal/Kg (6-12 months), Protein 5-3 gm/Kg. Weaning, prevent obesity
    • Protection from infection (skin, eye, ear, oral, GIT, Resp, umbilical).
    • Personal hygiene
    • Protection from accidents
    • Promotion of growth & development
    • Promotion of play
    • Care in teething, thumb sucking
    • Sleep & activity, infant shoes
    • Dental health
    • Regular medical check up
    • Psychological needs - Care to prevent separation anxiety
    • - Encourage inquisitive behaviour
    • - Develop sensory perception
    • - Avoid unpleasant tastes
    • - Avoid painful experiences
  • 34. Thank you !