Human development during birth and postnatal period

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Human development during birth and postnatal period

  1. 1. Infants : Birth – 12 Months D u ring th e firs t 1 2 m o nth s of life , an infant’s growth and d e ve lop m e nt occu r ve ry rap id ly.Mu ch of wh at h ap p e ns d u ring th is p e riod lays th e fou nd ation for a p e rs on’s ongoing d e ve lop m e nt.Th e re fore , it is im p ortant to u nd e rs tand wh at norm al d e ve lop m e nt d u ring th is tim e p e riod lo oks like ,s o th at if s om e th ing ap p e ars to b e off track, e arly inte rve ntions can occu r. Normal Development: OverviewS ocial Development B irth to One Year: Th e m os t im p ortant s ocial tas k is th e b ond ing and d e ve lop m e nt of attach m e nt to th e p rim ary care take r, m os t ofte n th e ch ild ’s m oth e r. Attach m e nt is re qu ire d for th e late r d e ve lo p m e nt of re cip rocal conne cte d ne s s d u ring tod d le r h ood , and u ltim ate ly for th e d e ve lop m e nt of inte rp e rs onal s kills , s ocial inte gration, and e m p ath y for oth e rs . Alth ou gh d e ve lop m e ntally s e ns itive , th is p roce s s goe s on th rou gh ou t infancy, ch ild h ood and ad ole s ce nce . Th e failu re to form an attach m e nt is like ly to b e m ore d e trim e ntal th an s u ffe ring a d is ru p tio n to an e xis ting conne ction. S u ch failu re m ay b e th e re s u lt of re p e ate d ch ange s in p rim ary care give rs as m ay b e th e cas e for an infant wh o
  2. 2. Phys ic al Development G es tation: P rior to b irth , th e fe tu s e xp e rie nce s rap id b rain growth , e s p e cially d u ring th e las t trim e s te r. Be cau s e of th is , wh e n th e infant is b orn, th e h e ad accou nts for 1 / 4th of th e ir e ntire b od y. As th e y grow and d e ve lop , th is grad u ally re d u ce s , and b y ad u lth ood th e h e ad accou nts fo r 1 /7th of th e b od y. Th e infant is b orn with ove r 1 00 b illion ne rve ce lls , and th e s e continu e to m u ltip ly afte r b irth , as th e infant is s tim u late d p h ys ically and s ocially. B irth to One Year: Th e b e ginnings of m as te ry ove r one ’s b od y is th e infant’s p rim ary p h ys ical tas k. Th e e m e rge nce , re fine m e nt, and coord ination of s e ns ory and m otor s kills cu lm inate in walking b e h avior ab ou t age one . D e ve lop m e nt p rogre s s e s from th e h e ad d own and from th e ins id e ou t. Th e b rain and ce ntral ne rvou s s ys te m s are th e firs t to b e gin to d e ve lop , and inte rnal organs will d e ve lop b e fore e xtre m itie s .E motional Development B irth to One Year: Th e d e ve lop m e nt of b as ic tru s t, a d e rivative of th e attach m e nt of th e infant to th e p rim ary care take r, occu rs d u ring th e firs t ye ar. Th is is a corne rs tone of e m o tional d e ve lop m e nt.
  3. 3. C ognitive Development G es tation: We now know th at s om e cognition b e gins in th e wom b ; ne wb orns are ab le to re cognize th e ir p are nts ’ voice . B irth to One Year: C ognition b e gins with ale rtne s s , aware ne s s , re cognition, and inte re s t in vis u al, au d itory and tactile (tou ch ) s tim u li. As m otor d e ve lop m e nt im p rove s , th e infant b e gins to e xp lore and m anip u late ob j cts and d e ve lop s a e ru d im e ntary u nd e rs tand ing of th e ir p rop e rtie s . Infants d e ve lop ob j ct p e rm ane nce e toward th e e nd for th e firs t ye arS exual Development B irth to One Year: Th e infant’s s e xu al d e ve lop m e nt b e gins with th e ir o rally fixate d b e h avior. Th is b e h avior allows th e m to b e gin to e xp lore not only th e ir world , b u t als o th e ir b od y. S e lf- e xp loratio n b e gins m os t fre qu e ntly with finge rs , and th e n toe s . It p rogre s s e s d u ring th e firs t ye ar to inclu d e oth e r b od y p arts , inclu d ing ge nitalia. D u ring th e firs t ye ar, infants are m aking ob s e rvations ab ou t th e ir world . Th e s e ob s e rvations le ad to a s e ns e of tru s t in th e ir world , and p rovid e a fou nd ation for th e infant’s fu tu re u nd e rs tand ing of ge nd e r ru le s and role s th at s h ap e one ’s ge nd e r id e ntity.
  4. 4. Normal Development: A B reakdown by A geS ocial Development B onding and A ttachment are p roce s s e s th at p re d o m inate th e firs t ye ar of life . B onding is a b iological p roce s s th at occu rs as a ne wb orn ch ild b e gins to find com fort in th e ir world . If, as a re s u lt of th is p roce s s , th e y are ab le to find a s p e cific p e rs on th at th e y want to b e clos e to and e nvironm e ntal cond itions p e rm it, th e proces s of attachment b e gins . Th is attach m e nt p roce s s le ad s to th e ch ild ’s s e ns e of tru s t in th e world .B onding: • th e d e s ire to h ave clos e ne s s to • can occu r to s om e th ing, o r s om e one – b lanke ts , toys or p e op le • a b iological and ins tinctive p roce s s th at occu rs natu rallyA ttachment: • th e d e s ire to b e clos e to a s p e cific p e rs on or p e rs ons , u s u ally th e care give r • h as anoth e r p e rs on as its ob j ct e • d e m ons trate d b y: - re s p ons ive ne s s (s m iling wh e n s om e one is ne ar; u p s e t wh e n th e y le ave ) - s e e king ou t p h ys ical clos e ne s s to s om e one
  5. 5. Birth to Three Months :D u ring th e firs t th re e m o nth s of life , m u ch of th e ne wb orn’s s ocial d e ve lop m e nt is d e p e nd e nt u p on th e ir s tate of ale rtne s s . • In th e active ale rt s tate , th e ne wb orn is ve ry involve d with th e ir e nvironm e nt: ofte n looking arou nd , lis te ning to variou s s ou nd s and re s p ond ing to s tim u li. • In th e qu ie t ale rt s tate , th e ne wb orn is aware of th e ir e nvironm e nt, s till looking an d lis te ning to th e ir e nvironm e nt, b u t th e y are u s u ally qu ie te r and le s s p h ys ically active . • In th e d rows y s tate , th e ne wb orn is u s u ally ve ry q u ie t and non-re s p ons ive to e nviron m e ntal s tim u li; th e y are re ad y to fall as le e p , b u t not ye t s le e p ing.
