GROWTH AND DEVELOPMENT OF INFANT<br />Pg 811- 817<br />Physical growth<br /><ul><li>Infants grow more rapidly both size an...
More infants double weight by 6 months of age
Triple by 1 year.
Height increase at 1 year by 50%
Head circumference increases due to rapid brain growth
Body proportion changes to amore typically infant appearance. Mandible becomes prominent and remain throughout life.
Chest is less than the size of the head at birth by about 2 cm.
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Growth and development of infant


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Growth and development of infant

  1. 1. GROWTH AND DEVELOPMENT OF INFANT<br />Pg 811- 817<br />Physical growth<br /><ul><li>Infants grow more rapidly both size and their ability to perform tasks.
  2. 2. More infants double weight by 6 months of age
  3. 3. Triple by 1 year.
  4. 4. Height increase at 1 year by 50%
  5. 5. Head circumference increases due to rapid brain growth
  6. 6. Body proportion changes to amore typically infant appearance. Mandible becomes prominent and remain throughout life.
  7. 7. Chest is less than the size of the head at birth by about 2 cm.
  8. 8. Even with the head at 6 months and in most 12 months.
  9. 9. Cervical, thoracic, and lumbar vertebrae curves develop as infants hold up their head, sit, and walk.
  10. 10. Lengtening of the lower extremities during the last 6 months of infancy readies the child for walking and often changes as
  11. 11. “baby like” to “ toddler like”</li></ul>Teeth<br /><ul><li>First baby tooth is the central incisor- erupts at age 6 months followed by a new one monthly
  12. 12. 1 in 2000 may be born with natal teeth
  13. 13. Or have erupt at first 4 weeks of life called neonatal teeth.
  14. 14. Deciduous teeth or temporary or baby teeth are essential for protecting the growth of the dental arch.</li></ul>0-1 month<br /><ul><li>Largely reflexes- motor
  15. 15. Keeps hand fisted: able to follow object to midline- fine
  16. 16. Play: Enjoys watching of primary caregiver: listening to soothing sounds</li></ul>2 month<br /><ul><li>Holds head up when prone- motor
  17. 17. Has social smile- fine
  18. 18. Makes cooing sounds- socialization and language
  19. 19. Play: Enjoys bright colored mobiles</li></ul>3 month<br /><ul><li>Holds head and chest up when prone
  20. 20. Follows object past midline- fine
  21. 21. Socialization and language- Laughs out loud
  22. 22. Spends time looking at hands or uses them as toy
  23. 23. during the month ( hand regard)</li></ul>4 month<br /><ul><li>Grasp, stepping, tonic-neck reflexs are fading- motor
  24. 24. Play: needs space to turn</li></ul>5month<br /><ul><li>Turns from front to back- motor
  25. 25. No longer head lag
  26. 26. Bears Partial weight when upright
  27. 27. Play- Handles rattles well</li></ul>6 month<br /><ul><li>Turn both ways
  28. 28. Moro reflex fading- motor
  29. 29. Uses palmar grasp- fine
  30. 30. May say vowel (oh-oh)-socialization and language
  31. 31. Play- Enjoys bathtub toys, rubber ring for teething</li></ul>7 months<br /><ul><li>Reaches out in anticipation of being picked up first tooth central incisor)- motor
  32. 32. Sits unsteadily or with support- motor
  33. 33. Transfers objects hand to hand- fine
  34. 34. Shows beginning fear of strangers- socialization and play
  35. 35. Play- likes objects that are good size for transferring</li></ul>8 months<br /><ul><li>Sits securely without support-motor
  36. 36. Socialization and language- Has peak fear of strangers ( ability to tell known from unknown people)
  37. 37. Play- Enjoys manipulation, rattles and toys of different textures</li></ul>9 months<br /><ul><li>Creeps or crawls- motor( abdomen off floor)
  38. 38. Socialization and language- Says first word ( da- da)
  39. 39. Play- needs space for creeping</li></ul>10 months<br /><ul><li>Pulls self to standing- motor
  40. 40. Uses pincer grasp- socialization and language
  41. 41. Play- Plays like patty cake and peek-a-boo</li></ul>11 months<br /><ul><li>Cruises “ Walks with support”- motor
  42. 42. Play- Cruises</li></ul>12 months<br />Stands alone: some infants take first step- motor<br />Holds cup and spoon well:<br />Helps to dress( pushes arm into sleeve)<br />Says to word da-da or ma- ma<br />Play- likes toys that fit inside each other, nursery rhyme<br />PROMOTING INFANT SAFETY<br /><ul><li>Accidents are leading cause of death from 1 month through 24 years of age.
