infancy period

1. GROWTH AND
DEVELOPMENT OF INFANT
Presented by :
Miss .Shrutika . S .Navilyale
MSc Nursing 1st year
Child Health Nursing
KAHER INS Belagavi

2. INTRODUCTION
The pediatric age group ranges form 0-18 yrs i.e. from the day of
conception to the 18 yrs of age .
They are :
 Prenatal period :From conception to birth
 Neonatal period :Birth to four weeks
 Infancy period :Four weeks to 1 year
 Toddler period :From 1-3 years
 Preschool period :3-6 years (early childhood )
 School period :6-12 years( late childhood )
 Adolescence :From puberty to beginning of adulthood (13-18 years)

3. Patterns of Growth and
Development in Infancy
Patterns
of growth
Height &
Weight
Brain Sleep Nutrition

4. Development follows an orderly, step-by-
step sequence in three different patterns:
Cephalo-caudal development is a “head-
to-foot” pattern. Prenatally and at birth
the newborn’s head is proportionately
larger; development continues
downward(for e.g. shoulders, middle trunk
and so on)
Head area : top parts of head eyes and
brain grow faster than the lower jaw
Motor development also follows Cephalo-
caudal development principle
• see objects before they can control
their torso
• Use hands long before they crawl and
walk

5. Proximal-distal (proximodistal) development
is an “inward-to-outward” pattern.
Development starts at the trunk of the body
and moves further outward.
Simple-to-complex development is a pattern
relating to the difficulty of tasks. Babies start
with simply eating and sleeping and progress
from there. Tasks involving a combination of
motions is more complex.

6. GROWTH AND DEVELOPMENT OF INFANT (0-1 YEAR)
PHYSICAL GROWTH:
• Weight :
Average weight of newborn is 2.5kgs which decreases by 10% in first 10
days of life and then increases at the rate of 500 to 600 gms per
month for first 6 months .
• Length :
At birth the length of newborn is 45-50 cm . It increases approximately
2-2.5 cm per month during first 6 months .
• Head circumference:
At birth it is approximately 33-35cm and increases at the rate of 1.5 cm
per month during the first 6 months .
• Chest circumference :
About 31-33 cm .
•Pulse rate :
130 ± 20 / min

7. Conti…
• Respiration rate:
35 ± 10 /minute
• Blood pressure:
80/50 ± 20/10 mm Hg
• Reflexes :
The baby has well developed sucking, rooting , swallowing , and
extrusion reflex. The baby also has moro’s reflex ., tonic neck reflex
and crossed extensor reflex

8. Conti…
MOTOR DEVELOPMENT:
a)Gross motor development :
• Lies in flexed position with hands clenched .
• Turns head when in prone position.
• Head lags behind when baby is pulled up from
supine to sitting position.
b)Fine motor development:
• Grasp reflex is strong .
• Baby can grasp an object placed in hand but
drops it immediately.
SENSORY DEVELOPMENT :
• Protective blinking reflex is present.
• Indefinite stare at surrounding .
• Notice faces and bright objects but if only if
they are in line vision.

9. Conti..
LANGUAGE DEVELOPMENT :
• Startles to loud noise .
• Responds to human voice.
• Makes comfort sounds during feeding .
• Begins to coo.
NEWBORN SENSES:
Touch:
• It is most highly developed senses.
• It is mostly at lips , tongue, ears, and forehead.
• Newborn is usually comfortable with touch.
Vision :
• pupils react to light.
• Follow objects in line of vision .
• Bright lights is unpleasant to newborns.

10. Conti….
 Hearing:
 The newborn infant usually makes some response to sound from
birth.
 The newborn infant responds to sounds with cry or eye movements ,
cessation of activity and /or startle activity.
 Taste:
 Well developed as bitter and sour fluids are resisted while sweet
fluids are accepted.
 Smell :
 Only evidence in newborn infants search for nipple .

11. 2 months
 Physical development:
 Posterior fontanel closes at 3-6 weeks age.
 Tears starts appearing .
 Drooling begins.
 Motor development:
 Gross motor:
 Less fixed prone position – arms flexed , hip flat and legs extended.
 Lifts head almost to 45 degree flat surface when lying prone.
 Fine motor:
 Hands may be open.
 Holds rattle when placed in hand.