  6. 6. D u ring th is e arly tim e , th e p roce s s of b ond ing b e gins . Bond ing occu rs as a ch ild b e gins to le arnab ou t th e u niqu e fe atu re s of th e ir care give r, and can occu r with anyo ne or anyth ing. Th e p roce s sof b ond ing o fte n occu rs d u ring th e qu ie t ale rt s tate . Be h aviors s u ch as s u cking, rooting, gras p ing,and cu d d ling allow th e infant to b e gin th is innate and ins tinctive p roce s s th at is s im ilar to th eim p rinting p roce s s in anim als . Two-we e k-old M ich ae l lays in h is m oth e r’s arm s s wad d le d tigh tly in h isb lanke ts . H e is m oving h is h e ad arou nd and rooting, looking fo r h is food . As h e b e gins tonu rs e , h is e ye s re m ain op e n and h e ap p e ars aware of h is e nvironm e nt. H is ab ility to s e e is ap p roxim ate ly 8 – 1 0 inch e s away from h is face , wh ich allows h im to vis u allyu nd e rs tand th e im p ortance of h is m oth e r and is d e ve lop ing a b ond .C re ating a b ond with th e care take r is u nid ire ctional, or a one -way re lations h ip th at th e ch ild iscre ating. Th is b ond ing p roce s s will allow for th e d e ve lo p m e nt of an attach m e nt. O nly if th e s e h aveoccu rre d can re cip rocal conne cte d ne s s b e ach ie ve d .A good tim e to as s e s s infants for th e ir p h ys ical and s ocial d e ve lop m e nt is wh e n th e y are in th e iractive ale rt s tate . M any of th e inte ractions th at an infant e xp e rie nce s d u ring th is tim e le ave as trong im p re s s ion on th e ch ild .If an as s e s s m e n t is atte m p te d d u ring th e qu ie t or d rows y s tate , th e as s e s s m e nt m ay b einaccu rate , as th e ch ild is not fu nctioning at h is d e ve lop m e ntal p e ak. It is als o im p ortant tou nd e rs tand th at wh e n a ch ild is in th e d rows y s tate , th e y are not like ly to b e e as ily e ngage d .
  7. 7. Three to S ix MonthsBy th e age of th re e m onth s , infants are vis ib ly re s p ons ive to s ocial s tim u lu s , and will m ake e yecontact, s m ile , lau gh , vocalize s ou nd s and p h ys ically re act in a volu ntary way to oth e r p e op le . Th e yh ave als o m ove d from re fle xive re s p ons e s to m ore co ntrolle d m ove m e nts and inte ractions . Th e s em ove m e nts b e gin to b e com e a ch ild ’s way of p laying, and als o d e m ons trate h ow th e ch ild is m ovingfrom b ond ing to d e ve lop in g attach m e nts .Accord ing to P e rry (2002), attach m e nt is "a s p e cial e nd u ring form of ‘e m otional’ re lations h ip with as p e cific p e rs on." P e rry fu rth e r p os tu late s th at s ince no h u m an b e h avior is m aintaine d with ou tre ward , attach m e nt re qu ire s "re ward ". M os t ofte n th is ‘re ward " com e s in th e form of s ooth ing,com fort and / p le as u re . orTh is m ove m e nt toward d e ve lop ing an attach m e nt b e com e s notice ab le as th e ch ild b e gins to s h owp re fe re ntial re s p ons e s , s u ch as a s m ile , to p e op le th at are fam iliar to th e m . Th e y m ay s h owe xcite m e nt at a p e rs on’s arrival and m ay e ve n b e gin to s h ow d is p le as u re for th e ir d e p artu re b y th eage of s ix m onth s . F ou r-m onth -old S am anth a is laying on a b lanke t, and s qu e als with a s m ile as th e toy in h e r h and s qu e aks . S h e th e n re -focu s e s on th e toy, and h e r face b e com e s m ore s e riou s . H e r m oth e r e nte rs th e room afte r h e aring th e s qu e al. S am anth a lifts h e r h e ad , s e e s h e r m oth e r and s m ile s .
  8. 8. S even to Twelve MonthsBy th e age of s e ve n m onth s , ch ild re n h ave b e gu n to d e ve lop a p h ys ical and cognitive le ve l th at h asth e m wanting and ab le to e xp lore th e ir e nvironm e nt, wh ich b e com e s th e p rim ary p u rp os e of p lay forinfants u nd e r th e age of 1 8 m onth s . Th e y h ave th e p h ys ical ab ility to m ove , and h ave co gnitives kills th at allow th e m to b e com e goal d ire cte d . S e ve n-m on th -old C h ris top h e r s e e s s om e colorfu l b u ild ing b locks acros s th e room . H e cre e p s with h is arm s and le gs to p u ll h im acros s th e room to re ach th e b locks . Wh e n h e ge ts th e re , h e u s e s h is wh ole h and to gras p and grab th e toy.
  9. 9. C h ild re n als o continu e to b e ve ry inte ractive with p e op le th at th e y h ave re lations h ip s with . Th e ywill m ake face s , lau gh and are u s u ally e as ily e ngage d in p lay. Th e y are now ab le to id e ntify andd is crim inate b e twe e n p e op le th at th e y know and th os e th e y d o not know, wh ich le ad to two ne wb e h avioral is s u e s in ch ild re n: S trange r anxie ty, or an infant’s fe e ling of d is com fort or u nh ap p ine s s arou nd u nfam iliar p e op le , m ay occu r d u ring th is tim e p e riod . O fte n at th is age , th e infant is s e e king ou t th e atte ntion of and inte ractions with , p e op le th at th e y are attach e d to, and b e com e u ncom fortab le arou nd p e op le th e y d o not re co gnize . Th is can le ad to variou s typ e s of p rote s t in re s p ons e to th e s itu ation. S e p aration anxie ty, or th e infant’s re action to a p are nt’s d e p artu re , als o b e gins u s u ally s om e wh e re arou nd th e age of 9 m onth s . Th e b e h avior re s u lting from s e p aration anxie ty can inclu d e a d is p lay of th e e m otions th at th e ch ild is fe e ling at th e tim e th e p are nt is trying to le ave .
  10. 10. Phys ic al DevelopmentB rain DevelopmentTh rou gh ou t th e firs t ye ar of life , th e b rain is th e m os t rap id ly d e ve lop ing organ in an infant’s b od y. Th e b rain’s d e ve lop m e nt lays th e fou nd ation and is th e catalys t for fu rth e r d e ve lop m e nt in all five d om ain are as , and is th u s fu rth e r e xp laine d h e re .Th e b rain is an organ th at is th e p rim ary ce nte r for: -R e gu lation and control of b od ily fu nctions and activitie s ; -R e ce p tion and inte rp re tation of s e ns ory d ata; -C ons ciou s ne s s , th ou gh t, m e m ory, and e m otions .Th e b rain: -C ons is ts of two h e m is p h e re s ; -E ach h e m is p h e re h as fou r lob e s ; -E ach lob e h as nu m e rou s fold s ; -Th e fold s m atu re (e .g., activate ) at varying tim e s d u ring th e ind ivid u al’s e arly ye ars ; -H as fou r s ys te m s (cortical, lim b ic, m id b rain, & b rains te m ).