  43. 43. They are only second to acute infections as a cause of morbidity
  44. 44. Most accidents in infants occur due to underestimation or overestimation of child’s ability.</li></ul>Aspiration Prevention<br /><ul><li>Round and cylindrical objects are dangerous because it can obstruct the airway( hotdog and carrots)
  45. 45. Educate the parents of the infant not to prop the bottles
  46. 46. Educate the parents to secure that the infant will not even reach a small object to be put into the mouth
  47. 47. When solid foods are introduced, encourage parents to offer a small pieces of food.</li></ul>Fall prevention- second major cause of infant accidents<br /><ul><li>As a preventive measure, no infant, should be left unattended on a raised surface.
  48. 48. Be sure that the crib sides are raised and secure before anyone walks away from the crib.</li></ul>Motor vehicle<br /><ul><li>Never transport unless the infant is buckled into an infant car seat in the back seat of the car
  49. 49. Do not be distracted while driving
  50. 50. Do not leave the infant unattended in the car park</li></ul>Suffocation<br /><ul><li>Allow no plastic bag’s within the reach of the infant
  51. 51. Do not use pillows in the crib
  52. 52. Store unused appliances with the doors removed
  53. 53. Remove constricting clothing such as bib at bedtime</li></ul>Drowning<br /><ul><li>Do not leave infant alone in the bath tub or unsupervised near water</li></ul>Animal Bites<br /><ul><li>Do not allow an infant to approach a strange dog</li></ul>Poisoning<br /><ul><li>Never present medication as candy
  54. 54. Never take medications in front of a child
  55. 55. Place all medications in a secure cabinets
  56. 56. Never leave the medications on a pocket or handbag
  57. 57. Hang plants or set on a high surfaces</li></ul>Burns<br /><ul><li>Test warmth formula and food before feeding
  58. 58. Do not smoke or drink hot liquids while holding the infant
  59. 59. Buy flame or retardant clothing
  60. 60. Use sunscreen on a child over6 months when out in direct or indirect sunlight
  61. 61. Turn handles of pans toward back of the stove
  62. 62. Monitor infants carefully near candles
  63. 63. Donot allow infants to blow matches
  64. 64. Keep electric wires out of reach
  65. 65. Toddler- great strides developmentally but growth are slow
  66. 66. Speaks in two word sentences
  67. 67. 20 deciduous teeth present at 2.5 years
  68. 68. Chest circumference becomes bigger than the head circumference at 2 years
  69. 69. Heart ate 90- 110 bpm
  70. 70. “ pouchy” abdomen from weak abdominal muscles
  71. 71. Noticeable lordosis
  72. 72. “ baby fat” begins to disappear
  73. 73. Wide based gait
  74. 74. 15months
  75. 75. Puts a small pellets into small bottles- fine
  76. 76. Scribbles voluntarily with a pencil or a crayon and holds a spoon well but may still turn upside down- fine
  77. 77. Walks alone well: can seat self in chair: can creep upstairs- gross
  78. 78. 4- 6 words
  79. 79. Play- can stack 2 blocks enjoys being read to; drop toys for adult to recover ( exploring sense of permanence)
  80. 80. 18 months
  81. 81. No longer rotates a spoon to bring it to mouth-fine
  82. 82. Can run and jump in place. Can walk up and down stairs holding onto a person’s hand or railing.
  83. 83. Typically places both feet on one step before advancing- gross
  84. 84. 7-20 words, uses of jargoning:
  85. 85. Names 1 body part- language
  86. 86. Play- Imitates household chores, dusting etc.
  87. 87. Begins parallel play (playing beside but not with another child)
  88. 88. 24 months
  89. 89. Can open doors by turning doorknobs, unscrew lids- fine
  90. 90. Walks up stairs alone still using both feet on same step at the same time
  91. 91. 50 words, 2 word sentences( such as noun, pronoun, verb) “Daddy go” “me come”
  92. 92. Parallel play evident
  93. 93. 30 months
  94. 94. Makes simple lines or strokes for crosses with a pencil- fine
  95. 95. Can jump down from chairs- gross
  96. 96. Verbal language increasing steadily. Knows full name: can name one color and holds up finger to show age
  97. 97. Play- Spends time playing house, imitating parents actions; play is “ rough- housing” or active</li></ul>Problem Concerns Associated With The Toddler Period:<br />Toilet training<br /><ul><li>It should begin when the infant is ready to accomplish it
  98. 98. They must have the control of rectal and urethral spinchter
  99. 99. They must have a cognitive understanding of what it means to hold urine and stools- so they can release it on time and proper place
  100. 100. They must have the desire to delay immediate gratification for a more socially accepted action</li></ul>Ritualistic Behavior<br /><ul><li>They will use their spoon at meal time
  101. 101. They will not go outside unless mother locates his cap
  102. 102. You need more guidelines and rule”</li></ul>NEGATIVISM<br /><ul><li>They always say “no”
  103. 103. Just make a staement not a question
  104. 104. Example: Are you ready for dinner?