12. Conti...
 Sensory development:
 Turns head to side when sound occurs at ear level.
 Eyes follow moving objects and persons nearby.
 Visual acuity is hyper active.
 Language :
 Laughs and squeals .
 Crying becomes differentiated.
 Utters single vowel sounds.
 Social development:
 Smiles to mother/ caregivers.
 Knows that cry will bring attention.

13. 3 months
 Physical development:
 Flexion posture is reduced .
 Grasping , crossed extensor and moro’s reflex disappears.
 Landavu reflex appears.
 Motor development:
 Gross motor:
 Able to lift head to 90 degree when in prone position.
 Able to hold head erect but head still bobs forward.
 Rolls over back to front.
 Fine motor:
 Can grasp toy but lacks firm hold.
 Carries objects and hands to mouth at will.

15. Conti...
 Sensory development:
 Turns head and looks at same direction to locate sound.
 Blinks at objects that threaten the eyes.
 Language development:
 Cries less.
 Shows pleasure in making sounds.
 Chuckles and coos.
 Social development:
 May lough loud.
 Looks in direction of speaker.

16. 4 months
 Physical development:
 Drooling indicates appearance of saliva.
 Tonic neck reflex and rooting reflex disappears.
 Motor development:
 Gross development:
 Holds head erect and steady when placed sitting
position.
 Sits for short time with support.
 Head lag disappears when pulled to sit.
 Fine motor:
 Brings hands together in midline and plays with fingers.
 Reaches for objects.

17. Conti...
 Sensory development:
 Follows objects to 180 degrees.
 Fairly good binocular vision .
 Beginning of hand – eye coordination.
 Language development:
 Utters two syllable vowels sounds.
 Can vocalize consonants like ‘m, b, g’.
 Responds differently to pleasant and angry voice.
 Social development:
 Initial social play by smiling.

18. 5 months
 Physical development:
 Weight is almost double of birth weight.
 Motor development:
 Gross motor :
 Sits with alight support.
 Pulls feet up to mouth when in supine .
 Rolls from back to abdomen.
 Fine motor:
 Attempts to catch dangling objects with 2 hands.
 Brings use of forefinger and thumb in pincer grasp.
 Tries to obtain objects beyond reach.
 Can hold 1 object while looking at another.

19. Conti...
 Sensory development:
 Looks in direction of sound made below ear.
 Stops crying in response to music.
 Visual acuity is 20/20.
 language development:
 Responds to his or her name.
 Vocalize disappears when desired object is taken away.
 Begins to mimic sound.
 Cries on seeing strangers.
 Social development:
 Smiles to self in mirror.
 Differentiates strangers from family members.

20. 6 months
 Physical development:
 Weight gain 300- 400 gms / month during next 6 months .
 Length increases at the rate of 1.25 cm/month.
 Head circumference increases at the rate of 0.5- 1 cm/ month.
 Pulse rate is 120±20/min.
 Respiration is 31 ± 9 / min.
 Blood pressure is 90/60 ± 28/10 mmHg .
 Teeth eruption starts with lower two central incisors.
 Motor development:
 Gross motor development:
 Sits leaning forward on both the hands .
 Moves from place to place by rolling .


21. Conti...
 Fine motor :
 Can grasp at will.
 Drops one object when offered other .
 Begins to transfer objects from one hand to another.
 Bangs objects that held.
 Language development:
 Babbling .
 Vocalizes monosyllables.
 Recognizes familiar words
 Talks to own image in mirror.
 Social development:
 Recognizes parents .
 Extends arms to picked.

22. 7 months
 Physical development:
 Parachute reflex appears.
 Mashes food with jaws.
 Motor development:
 Gross motor :
 Lifts head as if trying to sit up when in supine position.
 Sustains all weight on feet when held in standing position .
 Early stepping movements.
 Fine motor :
 Holds 2 toys together.
 Transfer toys from 1 hand to another.

23. Conti...
 Sensory development:
 Has preference in taste for food.
 Depth perception is beginning to develop.
 Language development:
 Recognize own name .
 Responds to gestures.
 V
ocalizes ‘baba ’‘dada’.
 Social development:
 Shows fears for strangers .
 Closes lips tightly when disliked food is offered.

24. 8 months
 Physical development:
 Begins to show patterns in bladder and bowl elimination .
 Eruption of upper central incisors.
 Motor development.
 Gross motor:
 Pulls to standing position with help.
 Raises self to sitting position.
 Palmar grasp disappears.
 Fine motor :
 Holds 2 objects while looking at third.
 Uses index finger and thumb like pincer
 Feeds self with fingers food .
 Drinks from cup with assistance .

