INFANCY

1. pediatric NURSING
INFANCY

2. INFANCY
 It is the period which starts at the end of the first
month up to the end of the first year of age.
Infant's growth and development during this
period are rapid.

3. Factors Influencing Growth and
Development
• Genetic factors
• Nutrition and feeding practices
• Health and illness
• Stimulation and play
• Parental bonding and care
• Socioeconomic environment

4. GROWTH AND DEVELOPMENT
OF INFANT

5. Infant growth and development refer to the physical increase in
size (growth) and the progressive acquisition of skills and
abilities (development) during the first year of life.

6. Aspect Growth Development
Meaning
Quantitative physical
changes
Qualitative
functional changes
Measurement
Weight, height, head &
chest circumference
Milestones: motor,
language, cognitive,
social
Example
Weight gain from 3 kg 9
→
kg
Learning to sit,
crawl, walk, and
speak
Difference Between Growth and Development

7. Physical Growth
Indicator Normal Pattern
Weight
Birth weight doubles by 5–6 months and
triples by 1 year
Height/Length Increases by 50% during the first year
Head
Circumference
Increases about 1.5 cm/month for first
6 months, then 0.5 cm/month
Teething
Usually begins at 6 months; 6–8 teeth by
12 months

10. Infant motor development refers to the
progression of muscular coordination
and movement abilities in babies,
enabling them to interact with their
environment. It includes both gross
motor skills (large movements like
crawling or walking) and fine motor
skills (small movements like grasping
objects).

11. Types of Motor Development
A. Gross Motor Skills- Involve large muscles for movements such as:
 Head control
 Sitting
 Crawling
 Standing
 Walking
B. Fine Motor Skills- Involve small muscles, particularly in hands and
fingers, for actions such as:
 Reaching
 Grasping
 Holding objects
 Pincer grasp

12. Age Gross Motor Fine Motor
0–2 months Lifts head briefly when prone Opens hands reflexively
3–4 months
Holds head steady, pushes up on
arms
Brings hands to mouth, bats at
objects
5–6 months Rolls over both ways
Reaches for and grasps
objects, transfers between
hands
7–8 months Sits without support Rakes objects with fingers
9 months Crawls, pulls to stand
Pincer grasp begins (thumb
and finger)
10–12 months
Cruises along furniture, stands
alone, may walk
Fine pincer grasp, can point
and release objects
12–18 months
Walks independently, may begin to
run
Scribbles, stacks blocks
18–24 months
Runs well, climbs stairs with
assistance
Feeds self with spoon, turns
pages of a book

13. Developmental Domains
A. Motor Development
Gross Motor Skills: head control rolling sitting
→ → →
crawling standing walking
→ →
Fine Motor Skills: grasping transferring pincer
→ →
grasp self-feeding
→
B. Cognitive Development(piaget-sensorimotor stage)
Recognizes caregivers and familiar faces
Understands cause-and-effect (e.g., shaking a rattle
makes sound)

14. C. Language Development
 0–2 mo: Crying as communication
 2–4 mo: Coos, smiles responsively
 6 mo: Babbles (“ba,” “da”)
 9–12 mo: Understands simple commands, may say
“mama/dada”
D. Emotional and Social Development
 Develops trust (Erikson: Trust vs. Mistrust)
 Smiles at caregivers (social smile by 6 weeks)
 Shows stranger anxiety at 8 months
 Expresses affection and enjoys social play

16. pediatric NURSING
Prepared by:
TODDLER
ELENITA C. TAN RN,RM,MAN

17. TODDLER
The toddler stage spans from 1 to 3 years of age — a period
of rapid physical, cognitive, and psychosocial growth where
the child begins to assert independence, develop
coordination, and explore their environment actively.

18. “Safety becomes a problem as the
toddler becomes more mobile”

19. Aspect Growth Pattern
Weight
Gains about 1.8–2.7 kg (4–6 lb) per year; birth
weight is quadrupled by 2½ years.
Height Increases by 7.5 cm (3 in) per year.
Head
circumfer
ence
Growth slows; about 2.5 cm total increase during
toddler years.
Body
proportio
n
Legs grow faster; abdomen protrudes; lordosis
and bow-legged appearance common.
Teeth
By 2½ years, all 20 primary (deciduous) teeth
usually erupted.
Physical Growth of Toddlers

20. Skill Type Milestones
Gross
Motor
Walks alone (12–15 mo), runs (18 mo), climbs
stairs with support (2 yr), jumps with both feet
(2½–3 yr).
Fine Motor
Builds tower of 2–6 blocks, uses spoon, turns
pages, scribbles, begins to draw circles.
Developmental Domains
A. Motor Development of Toddlers

21. B. Cognitive Development of Toddlers
(Piaget: Sensorimotor Preoperational Stage)
→
Thinks symbolically and imitates actions.
Begins problem-solving through trial and error.
Understands object permanence fully.
Develops cause-and-effect thinking.
Enjoys simple pretend play (feeding a doll, talking on
toy phone).