  105. 105. Instead tell come to table its dinnertime</li></ul>DISCIPLINE-means setting rules or road signs so children know what is expected of them<br />Punishment- is a consequence that results from a breakdown in discipline <br />A. Parents need to be consistent<br />B. rules are learned best if correct behavior is praised than wrong nehavior is punished<br />“timeout:”- help children that their actions have consequences<br />SEPARATION ANXIETY<br />6 mos persists up to preschool period<br />Inform the child before leaving<br />But they will still cry if they don’t see their parents<br />Sneaking can prevent crying but increases abandonment<br />TEMPER TANTRUMS<br />Child may kick, scream, stamp, shout<br />No no no and lie on the floor<br />Sometimes they are holding their breath, true breath holding is a neurologic problem in wc children under stress <br />Just ignore!<br />PRESCHOOL CHILD<br />Physical Growth<br />-Definitive changes in the body contour- ectomorphic( slim) endomorphic( large)<br /><ul><li>Vocabulary increases
  106. 106. Tonsils appear enlarged
  107. 107. Growth is only 2- 3.5 inches a year
  108. 108. Pulse rates decreases to about 85bpm
  109. 109. Genu valgus (knock knees) may be evident
  110. 110. Increase coordination makes bicycle riding, running, kicking if possible
  111. 111. Weight gain- child gains only about 4.5lb (2kg)
  112. 112. Height gain- only 2 to 3.5 in (6-8cm)
  113. 113. Teeth- generally have 20 deciduous teeth by 3 years of age.
  114. 114. Oedipus complex- strong emotional attachment a preschool boy demonstrates toward his mother
  115. 115. Electra complex- preschool girl to her father
  116. 116. DEVELOPMENTAL MILESTONES </li></ul>3 years old<br />Undresses self; stacks tower of blocks; draws a cross-fine motor<br />Runs; alternate feet on stairs; rides tricycle; stand on one foot- gross<br />Vocabulary of 900 words<br />Play- Able to take turns; very imaginative<br />4 years old<br />Can do simple buttons- fine<br />Constantly in motion jumps; skips- Gross<br />Vocabulary of 1500 words- language<br />Play: Pretending is major activity<br />Ex: imaginary friends are normal<br />5 years<br />Draws a 6 part man, can lace shoes- fine motor<br />Throws overhead- gross<br />Vocabulary of 2100 words- language<br />Play: likes games with numbers or letters<br />PARENTAL CONCERNS ASSOCIATED WITH PRESCHOOL PROBLEMS<br />COMMON FEARS OF THE PRESCHOOLER<br />Fear of darkness- sleep with the child<br />Fear of mutilation-which involves the loss of, or incapacity to use, a bodily member<br /> - need of good explanation<br />Separation abandonment- explain on the time and place that a child can relates<br />Ex: television shows, or a friends house<br />Preparing for new sibling<br />Eliminate the sibling rivalry by explaining that the preschool is already big boy<br />Tell the preschool child in advance<br />Allow the child to visit in the hospital<br />SEX EDUCATION<br />Why does james looks differ from mine?<br />Answer: “boys look different from girls”<br />The different part is penis<br />Where does the babies come from?<br />Answer: “Babies grow in a special place in a mothers body called uterus.”<br />SCHOOL AGE CHILD<br />Chronological Devt of secondary characteristics<br />AgeBoysGIrls9-11Prepubertal weight gainBreasts: elevation of papilla with breast bud formation, areolar diameter enlarges11-12Sparse growth of straight, downy slightly pigmented hair at base of penisScrotum become texturedGrowth of penis and testesPerspiration increasesStraight hair along the labia, vaginal epithelium cornifiedPerspiration also increases12-13Pubic hair present across pubisPenis lengthensDramatic linear growth spurtBreast enlargement occursPubic hair grows darker; spreads all over pubisBreast enlarges, still no protrusion of nipples axillary hair is presentMenarche occurs<br />SCHOOL AGE DEVELOPMENT<br />6 years<br />A year of constant motion, skipping is a new skill- physical<br />Teacher becomes authority figure- psychosocial<br />Define words by their use- cognitive<br />Ex: a key is to unlock a door not a metal object<br />7 years<br />Central incisor erupt-permanent<br />Play: video games and dolls- quiet play<br />A quiet year: striving for perfection leads to this year being called an eraser year.<br />Can tell time, can make simple changes<br />8 years<br />Coordination definitely improved; <br />playing with gang becomes important; eyes become fully developed<br />Best friends develop<br />Whispering and giggling begins<br />Can write as well as print<br />Can tell the present, past and future<br />9 years<br />All activities done with a gang<br />Gang age- secrets<br />All boys or all girls<br />If gang disband and reform quickly<br />10 years<br />Coordination improves<br />Ready to camp away from home<br />Ready for competitive games<br />11 years<br />Active but awkward and ungainly<br />Insecure with members of the opposite sex, repeats off color jokes<br />12 years<br />Coordination improves<br />A sense of humor is present: is social and cooperative<br />CONCERNS OF PROBLEMS DURING SCHOOL AGE<br />Common: <br /><ul><li>Attention deficit hyperactivity disorders