  11. 11. B irth to Three MonthsAt b irth , ch ild re n are ofte n fou nd p h ys ically to b e looking "b e nt" from b e ing in th e ir m oth e r’swom b . Th is m e ans th e ir fe e t and le gs are b owe d and tu rne d inward , with th e ir kne e s b e nt u ptoward th e ir ch e s t. Th e ir ofte n s kinny loo king in th e ir lim b s and h ave a large rou nd e d b e lly. Th isap p e arance las ts for th e firs t s e ve ral we e ks of life .M os t of th e fe tu s and infant’s p h ys ical d e ve lop m e nt p rogre s s e s from th e h e ad d own and th eins id e ou t. Th is m e ans th at a b ab y’s b rain and ce ntral ne rvou s s ys te m d e ve lop b e fore th e irinte rnal organs afte r and th e u p p e r b od y d e ve lop s b e fore th e le gs and fe e t.N e wly b orn ch ild re n can s e e ap p roxim ate ly 8 – 1 0 inch e s away from th e ir face at b irth , wh ichallows th e m to s e e th e p e rs on fe e d ing th e m , and allows for s ocial inte ractions to b e gin with th e ircare take rs . Th is d is tance incre as e s grad u ally b y th e tim e th e infant re ach e s 4-5 we e ks of age .Ad d itionally, th e ne wb orn ch ild can re cognize voice s of variou s p e op le with in a fe w d ays of b irth ,and will "orie nt" to s ou nd s b y tu rning th e ir h e ad in th e d ire ction of th e s ou nd . As h le y, a s e ve n-we e k-old ch ild , lie s in h e r fath e r’s arm s looking at h is face as s h ed rinks from a b ottle . H e r m oth e r com e s in from th e lau nd ry room and th e d oor s lam sb e h ind h e r. H e r h e ad im m e d iate ly tu rns toward th e d ire ction of th e d oor.D u ring th e firs t th re e m onth s , th e infant is d e ve lop ing m u s cle co ntrol p rim arily in th e ir h e ad , ne ckand s h ou ld e rs . Th e ir h and s are ofte n fo u nd to b e in fis ts , and th e y e xh ib it a gras p ing re fle x th atwill cau s e th e m to clos e th e ir h and s arou nd an ob j ct. Th e s ignificant th ing ab ou t th is is th at it is ere fle xive , and not a volu ntarily controlle d m ove m e nt.
  12. 12. Three to S ix MonthsAs with th e ir s ocial inte ractions , m u ch of th e infant’s p h ys ical m ove m e nt th at was initiallyre fle xive , is now b e com ing qu ite controlle d . Th e ir h e ad control is now e xce lle nt as th e m u s cle s inth e ir u p p e r b od y h ave s tre ngth e ne d , and th e ir m otor d e ve lop m e nt b e gins to b e com e focu s e d onfine m otor s kills . If th e y grab at ob j cts , it is b e cau s e th e y want to h old it, and th e y m ay like ly p u t eit into th e ir m ou th , b e ginnin g to s h ow h and / ye coord ination. Ad d itionally, th e y m ay b e gin to ed e ve lop h and -to-h and m ove m e nts , alth ou gh th e re will b e no cle ar ind ication of a h andp re fe re nce u ntil th e age of 1 2-1 8 m onth s .Th e re is als o a rap id e xp ans ion in th e ir gros s m otor d e ve lop m e nt, and b y th e age of 5 m onth sth e y are b e ginn ing to d e ve lop th e ir lowe r b od y coord ination. Th is m e ans th e y b e gin to b e ab le tos u p p ort we igh t on th e ir le gs , roll th e m s e lve s ove r, and p ote ntially e ve n acros s th e room ! R e m e m b e r s e ve n-m onth -old , C h ris top h e r, wh o s e e s s om e colorfu l b u ild ing b locksacros s th e room ? H e cre e p s with h is arm s and le gs to p u ll h im acros s th e room to re ach th eb locks . Wh e n h e ge ts th e re , h e u s e s h is wh ole h and to gras p and grab th e toy. H is s ocial d e ve lop m e nt h ad h im wanting to p lay with th e ob j cts , and h is p h ys ical d e ve lop m e nt eallowe d h im to m ake th at actu ally h ap p e n.
  13. 13. S even to Twelve MonthsBy th e age of s e ve n m onth s , infants h ave no w d e ve lop e d u p p e r b od y s tre ngth and coord inate dle g m ove m e nts th at allow th e m to s it and th e n b e gin crawling. S oon, th e y will h ave th e ab ility tos u p p ort we igh t on th e ir le gs with ou t s u p p ort, b u t will h ave little b alance . Th e y will work onincre as ing th e ir le g s tre ngth and im p roving th e ir b alance b y p u lling u p on ob j cts th at will h e lp es tab ilize th e m , and s om e m ay e ve n b e gin walking. N ine -m onth -old B rooke crawls acros s th e room to th e cou ch and p u lls h e rs e lf u p to a s tand ing p os ition. S h e can s tand for a long p e riod of tim e , as long as s h e is h old ing onto s om e th ing. S h e m ay le t go b rie fly, b u t will re s u m e contact to ke e p h e r b alance . Th is ish ow s h e p ractice s incre as ing h e r s tre ngth and d e ve lop ing h e r b alance .Infants will als o b e working on th e ir fine m otor s kills . Th e ir h and -e ye coord ination is im p roving, b u tinitially, th e y d o not h ave th e ab ility to u s e th e ir th u m b op p os ite th e ir finge rs to p ick u p or m o veob j cts . Th e y ofte n re s ort to "raking" th e ir h and s ove r s om e th ing to grab onto it. H owe ve r, d u ring eth is s ix-m onth p e riod , th e y will d e ve lop th e ab ility to p u t th e ir h and ove r an ob j ct and p ick it u p eand m ove it wh e re th e y want it to go. Te n-m onth -old D om inic is s itting in h is h igh ch air with ce re al in front of h im to e at. H ep icks u p th e p ie ce s , one at a tim e , clos ing h is th u m b and fore finge r ro u nd e ach p ie ce . H eth e n p u ts th e m into h is m ou th and e ats it.
  14. 14. E motional DevelopmentB irth to Three MonthsO ne of th e m os t notice ab le p ie ce s of an infant’s e m otional s tate is th e ir te m p e ram e nt, or th e way a ch ild re s p ond s to th e ir e nvironm e nt. D e b ate continu e s ab ou t to wh at e xte nt ou r b e h avior and p e rs onality traits are ge ne tic, b iological or a fu nction of inb orn te m p e ram e nt. To wh at e xte nt d o e arly life e xp e rie nce s s h ap e and influ e nce th e d e ve lop ing ind ivid u al?O ne s tu d y th at followe d infants into ad u lth ood and as s e s s e d th e ir te m p e ram e nt fou nd b ab ie s fit into th e followin g fou r cate gorie s : • E as y b ab ie s (40% ) s h owe d p os itive m ood , re gu lar b od y fu nctions , ad ap te d we ll, and ap p roach e d rath e r th an with d re w from ne w s itu ations . • D ifficu lt b ab ie s (1 0% ) d is p laye d ne gative m ood , we re s low to ad ap t, with d re w in nove l s itu ations , and we re irre gu lar in b iological fu nctioning. • S low-to-warm b ab ie s (1 5% ) we re s im ilar to th e d ifficu lt b ab ie s , b u t re acte d with le s s activity and inte ns ity. • Mixe d b ab ie s (35% ) d is p laye d com b inations of all of th e traits .Th e ch ild re n with d ifficu lt te m p e ram e nts d e ve lop e d th e m os t e m otional and b e h avioral p rob le m s ove r tim e . R e s e arch e rs conclu d e d th at th is was d u e to an inte raction b e twe e n natu re and nu rtu re .C h ild re n with d ifficu lt te m p e ram e nts we re m u ch m ore like ly to e xp e rie nce ne gative re s p ons e s from oth e rs as th e y d e ve lop e d . Th e s e ch ild re n we re m ore like ly to "trigge r" th e ir p are nts , cau s ing ne gative p are ntal attitu d e s and re actions and p rovoking old u nfinis h e d is s u e s to
  15. 15. Three to S ix MonthsD u ring th is th re e -m onth p e riod , an infant h as d e ve lop e d cle arly re cognizab le te m p e ram e nt andvariou s e m otional s tate s inclu d ing p le as u re , ange r, p ain fe ar, and p rote s t. Th e s e s tate s are ve ryap p are nt in th e ch ild at any p oint in tim e . Th e ir te m p e ram e nt continu e s to b e d e ve lop e d b y th einte ractions b e twe e n th e m and th e ir e m otional s tate and th e p are nt’s re s p ons e to th e ir b e h aviors .S even to Twelve MonthsIs s u e s arou nd s trange rs and s e p aration th at m ay h ave aris e n p re viou s ly as p art of th e ch ild ’ss ocial d e ve lop m e nt, ofte n continu e to b e p re s e nt u ntil th e age of one ye ar. E m otionally, ch ild re nare continu ing to s tre ngth e n th e ir attach m e nt to th e ir care give rs and e nj inte racting with th e ir oycare give rs . Th e y continu e to op e nly d is p lay a range of e m otions and are b e ginning to d e ve lop as e ns e of tru s t in th e ir world .As a ch ild re ach e s th e age of twe lve m onth s , th e y are b e ginning to focu s on th e d e ve lop m e nt ofth e ir au tonom y, or ind e p e nd e nce from th e ir p rim ary care give r. Th is ab ility to d iffe re ntiate isne ce s s ary for th e h e alth y d e ve lop m e nt of th e p e rs onality.If th e ch ild h as a p os itive attach m e nt to th e care give r, th e y are m o re like ly to e xp lore th e ire nvironm e nt, b u t will re tu rn to th e p are nt for re as s u rance or com fort afte r tim e , or wh e nd is tre s s e d .Ad d itionally, as ch ild re n b e gin to d e ve lop th e ir au to nom y, wh ich is facilitate d b y th e ir p h ys icald e ve lop m e n t, tantru m s m ay b e gin to ap p e ar. Th e ge ne rally p lacid , frie nd ly, re s p ons ive , andcoop e rative ch ild s u d d e n ly b e com e s willfu l, u ncoop e rative and s tu b b orn. Afte r com ing b ack into th e h ou s e , Alana atte m p ts to re tu rn to th e p o rch . Wh e n h e rm oth e r, wh o p icke d h e r u p and told h e r s h e cou ld not go ou ts id e , s top s h e r, Alana b e gins tocry and m ove h e r b od y ab ou t e xp re s s ing h e r d is p le as u re .