25. Conti...
 Sensory development :
 Recognizes familiar words and sounds.
 Language :
 Begins to understand meaning of “No” .
 Continues syllable ‘dada’, ‘mama’with specific meaning .
 Vocalizes to toys.
 Social development:
 Fear for strangers .
 Dislike dressing and diaper changing .
 Separation anxiety develops.

26. 9 months
 Physical development:
 Eruption of upper lateral incisors.
 Motor development:
 Gross motor :
 Sits down.
 Crawls and creeps .
 Holds own bottle .
 Fine motor:
 Rings bell.
 Holds bottle and places nipple in mouth if wants .

27. Conti..
 Sensory development:
 Head turns directly to the source of noise .
 Recognizes by looking or moving towards familiar objects when
named .
 Language development:
 Stops activity in response to “ no” .
 Social development:
 Dislike face wash.
 Cries when scolded.
 Wants to please the caregiver .

28. 10 months
 Physical development:
 Drooling stops .
 Macula is well developed and fine visual discrimination can be made .
 Motor development :
 Gross motor :
 Walking skill development continues .
 Creeps and cruises well.
 Does not want lie down unless sleepy.
 Making stepping movements forward when 2 hands are held .
 Fine motor :
 Fine grasp of tiny objects.
 Brings hand together and plays .

29. Conti...
 Sensory development :
 Tilts head backwards to see up.
 Localizes sound from above or below .
 Searches for lost toys.
 Language development:
 Says dada , mama with meaning .
 Comprehends “bye – bye” .
 Imitates sound of animals .
 Social development:
 Plays social games with adults .

30. 11 months
 Physical development:
 Sleeps 14-16 hrs / day and still naps.
 Motor development:
 Gross motor:
 Stands erect with minimum support.
 Walks holding furniture .
 Pushes toys .
 Fine motor :
 Explore objects carefully.
 Removes covers from boxes and toys out of boxes.
 Beginning to hold pen and marks on paper.

31. Conti….
 Sensory development:
 Can follow rapidly moving objects.
 Language development:
 Responds to simple questions .
 Understands simple directions .
 Imitates specific sounds of other.
 Social development:
 Reacts to restriction with frustration.
Enjoys playing with empty dish and spoon after
meals .

32. 12 months
 Physical development:
 Weight becomes tripe of birth weight .
 Height is increased about 50% of birth.
 Head circumferences is about 46 cm , increased by 1/3 since birth.
 Chest circumference becomes equal to head circumferences .
 Pulse rate is 115 ± 20 per minute .
 Respiration is 30 ± 10 per minute .
 Blood pressure is 96/66 ± 30 / 24 mm Hg .
 Babinski reflex disappears.
 Landau reflex also disappears .
 Has 6-8 deciduous teeth.

33. Conti….
 Motor development :
 Gross motor :
 Stands alone for variable length of time .
 Walks few steps with help or alone .
 Can sit down from standing position with help.
 Improved competence in motor skills through practice .
 Fine motor :
 Good pincer grasp.
 Picks up small bits of food and transfer to mouth .
 Enjoy eating with fingers.
 Can drink himself with cup.
 Tries to feed himself / herself with spoon but spills
content.
 Releases one or more objects inside another object or
container.

34. Conti...
 Sensory Development:
 Full binocular vision well- established .
 Follows fast moving objects with eyes .
 Language development:
 Has one words or a few in vocabulary.
 Comprehends ‘give’and stops when told ‘no’.
 Has receptive vocabulary of several words .
 Says 3-5 words besides dada , mama.
 Social development:
 Responds to request for affection such as kissing .
 Attachment developed to primary caregiver.
 Cooperates in dressing .

35. Psychosocial development ( 0-1 yr )
Trust v/s mistrust
Psychosexual development (0-1yr )
Oral stage
Intellectual development ( 0-1 yr )
Sensory motor development
Moral development (0-2 yr )
Preconventional morality

36. Play materials :
• 4 weeks to 4months : bright and moving objects, hanging cradle toys,
musical toys , balloons , rattles etc.
• 4- 6 months : soft squeeze toys, rattles , toy animals , balloons etc.
• 7- 9 months : squeeze and sounds toys , blocks, cubes , plastic ring
and rattles .
• 10 – 12 months : motion toys , water play, blocks , dolls, ball, musical
toys ,rocking horse wakers , pull and push objects.