  117. 117. Fears
  118. 118. Language
  119. 119. Responsibility</li></ul>Language<br />Articulation- the child is difficult in saying<br />S,z, th,l r, and w substitutes for “westroom” or “radies room”<br />Fears<br /><ul><li>Anxiety related to beginning school- adjusting to the environment
  120. 120. School refusal or phobia- resist to attend school just like agoraphobia
  121. 121. Cause: bully harsh teacher, showering in the gym class
  122. 122. Manage by counseling or transferring to another room</li></ul>Sex Education<br /><ul><li>Reproductive organ function
  123. 123. Secondary sexual characteristics-aware of their body
  124. 124. Physiology of reproduction-understand menstruation
  125. 125. Explanation of the physiology of pregnancy and the possibility that comes with sexual maturity for unplanned or unwanted pregnancies
  126. 126. Social and moral implications sexual maturity</li></ul>Stealing- during early age it is normal- around 7 yrs old<br />Tell your child that the money is missing<br />Not pointing that the child steal the money<br />The importance of money is reviewed<br />Mother and father is theirs<br />Child;s money is the childs money<br />Violence and tourism- such as shooting or reports of terrorism<br />COMMON RECOMENDATIONS<br /><ul><li>Assure children they are safe;
  127. 127. Assure children their parents are actively involved in keeping them safe.
  128. 128. Observe for signs of stress- sleep disturbance, fatigue, lack of pleasure,
  129. 129. Not allow children or adolescents to view footage of traumatic events over and over
  130. 130. Watch news programs with children so they can explain that the situation.
  131. 131. Explain there are bad people in the world, and bad people do bad things. But encourage not to see only one side of it.
  132. 132. Prepare a family disaster plan</li></ul>BULLYING<br /><ul><li>Tell the child that it should be reported
  133. 133. School age child bullying has long term effects on mental health </li></ul>ADOLESCENTS<br /><ul><li>Puberty- is the time at which an individual first become capable of sexual reproduction
  134. 134. Range 11- 14years
  135. 135. Girls- < 13 years- menstruation
  136. 136. Boys- begins producing spermatozoa</li></ul>SECONDARY SEX CHARACTERISTICS<br />AgeMalesFemales13-15Growth spurt coninuesPubic hair is abundant and curlyTestis, scrotum and penis enlarging furtherFacial hair, voice changesPubic hair is thick and curly- triangularMenstruation is ovulatoryPregnancy is possible15-16Genitalia adultScrotum dark and heavily rugatedFacial and body hair is presentSperm production is maturePubic hair abindantAreolas no longer project as separates ridges from the breastFacial acne16-17Pubic hair curly and abundant may extend to the medial aspect of the thighFacial acneGynecomastia – enlarged breast tissueEnd of skeletal growth17-18End of skeletal organ<br />Play or recreation<br /><ul><li>Change from more adults forms of recreation such as: listening to music, chatting on computers, following a sports teams wins or losses.</li></ul>Emotional devt: identity vs. role confusion<br />Four main areas to achieve a sense of identity<br /><ul><li>Accepting a change or body image
  137. 137. Establishing a value system or what kind of person they want to be
  138. 138. Making a career decision
  139. 139. Becoming emancipated from their parents</li></ul>13 years old<br /> feel self doubt than self confidence<br />Because they still look children but want to grown up<br />14 years old<br />Becoming used of their body changes and quieter- have more self confidence<br />15 years old<br />Fall in love 5 to six times a year<br />Based on physical features<br />16 years<br />Becoming sexually mature- trust their own bodies<br />17 years<br />Left behind the childish behaviors they used in early adolescence<br />Shoving and punching- to get the attention of the opposite sex<br />