  16. 16. C ognitive DevelopmentBirth to Three MonthsD u ring th e firs t th re e m o nth s of life , a s ignificant ch ange in a ne wb orn’s cognitive d e ve lop m e ntcan b e notice d . Initially at b irth , an infant’s re s p ons e s are ve ry re fle xive , or u ncontrolle d . Th e ycry b e cau s e th e y ne e d s om e th ing, b u t it is initially d ifficu lt to te ll wh at th e y want or ne e d .H owe ve r, with in a m onth , infants b e gin to b e ab le to d is tingu is h wh at it is th e y want and / orne e d , and in tu rn, m ake oth e r s ou nd s th at re fle ct wh at th e y want. S om e d iffe re ntiation in th e ircry b e gins to ap p e ar and is id e ntifiab le to a care give r. Th is will fu rth e r d e ve lop into s qu e als andcooing s ou nd s , and e ve ntu ally th e y will b e gin vocally inte racting with a care take r as if inconve rs ations . B y th e age of th re e m onth s , it is like ly th at one can e as ily id e ntify fe e lings ofp le as u re and u nh ap p ine s s in th e infant.
  17. 17. Three to S ix MonthsO b j ct p e rm ane nce is one of th e m os t s ignificant cognitive m ile s tone s , and it is not ye t ep re s e nt d u ring th is p e riod of growth & d e ve lop m e nt in ch ild re n. O b j ct p e rm ane nce is p art eof P iage t’s th e ory ab ou t a p roce s s in wh ich a ch ild b e gins to u nd e rs tand th at j s t b e cau s e uth e y d o not s e e s om e th ing (e .g., a toy), d oe s not m e an th at it d oe s not e xis t. C h ild re n in th isage ran ge d o not ye t h ave th is u nd e rs tand ing. If an ob j ct is ou t of th e ir s igh t, it is econs id e re d ou t of m ind , like it d oe s not e xis t at all. Je nnife r and h e r m oth e r are in th e fam ily room p laying with a b all. Je nnife r’sm oth e r h id e s th e b all b e h ind a b ox ne xt to h e r. N ow, h e r m oth e r s its with a b lanke t.Je nnife r m ove s to h e r m oth e r and p icks u p th e b lanke t, wh ich is s om e th ing ne w th at s h eh ad not p laye d with b e fore . It is in h e r fie ld of vis ion, and s h e find s it inte re s ting. S h eh as forgotte n th e b all and now p lays with th e b lanke t ins te ad b y p u tting it in h e rm ou th .Je nnife r is too you ng to h ave d e ve lop e d ob j ct p e rm ane nce , b u t s h e d oe s h ave atte ntion to eob j cts , wh ich is a critical com p one nt of cognitive d e ve lop m e nt th at will u ltim ate ly h e lp le ad eto th e d e ve lop m e nt of ob j ct p e rm ane nce . e
  18. 18. S even to Twelve MonthsU ntil th is tim e , ch ild re n fu nction in an "ou t of s igh t, ou t of m ind " p e rs p e ctive . Th is now b e gins toch ange as th e ch ild ap p roach e s th e age of one and d e ve lop s a s e ns e of ob j ct p e rm ane nce . eTh e y b e gin to u nd e rs tand th at j s t b e cau s e th e y cannot s e e s om e th ing d oe s not m e an th at it uis n’t s om e wh e re th at th e y can find . Ju nior, age 1 2 m onth s , is p laying with a footb all in th e b ack yard with h is u ncle . H is u ncle take s th e footb all wh ile Tyrone is watch ing, and h id e s it u nd e r a towe l. Tyrone goe s to th e towe l and p icks it u p , and ge ts th e footb all.Ju nior h as d e ve lop e d an e arly s tage of ob j ct p e rm ane nce . H e is ab le to s e arch for th e footb all eb e cau s e h e watch e d h is u ncle h id ing it. If h e h ad not s e e n h is u ncle h id e it, h e wou ld not h avecontinu e d looking for it. C h ild re n are s ch o ol-age d b e fore th e y wou ld h ave b e gu n to wond e r wh ath ap p e ne d to it and inve s tigate wh e re it h ad gone .Th is is als o p art of e arly p rob le m s olving in p e op le . Infants d e ve lop th e ab ility to m o ve ob j cts ewh e re th e y want th e m , and m ay e ve n p u ll at th ings to s e e if th e y will com e ap art. Th is m ay b es om e th ing th at th e y d o ove r and ove r again, wh ich allows for re p e tition and m as te ry ove r tas ks ,wh ich lays a fou nd ation for atte ntion s p an d e ve lop m e nt. Th e clos e r th e y ge t to th e age of one ,th e m o re goal d ire cte d th e ir b e h aviors b e com e , and th e b e tte r at p rob le m s olving th e y m ay b e . 1 1 -m onth -o ld Lou is s e e s h is m oth e r p lace a toy acros s th e room , afte r h aving it take n away. H e th e n cros s e s th e room , p u lls u p on a coffe e tab le and re ach e s for th e toy s o th at h e can take it ap art.In th is cas e , h is b e h avior of m oving acros s th e room involve d h aving a goal (ge tting th e toy) andp rob le m s olving (h ow to ge t acros s th e room ).
