growth and development of newborn

1. Growth and
Development During
Infancy
Dr.(Mrs.) S.Valliammal
Lecturer
College of Nursing
NIMHANS
Bangalore

2.  Skin of newborn is pink and look healthy.
 Newborn will have fine textured hair.
 80% of newborn may have physiological jaundice
(yellow skin)

3. APGAR Score
Permits rapid assessment of the newborn’s transition to
extrauterine existence based on five signs that
indicate the physiologic state of the newborn:
(1) Heart Rate
(2) Respiratory Rate A- Activity
(3) Muscle Tone P- Pulse
(4) Reflex irritability G- Grimace
(5) Color A- Appearance
R- Respiration

4. APGAR Score
Sign Score
0 1 2
Heart Rate Absent Slow (<100) > 100
Respiratory Rate Absent Slow, irregular Good cry
hypoventilation
Muscle Tone Flaccid Some flexion of Active motion, well
extremities flexed
Reflex Activity No Response Crying ,Some Vigorous cry
body motion
Colour Blue Pale Body pink, pink
extremities blue

5. One Month
-Follows and fixes on bright objects with eyes when it
moves within field of vision.
-Turns head when prone, but unable to support.
-Holds hands in fists.
-Grows 1 inch monthly for 6 months.
-Cries when hungry or uncomfortable.
-Makes small, throaty sounds.

6. Two Months
-Has closed posterior fontanel.
-Listens actively to sounds.
-Lifts head almost 45 degrees off table when prone.
-Follows moving objects with eyes.
-Recognizes family faces.

7. Piaget’s Five Stages of
Infant Development
Stage 1: Birth to 1 month
-Modification of reflexes
Infant practices and perfects reflexes present at birth.
Sucking reflex becomes more refined and voluntary.

8. Eriksons stage of
Development
 Trust vs Mistrust
 Birth to one year
 Develop a healthy personality

9. Feeding
36-48 Hr to Discharge:
A breast feeding and formula feeding mom
should be feeding successfully 8-10 times/day.

10. Advantages of Breast
Feeding
The correct balance of all essential nutrients for infants.
Full of immunological agents to protect against disease.
Easier to digest than formula.
Contains anti-inflammatory properties.
Promotes growth of Lactobacillus bifidus.

11. Skin to Skin Contact
 It is helpful to place the infant on the
mothers abdomen soon after birth.
 It helps with spontaneous breastfeeding
and allows for bonding.

12. Kangaroo Care
 The infant is placed on the mothers bare
chest and is only wearing a diaper.
 It is used for both full term and preterm
infants.
 Benefits……

13. Normal Sleep Patterns
 2-3 Months
Low: 10 hours of sleep in 24-Hour period
Average: 16 ½ hours of sleep in 24-Hour period
High: 23 hours of sleep in 24-Hour period (2 to 4 naps)

14. Bathing a Newborn
 Benefits of bathing
- complete cleaning of infant.
- observer infants condition.
- promote comfort and bonding time

15. Bathing a newborn...
 Temperatures
 Gather supplies needed
 Bathing
 Cleansing hands and feet
 Cleansing genitals

16. Umbilical Cord Care
 The umbilical cord stump is an excellent medium for bacterial
growth and can easily become infected.
 Common methods of care include use of an antimicrobial agent
such as bacitracin or triple dye. Also, use of soap and water or
sterile water alone are used.
 Current recommendations for cord care include cleaning the cord
with sterile water or a neutral pH cleanser.
 The stump and base should be assessed for edema, erythema,
and drainage with each diaper change.
 The stump deteriorates and average seperation time is 10 to 14
days.

17. Bowel Movements
 Meconium
 Transitional Stools
 Milk Stool

18. Reflexes
 Good reflexes indicate a healthy nervous
system.
 Reflexes are developed for survival
 Newborn exhibits many reflexes.

19. ROOTING

20. SUCKING

21. Palmer Reflex

22. Babinski Reflex

23. Stepping Reflex

24. MORO Reflex

25. Tonic Neck

26. Normal development of
hearing
After the amniotic fluid drains from the middle ear several
days after birth, the infant’s hearing becomes acute.
Hearing is one of the better-developed senses in the
infant; the fetus can hear in utero and responds to loud
sounds.
The ability to listen and discriminate among sounds is an
important task during infancy. The closer the infant is to
the sound, the easier the sound can be discriminated.

27. Touch
 The newborn is responsive to touch on
all parts of the body. The face (especially
the mouth), hands, and soles of the feet
seem to be most sensitive.

28. Taste
 The newborn can distinguish between tastes,
and various types of solution elicit different
facial expressions.

29. Smell
 Newborns react to strong odors such as
alcohol or vinegar by turning their heads away.
Breastfed infants are able to smell breast milk
and can differentiate their mother from other
lactating women by the smell.

30. Immunizations
 If the infant is born to an infected mother or to a mother
who is a chronic carrier, hepatitis vaccine and hepatitis
B immune globulin (HBIG) should be given within 12
hours of birth.
 For infants born to a hepatitis B-negative woman, the
first dose of the vaccine may be given at birth or at 1 or
2 months of age (depending on province of residence).

31. Family Assessment Process
Do the parents and infant have eye to eye contact frequently?
How much body contact is present?
Does vocalization by the parents evoke a smile from the infant?
How much does the infant cry? What is the mother’s reaction? What is the
father’s reaction?
How does the mother describe the infant’s feeding and sleeping patterns?
Does the mother describe the infant’s tasks positively or negatively?

32. Nursing Interventions
Improve family interactions and relationships.
Improve family’s ability to cope with stress from the new addition to their family.
Praise positive parenting behaviors.
Provide adequate nutrition to malnourished infant.
Allow parents to vent their feelings about the infant.
Refer to appropriate agency for financial, social, or other family needs.

33. Determinants of Health
 EDUCATION
 FINANCIAL SUPPORT
 SUPPORT NETWORKS

34. SUMMARY
 Appearance of Newborn
 Sleeping, eating, and elimination patterns
 Reflexes
 SIDS
 Car seats
 Bathing Process

35. References
 Edelman, C. L. and Mandle C. L. (2002).
Health promotion throughout the
lifespan. St. Louis: Mosby
 Wong, D. L., Perry, S. E., Hockenbery,
M.J., Lowdermilk, D. L., & Wilson D.
(2006). Maternal Child Nursing Care (3rd
ed.). St. Louis: Mosby.