  19. 19. S exual DevelopmentTh e e arlie s t form of s e xu alize d b e h avior is b e lie ve d to b e fou nd in th e infant’s love to p laceth ings in th e ir m ou th . N e wb orns are ofte n orally fixate d , and it h e lp s give th e ir world m e aning.Th e y cann ot ye t u tilize lan gu age to b e gin to inte ract with th e ir world , b u t th e y can b ring th e irworld to life with oral contact.Th is , in conj nction with th e infants ne e d s to u nd e rs tand and m as te r th e ir b od y, le ad s to ue xp loration as an infant re ach e s th e age of one . As a ch ild d e ve lop s th e ab ility to control th e irb e h avior, th e y b e gin to le arn th at th e re are a varie ty of p arts to th e ir b od y. Wh ile th is m ay b e ginwith le arning ab ou t finge rs and toe s , it ofte n le ad s to th e d is co ve ry of one ’s ge nitals . Th ise xp loration is d one volu n tarily and can p ro d u ce p le as u rab le s e ns ations for th e ch ild .A ch ild ’s s e xu al d e ve lop m e nt is s h ap e d b y th e ir fam ily’s cu ltu re . Th e norm s o f wh at is acce p tab leand e xp e cte d are m old e d b y a p are nt’s d ire ct and ind ire ct b e h aviors .Wh ile infants m ay not b e cle ar on wh at ge nd e r is , le t alone wh at th e ru le s and role s as s o ciate dwith one ’s ge nd e r are , th e y are watch ing and ob s e rving th e m any th ings th at are going onarou nd th e m .If th e m o th e r is re s p ond ing to th e ch ild as a p rim ary care give r, th e y are ofte n re s p ond ing d ire ctlyto th e cu e s of th e ir ch ild , wh o m ay b e as king to b e com forte d , cu d d le d , talke d to, fe d , e tc.M oth e rs are typ ically m ore con ce rne d ab ou t th e p roce s s of h ow th e ir ch ild e xp re s s e s th e ir ne e d sand e ns u ring th os e ne e d s are m e t. Th is is ofte n in contras t to th e fath e r, wh o re s p ond s m orefre qu e n tly to ch ild re n b y re d ire cting th e cu e s th at a ch ild m ay offe r to oth e r activitie s . Th e role ofth e fath e r m ay b e m ore clos e ly conne cte d to p lay, and p os s ib ly d is cip line .H owe ve r th e s e role s are d ivid e d , th e ch ild is le arning from th e m . Wh at th e ch ild le arns b e com e sth e ir u nd e rs tand ing of wh at s ocial ru le s and role s are for p e op le in th e ir cu ltu re , wh ich h e lp s to
  20. 20. The Developing BabyThe firs t monthFertilizationE ve ry h u m an b e ing b e gins life as a s ingle ce ll, form e d wh e n fath e rs s p e rm fe rtilize s m oth e rs e gg.F e rtilization norm ally take s p lace in th e m oth e rs F allop ian tu b e , wh ich conne cts th e u te ru s (wom b )with th e ovary. Th e u te ru s is th e s ize and s h ap e of a large p e ar: it is m ad e of m u s cle and its tre tch e s to allow th e b ab ys growth th rou gh ou t th e m onth s of p re gnancy.A wom an ord inarily h as two tu b e s and two ovarie s , one at e ach s id e of h e r u te ru s . E ve ry m onth oneof th e ovarie s in tu rn re le as e s an e gg (ovu m ) wh ich p as s e s s lowly along th e tu b e toward s th e wom bcavity
  21. 21. If th e e gg is not fe rtilis e d with in 1 2 h ou rs or s o of b e ing re le as e d , it d ie s ; it cannot d e ve lop fu rth e r.Bu t if th e wom an h as s e xu al inte rcou rs e d u ring th e d ays of h e r m onth ly cycle j s t b e fore or at th e utim e wh e n an e gg h as b e e n re le as e d from th e ovary, th e n m any s p e rm ce lls re le as e d b y h e rp artne r m ay trave l u p to th e F allop ian tu b e and one m ay fe rtilis e th e e gg. Wh e n fe rtilis ation iscom p le te d and th e nu cle i of e gg and s p e rm h ave com b ine d , a ne w b e ing com e s into e xis te nceand is cap ab le of fu rth e r d e ve lop m e nt. Be cau s e th e p are nts are h u m an - b e longing to th e s p e cie sH om o s ap ie ns - th e ne w b e ing is als o h u m an. F e rtilis ation (b y wh ich we m e an conce p tion) m arksth e b e ginn ing of th e h u m an life s p an.A cons u ltant s p e cialis ing in th e care of p re gnant wom e n write s : "Life d oe s not b e gin with b irth .Wh e n b orn, we are alre ad y nine m onth s o ld ... we h ave a re s p ons ib ility to le arn h ow to s tu d y th elife in ute ro, and h ow to care for it"HeredityTh e ce lls of living b e ings contain D N A (d e o xyrib onu cle ic acid ), th e s u b s tance in th e nu cle u s th ate nab le ce lls to re p rod u ce and trans m it ch aracte ris tics from ge ne ration to ge ne ration. Wh e n ce llsd ivid e , th e D N A take s th e form of ch rom os om e s - th e u nits carrying th e ge ne s th at p as sh e re d itary fe atu re s from p are nts to offs p ring. D iffe re nt s p e cie s h ave varying nu m b e rs ofch rom os om e s p e r ce ll: for e xam p le , a m ou s e h as 40 wh ile a cat h as 38. H u m an b od y ce llsnorm ally contain 46 d is tinctive ly h u m an ch rom os om e s . Bu t an e gg and a s p e rm ce ll contain only23 ch rom os om e s e ach , to allow for th e ir ad d ing toge th e r at fe rtilis ation: s p e rm and ovu m arete rm e d gam e te s (from a G re e k word for "m arriage p artne rs "). Wh e n th e y "m arry" th e y m ake onecom p le te ly ne w ce ll - th e h u m an e m b ryo, zygote or conce p tu s - with 46 ch rom os om e s carrying afre s h , u niqu e com b ination of ge ne s . At fe rtilis atio n th is h u m an e m b ryo is ab ou t 0.1 m m ind iam e te r. S ince ch aracte ris tics co m e from b o th p are nts th e zygote is ne ve r th e s am e as , o r p artof, th e m oth e r, b u t is a ge ne tically d is tinct ind ivid u al. Th e colo u ring of h air, s kin and e ye s , th e s e xof th e ne w h u m an b e ing, and factors influ e ncing h e igh t and b u ild , are d e te rm ine d at fe rtilis ationb y inform ation on th e D N A.
  22. 22. GenderA b ab ys s e x is d e te rm ine d at fe rtilis ation. A ch rom os om e from th e fath e rs s p e rm d e te rm ine swh e th e r th e ch ild is m ale or fe m ale . If an X ch rom os om e is p re s e nt th e b ab y is a girl; if a Ych rom os om e is carrie d b y th e s p e rm ins te ad , th e b ab y is a b oy.TwinsO ccas ionally two e ggs are re le as e d b y th e ovary and fe rtilis e d . Th is re s u lts in frate rnal twins wh oare d iffe re nt in ap p e arance and m ay b e of d iffe re nt s e xe s b e cau s e th e ir ge ne s form from two e ggsand two s p e rm ce lls .R are ly, on e e m b ryo s p lits into two and b oth ce lls d e ve lo p s e p arate ly, as id e ntical twins , s im ilar inap p e arance ."Th e y h ave th e s am e ge ne tic m ake -u p and ap p are ntly th e wh ole ge ne tic m e s s age is th e s am e inb oth of th e m . N e ve rth e le s s , th e y are ob viou s ly d iffe re nt h u m an b e ings ."2B lueprint, builder and hous eTh e e m b ryo is not s im p ly a s e t of ins tru ctions for m aking a ne w h u m an b e ing, like a b lu e p rint forb u ild ing a h ou s e . A b lu e p rint is ine rt and cannot carry ou t ins tru ctions , b u t th e e m b ryo is active andb e gins work at once . A h ou s e ne e d s b u ild e rs , carp e nte rs , e le ctricians and p lu m b e rs to com p le te it;b u t th e e m b ryo h as th e ab ility to grow s p ontane ou s ly, m oving on to oth e r p h as e s of d e ve lop m e ntand cons tru cting th e s ke le ton, fle s h , ne rve conne ctions and a was te d is p os al s ys te m of th e h u m anb od y. Afte r a h ou s e is b u ilt, a b lu e p rint re m ains s e p arate ; b u t th e e m b ryo - alre ad y an e s s e ntialh u m an b y virtu e of th e ge ne s - is b lu e p rint, b u ild e r and "h ou s e " toge th e r.
  23. 23. ImplantationAfte r fe rtilis ation th e s ingle ce ll s p lits into two, th e n th e two ce lls d ou b le to fou r, fou r to e igh t, e igh tto s ixte e n and s o on. B e cau s e th e ce ll clu s te r looks s u p e rficially like a b e rry it is calle d th e m oru la(Latin for "m u lb e rry"), b u t th e ne w life is always b iologically h u m an (s p e cie s H om o s ap ie ns ).Th e j rne y along th e F allop ian tu b e continu e s s lowly for ab ou t fou r d ays . G rowth incre as e s . By th e outim e th e wom b cavity is re ach e d , th e ce ll clu s te r b e com e s h ollow and flu id -fille d , and is re fe rre d toas th e b las tocys t. H owe ve r, th is is not an ine rt clu m p of ce lls b u t a b u s ily d e ve lop ing h u m anind ivid u al: d iffe re ntiation (organis ation into d iffe re nt p arts and fu nctions ) is alre ad y taking p lace .Me anwh ile th e u te ru s is form ing a s p ongy lining with in wh ich th e e m b ryo will im p lant. To ach ie veth is th e e m b ryo b u rro ws into th e wall of th e wom b and is cove re d ove r b y th e lining of th e wom b .Th is b e gins 6 d ays afte r fe rtilis ation and is com p le te d with in th e ne xt 7 d ays .If fe rtilis ation h as not take n p lace , th e lining of th e u te ru s com e s away at th e e nd of th e m onth lycycle as th e wom ans m e ns tru al p e riod . Bu t once im p lantation occu rs , th e e m b ryo s e nd s ou t ah orm onal s ignal wh ich p re ve nts th e m oth e rs p e rio d . Th is is u s u ally h e r firs t ind ication of p re gnancy.
  24. 24. E s timating length of pregnancyG e ne rally a wom an d oe s not know th e e xact d ate of h e r b ab ys conce p tio n. Wh e n s h e m is s e s ap e riod s h e m ay take a p re gnancy te s t; s h e s h ou ld s e e a d octor p rom p tly to ob tain p rofe s s ionalcare for h e rs e lf and h e r ch ild . Th e d octor take s th e d ate of th e firs t d ay of th e m oth e rs las tm e ns tru al p e riod as th e s tarting-p oint for a 40-we e k p re gnancy. Th is give s th e b ab ys ge s tationalage . H owe ve r s ince fe rtilis ation only occu rs wh e n th e ovu m is re le as e d fro m th e ovary, s om e twowe e ks from th e b e ginning of th e las t p e riod , th e b ab ys actu al (conce p tional) age is als o two we e ksle s s . F u ll-tim e d e live ry occu rs 38 we e ks afte r fe rtilis ation, b u t 40 we e ks afte r th e m oth e rs las tm e ns tru al p e riod . (In th is b ookle t all d e ve lop m e nts of th e e m b ryo and foe tu s are d ate d from th etim e of conce p tion, or fe rtilis ation u nle s s s tate d oth e rwis e .)Protection and life s upportD u ring and afte r im p lantation th e e m b ryo d e ve lop s a p ro te ctive , flu id -fille d cap s u le wh ichs u rrou nd s and cu s h io ns th e d e ve lop ing b od y to p re ve nt inj ry. E m b ryo and flu id are e nclos e d in utwo m e m b rane s , an inne r am nion and an ou te r ch orion. Th e ch orion is cove re d in rootlike tu fts ,s om e of wh ich form th e e arly p lace nta - an o rgan m ad e b y th e b ab y and th e m oth e r wh ichtrans fe rs nu trie nts from th e m oth e rs b lood s tre am and re m ove s was te p rod u cts from th e ch ild s ,th ou gh m oth e rs and b ab ys circu latory s ys te m s re m ain s e p arate . Th e p lace nta als o p rod u ce sh orm one s to m aintain th e p re gnancy. In th e ninth m onth it will alte r th e m oth e rs h orm onal b alanceand trigge rs off th e b irth p roce s s - alth ou gh we are s till u ns u re wh at cau s e s lab ou r to b e gin.Th e b ab y is conne cte d to th e p lace nta b y th e u m b ilical cord , th e life line ch anne lling nou ris h m e nt inand taking was te s ou t, wh ich will b e cu t clos e to th e b ab ys ab d om e n at b irth and will le ave th em ark of th e nave l. D u ring p re gnancy th e b ab y ob tains oxyge n from th e m oth e rs b lood via cord andp lace nta, s o d oe s n ot d ro wn in th e s u rrou nd ing flu id .
  25. 25. Body developmentBy 25 d ays from fe rtilis ation th e b od y is d e ve lop ing. H e ad and tru nkap p e ar and tiny arm b u d s b e gin to form , followe d b y le g b u d s . Th e e arlye m b ryo s e e m s to h ave a "tail", b u t th is is re ally a p rote ctive cove ring forth e s p inal cord . Be cau s e th e ce ntral ne rvou s s ys te m (b rain. s p ine ands p inal cord ) is s o im p ortant, gove rning s e ns ory and m otor fu nctions , th ee m b ryos b od y is d e s igne d for rap id growth of h e ad and b ack.By 21 to 25 d ays th e b ab ys h e art is b e ating. O th e r inte rnal organs arep re s e nt in s im p le form and fu nctioning as th e y grow. E arly facial fe atu re sap p e ar. Th e d octor wh o p e rform e d th e firs t-e ve r b lood trans fu s ion to anu nb orn b ab y h as d e s crib e d th e e m b ryo at th e e nd of th e firs t m onth fromfe rtilis ation:"B y 30 d ays , j s t two we e ks p as t m oth e rs firs t m is s e d p e riod , th e b ab y - uone qu arte r of an inch long - h as a b rain of u nm is takab le h u m anp rop ortions , e ye s , e ars , m ou th , kid ne ys , live r, an u m b ilical cord and a h e art
  26. 26. The s econd monthGrowingTh e e m b ryo in cre as e s in s ize from 5m m at fou r we e ks to 4O m m b y th e e nd of th e e igh th we e k. Th eb ab y in th e wom b is u s u ally m e as u re d from th e top of th e h e ad to th e b ottom of th e s p ine (crown-ru m p le ngth s ).Hands and feetBy th e s ixth we e k from fe rtilis ation tiny finge rs ap p e ar, followe d with in d ays b y th e toe s . By th es e ve nth we e k th e b ab y h as ind ivid u al finge rp rints ; no two s e ts of finge rp rints are e ve r th e s am e .E ve n in u te ro th e b ab y h as u niqu e ch aracte ris tics .E yes and earsBy s ix we e ks th e e ye s wh ich ap p e are d in s im p le form in th e firs t m onth d e ve lop le ns and re tina; th ee ye lid s s tart to take s h ap e .Th e e ars continu e to d e ve lop : b y s e ve n we e ks th e ou te r e ar is p re s e nt, and th e inne r e ar, with itsh e aring and b alancing m e ch anis m s , is we ll e s tab lis h e d .
  27. 27. MovementsS p o ntane ou s m ove m e nts b e gin at s e ve n we e ks :"By 45 d ays , ab ou t th e tim e of th e m oth e rs s e cond m is s e d p e rio d , th e b ab ys s ke le ton is com p le te incartilage , not b one , at firs t; ... h e m ake s th e firs t m ove m e nts of h is b od y and ne w-grown lim b s ,alth ou gh it will b e anoth e r 1 2 we e ks b e fore h is m ove m e nts are s trong e nou gh to b e trans m itte dth rou gh th e ins e ns itive u te ru s to b e d e te cte d b y th e m oth e rs s e ns itive ab d om inal wall."Brain functionBrain wave s h ave b e e n re cord e d b y E E G (e le ctro- e nce p h alograp h ) in th e h u m an e m b ryo 40 d aysafte r fe rtilization.Res pons e to touchH u m an e m b ryos of five we e ks ge s tational age h ave b e e n s e e n to m ove away from an ob j ct tou ch ing eth e m ou th are a. Th e s e ns itive are a e xte nd s to inclu d e th e re s t of th e face in th e s ixth and s e ve nthwe e ks and th e p alm s of th e h and s and s ole s of th e fe e t in th e e igh th and ninth we e ks re s p e ctive ly.6A Britis h s tu d y s h ows th at th e b ab ys m ove m e nts b e gin at th e s am e tim e as s e ns ory ne rve s b e gin togrow into th e s p inal cord in th e s e cond m o nth of p re gnancy; th e ne rve fib re s re s p ond to tou ch e s toth e s kin and m ove m e nt of th e lim b s : at th is s tage th e b ab ys s e ns ory ne rve s "ap p e ar to b e m ores e ns itive th an th os e of th e ad u lt or ne wb orn b ab y."
  28. 28. From embryo to fetusArou nd e igh t we e ks th e b ab ys cartilage s ke le ton b e gins to tu rn into b one . Th e b od y is e s s e ntiallycom p le te . N ow th e b ab y can b e re fe rre d to as th e foe tu s - a Latin te rm m e aning "you ng,offs p ring." Latin- or G re e k-d e rive d nam e s are give n to h u m an b e ings at s u cce s s ive p h as e s ofd e ve lop m e nt, e .g. "zygote " for th e ne wly-conce ive d , "ne onate " for ne wb orn b ab y, "ad ole s ce nt" forgrowing-u p te e nage r, "ge riatric" for a p e ns ione r. Th e s e te rm s s im p ly id e ntify d iffe re nt s tage s inth e h u m an life s p an wh ich b e gins at fe rtilization.The third monthDevelopmentBy th e e nd of th e twe lfth we e k th e b ab y m e as u re s alm os t 90m m and we igh s 45g. Th e b ab ysface , at firs t b road , now b e com e s narrowe r; th e e ye s are clo s e d for p rote ction from ab ou t 1 0we e ks u ntil th e s ixth m onth . Bo yh ood or girlh oo d is now ob viou s .S ens itivityTwo B ritis h cons u ltants , one caring for p re gnant wom e n and th e oth e r for ch ild re n afte r b irth ,d e s crib e h u m an d e ve lop m e nt at th is s tage :"N ine we e ks afte r conce p tion th e b ab y is we ll e nou gh form e d to b e nd h is finge rs rou nd an ob j ct ein th e p alm of h is h and . In re s p ons e to a tou ch on th e s ole of h is foo t h e will cu rl h is toe s or b e ndh is h ip s and kne e s to m ove away from th e tou ch ing ob j ct. At 1 2 we e ks h e can clos e h is finge rs eand th u m b and h e will op e n h is m ou th in re s p ons e to p re s s u re ap p lie d at th e b as e of h is th u m b ."F rom a s im p le , ge ne ralize d re s p ons e to s tim u lation at 6 we e ks ge s tational age , th e fe tu s
  29. 29. Feeling painTh e b rain and ne rve fib e rs m u s t b e fu nctioning for anyone to fe e l p ainBrain ce lls wh ich are e s s e n tial for cons ciou s ne s s in th e ad u lt are known to b e p re s e nt in th e fe tu s b y1 0 we e ks . N e rve fib e rs wh ich trans m it p ain im p u ls e s are known to b e p re s e nt b e fore fib e rs inh ib itingp ain are com p le te d .Accord ing to a s ch olarly s tu d y of th e availab le e vid e nce , th is "im p lie s th at th e firs t trim e s te r fe tu s m ayb e m ore s u s ce p tib le to p ain th an s ligh tly old e r s u b j cts .. Th e firs t trim e s te r of p re gnancy is th e firs t eth re e m onth s .In oth e r word s , if th e b ab y can e xp e rie nce p ain b e fore th e b od ys m e ch anis m s to s u p p re s s p ain h aved e ve lop e d , th is m e ans th at th e b ab y m ay b e ab le to fe e l p ain at a m u ch e arlie r s tage th an wasp re viou s ly th ou gh t, and p e rh ap s e ve n m ore ke e nly in th e firs t th re e m onth s of p re gnancy th an late r.Th e s am e s tu d y conclu d e s th at th e re is a like lih o od th at th e "fe tu s h as s tarte d to acqu ire a s e ntie ntcap acity p e rh ap s as e arly as s ix we e ks , ce rtainly b y nine to te n we e ks of ge s tation. Anatom icale xam ination of s u ch fe tu s e s ind icate s th e p rob ab ility th at d iffe re ntiation s u fficie nt for re ce p tion,trans m is s ion and p e rce p tion of p rim itive p ain s e ns ation h as alre ad y occu rre d ."Practicing for life outs ide the womb"At 1 1 we e ks afte r conce p tion th e fe tu s s tarts to s wallow th e s u rrou nd ing am niotic flu id and to p as s itb ack in h is u rine . H e can als o p rod u ce com p le x facial e xp re s s ions and e ve n s m ile . S wallowingp re p are s th e b ab y for taking in m ilk at b irth . Th u m b -s u cking h as als o b e e n re co rd e d in th e fe tu s .F e tal b re ath ing m ove m e n ts h ave b e e n d e te cte d as e arly as 1 1 we e ks 1 4. Alth ou gh th e b ab y d oe s notb re ath e air ins id e th e flu id -fille d am nion, th e s e m ove m e nts h e lp d e ve lop th e re s p iratory organs .
  30. 30. Four to five monthsE nlargement of baby and uterusBy s ixte e n we e ks th e b ab y m e as u re s 1 40m m from crown to ru m p , j s t o ve r one th ird o f th e s ize h e or us h e will b e at fu ll te rm , and we igh s arou nd 200g. Th e h e art now p u m p s 30 lite rs of b lo od a d ay. Th eu te ru s e xp and s and ch ange s s h ap e to accom m od ate th e growing b ab y; p re gnancy b e gins to s h owe xte rnally. Th e d octor can te ll ap p roxim ate ly h o w ad vance d th e p re gnancy is b y lo cating th e fu nd s (th etop p art of th e u te ru s b e twe e n th e F allop ian tu b e s , wh ich s tre tch e s u p ward s toward s th e m oth e rsch e s t as th e u te ru s e xp and s ).HearingTh e re is e vid e nce th at from fou r m onth s th e fe tu s re s p ond s to s ou nd . D octors te s ting u nb orn ch ild re nfor d e afne s s , wh ile m onitoring th e ir re actions to nois e with u ltras ou nd (a te ch niqu e for vis u alizing th ech ild re n in u te ro), h ave ob s e rve d e ye m ove m e nts and "b link-s tartle " re s p ons e s in fe tu s e s of 1 6 to 32we e ks ge s tation.1 5Th e au th ors of a te xtb ook on th e u nb orn wh ich is u s e d in m e d ical s ch ools world -wid e e xp lain wh y th efe tu s can h e ar wh ile im m e rs e d in flu id :"Th e e ars of th e fe tu s fu nctio n as e arly as th e fou rth m onth , and th e re is e vid e nce th at it h e ars a goodd e al. O ne m igh t ob j ct th at if a p e rs o n d ive s u nd e r wate r and s om e one e ls e talks to h im h e h e ars only ea m u ffle d s ou nd . Th is is tru e . Th e s ou nd is m u ffle d b y th e cu s h ion of air re m aining in th e au d itorycanal ou ts id e th e e ar d ru m . Bu t th e fe tu s living in th e am niotic flu id h as no m u ffling air cu s h ionsarou nd its e ar d ru m - and wate r cond u cts s ou nd b e tte r th an air d oe s . Th e s ile nt world of th e fe tu s (or,b e low th e s u rface of th e oce an) is a fantas y, u nfou nd e d in re ality.
  31. 31. Th e b ab y h e ars s ou nd s from th e ou ts id e world as we ll as from th e m oth e rs h e art and d ige s tives ys te m : "In fact th e inne r e ar of th e foe tu s is com p le te ly d e ve lop e d b y m id -p re gnancy, and th efoe tu s re s p ond s to a wid e varie ty of s o u nd s . H e is s u rro u nd e d b y a cons tant ve ry lou d nois e in th eu te ru s - th e rh yth m ical s o u nd of th e u te rine b lood s u p p ly p u nctu ate d b y th e nois e s of air p as s ingth rou gh th e m oth e rs inte s tine . Lou d nois e s from o u ts id e th e u te ru s s u ch as th e s lam m ing of a d ooror lou d m u s ic re ach th e foe tu s and h e re acts to th e m ."1 7 Te s ts u s ing d iffe re nt typ e s of m u s icind icate th at th e b ab y e ve n ap p e ars to h ave p re fe re nce s : "A fou r- or five -m onth -old foe tu s d e finite lyre s p on d s to s ou nd and m e lod y - and re s p ond s in ve ry d is crim inating ways . P u t Vivald i on th ere cord p laye r and e ve n th e m os t agitate d b ab y re laxe s ... In a film m ad e at th e C ity of Lond onMate rnity H os p ital, Ye h u d i M e nu h in d e m ons trate d th at it was p os s ib le to contact th e u nb orn viam u s ic."1 8 Bab ie s le arn to re cognis e th e ir m oth e rs voice s wh ils t in th e wom b 1 9 and e ve n tore cogn is e s torie s wh ich are re ad to th e m in th e wom b .20 N e wb orn b ab ie s wh os e m oth e rs watch e dN e igh b ou rs d u ring p re gn ancy h ave b e e n s e e n to s to p crying and b e com e ale rt wh e n th e y h e ar th eth e m e tu ne afte r b irth .S ens itivity to lightF rom th e s ixte e nth we e k th e foe tu s re s p ond s to ligh t. If a b linking ligh t is s h one on to th e m oth e rsab d om e n, th e foe tal h e artb e at flu ctu ate s .22 "In late p re gnancy, s om e ligh t p e ne trate s th rou gh th eu te rine wall and am niotic flu id , and foe tal activity h as b e e n s h own to incre as e in re s p ons e to b righ tligh t."23 Th e wom b is a m ore s tim u lating e nvironm e nt th an s om e p e op le th ink; its occu p ant is ale rtand re s p ons ive .
  32. 32. The fifth month and beyondAfte r 20 we e ks th e b ab y is 1 90m m from crown to ru m p and we igh s 460g. H e ad h air, e ye b rows .e ye las h e s and nails are gro wing. To p rote ct th e b ab ys s kin from p rolonge d contact with th eam niotic flu id , a gre as y s u b s tan ce calle d ve rnix cove rs th e b o d y. Be twe e n th is s tage and b irth th eb ab y will gain we igh t and will d e ve lop an ins u lating laye r of fat b e ne ath th e s kin. H e or s h e will als ore ce ive m ate rnal antib od ie s agains t s om e infe ctions as a te m p orary p rote ction u ntil th e infants ownim m u ne s ys te m is b e tte r d e ve lop e d .Waking and s leepingF e tal activity is affe cte d wh e n th e m oth e r is tire d or u nd e r s tre s s .24 Th e b ab y is u s u ally m os tnotab ly active wh e n th e m oth e r is lying d own at nigh t. Th e m oth e r fe e ls th e b ab ys kicking and m aynotice s h arp m o ve m e nts wh e n th e b ab y ge ts h iccu p s afte r d rinking th e am niotic flu id or p ractice s itsb re ath ing m ove m e nts . In late r p re gnancy th e fe tu s h as b e e n ob s e rve d to s h ow "b e h avioral s tate s " -waking, calm s le e p ing, and "rap id e ye m ove m e nt s le e p " wh ich is as s ociate d with d re am ing inad u lts .The ques t for comfortTh e b ab y s till h as s om e room to m ane u ve r ins id e th e wom b and s e e ks th e p os ition wh ich fe e lsm os t com fortab le :"It is ve ry e as y to d e m ons trate now with u ltras ou nd th at th e b ab ie s m ake th e m os t of all th e s p aceand room availab le to th e m ... We know th at fe tal com fort d e te rm ine s fe tal p os ition, th at ch ange s inm ate rnal p os ition p rovoke b ab y to s e e k a ne w p os itio n of com fort."
  33. 33. S urvival outs ide the wombIf th e b ab y is b orn too e arly, th e re is s till a good ch ance th at h e or s h e will s u rvive , give ns p e cial m e d ical care . A d ocu m e nt from th e R oyal C olle ge of O b s te tricians andG ynae cologis ts (th e p rofe s s ional b od y of d octors wh o tre at p re gnant wom e n) s tate s : "In1 984, 72 p e r ce nt of live b orn infants of 22 to 27 we e ks ge s tation b orn at th e Bris tolM ate rnity H os p ital s u rvive d , as d id 64 p e r ce nt of infants of 500 to 999 gram m e sb irth we igh t.“Th e s e p e rce ntage s h ad incre as e d from p re viou s ye ars . With ad vance s in te ch nology and inu nd e rs tand ing of h u m an foe tal d e ve lop m e nt, p re m atu re b ab ie s ch ance s of s u rvival areim p roving.Th e s e figu re s re fe r to th e le ngth of th e p re gnancy from th e tim e of th e m oth e rs las tm e ns tru al p e riod . and not to th e age of th e b ab y from fe rtilis ation. wh ich wou ld u s u ally b etwo we e ks le s s .
  34. 34. 3.5 Week 3.5 Week Fetus 8.5 Week FetusFetus Fetus (12 Weeks Old) 16-Week Fetus8.5 Week Fetus24-Week 26 to 28-Week Fetus 30 to 32 Week FetusFetus

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