22. Age Language Skills
1 year Says a few words besides “mama” and “dada.”
2 years
Uses 2-word phrases (“me go,” “want milk”),
vocabulary ~300 words.
3 years
Uses short sentences, vocabulary ~900 words,
follows 2–3 step directions.
C.Language Development of Toddler

23. D. Psychosocial Development (Erikson: Autonomy vs.
Shame and Doubt)
Main Task: Developing independence and self-control.
Toddlers say “No!” as they test limits and assert will.
Develops toilet training readiness (usually between 18–30
months).
Shows separation anxiety but begins to enjoy brief
independence.

24. E. Social and Emotional Development
 Engages in parallel play (plays alongside, not with, other
children).
 Shows affection to familiar people.
 Begins to imitate adults and older children.
 Experiences frequent mood changes (temper tantrums are
normal).
F. Moral and Spiritual Development
 Begins to develop a sense of right and wrong based on parental
approval.
 Moral behavior guided by rewards and punishments
(preconventional stage — Kohlberg).

25. G. Nutrition
Requires 3 meals and 2 snacks per day.
Transition from bottle to cup by 12–15 months.
Avoid small, hard foods that may cause choking.
Encourage self-feeding with supervision.
H. Safety Considerations
Risk of falls, choking, poisoning, burns, and drowning is high.
Teach parents about childproofing the home and supervised
exploration.

26. Nursing Implications
Promote independence but ensure safety.
Encourage routine and consistency for security.
Support toilet training readiness signs (dry
periods, interest, awareness).
Provide anticipatory guidance to parents about
discipline, nutrition, and safety.

27. Age Gross Motor Fine Motor Language Social
1 year
Walks with
Milestonesh
support
Pincer grasp
Says few
words
Shows affection
2 years
Runs, climbs
stairs
Builds tower,
turns pages
2-word
phrases
Parallel play
3 years
Jumps, rides
tricycle
Draws circles
Uses short
sentences
Begins
cooperative play
Summary Table of Toddler Milestones

28. pediatric NURSING
Prepared by:
PRE SCHOOLER
ELENITA C. TAN RN,RM,MAN

29. PRE SCHOOLER (ages 3–6 years) is a period of refined
motor, cognitive, language, and social development.

30. Aspect Growth Pattern
Weight Gains about 1.8–2.7 kg (4–6 lb) per year.
Height
Increases about 6–8 cm (2.5–3 in) per
year.
Body proportion
Becomes more slender and upright;
abdomen flattens, limbs lengthen.
Teeth
Has all 20 deciduous teeth; begins to
learn proper brushing.
Appetite
May decrease slightly due to slower
growth rate.
Physical Growth of Pre schooler

31. Type Milestones
Gross Motor
Runs smoothly, climbs, hops on one foot (4
yr), skips and rides tricycle (5 yr).
Fine Motor
Draws circles and stick figures, uses
scissors, builds towers, dresses self, ties
shoelaces (by 5–6 yr).
Developmental Domains
A. Motor Development

32. B. Cognitive Development (Piaget:
Preoperational Stage)
 Thinks egocentrically (sees world from own
view).
 Uses symbolic thought and imaginative play.
 Has limited concept of time and conservation.
 Enjoys make-believe and fantasy play.
 Begins to understand cause-and-effect
relationships.

33. Age Language Skills
3 years
Speaks in short sentences (3–4
words); vocabulary ~900 words.
4 years
Asks many “why” questions;
vocabulary ~1500 words.
5–6 years
Speaks in full sentences;
vocabulary ~2000 words; tells
stories and uses future tense.
C. Language Development

34. D. Psychosocial Development (Erikson:
Initiative vs. Guilt)
Main Task: Develops initiative through
play, imagination, and trying new
things.
Takes pride in accomplishments but
feels guilt if criticized or controlled.
Wants to please adults and gain
approval.

35. E. Social and Emotional Development
Engages in associative and cooperative
play (plays with others, not just beside
them).
Learns to share, take turns, and follow
simple rules.
Develops friendships and empathy.
Shows increased independence from
parents.

36. F. Moral Development (Kohlberg:
Preconventional Level)
Morality is based on consequences
(reward or punishment).
Understands “good” and “bad”
through adult guidance.

37. Age Gross Motor Fine Motor Language Social/Emotional
3 years
Runs,
climbs, rides
tricycle
Builds tower,
draws circle
Short
sentences
Parallel →
Associative play
4 years
Hops on one
foot
Uses
scissors,
draws
person
Asks “why”
questions
Cooperative play
begins
5 years
Skips,
catches ball
Prints name,
dresses self
Tells stories
Understands
rules, shares
6 years
Balances,
rides bike
Ties
shoelaces
Uses full
sentences
Forms close
friendships
Summary Table of Preschool Milestones

38. pediatric NURSING
Prepared by:
SCHOOL AGE
ELENITA C. TAN RN,RM,MAN

39. SCHOOL AGE (ages 6–12 years) is characterized by steady
physical growth, cognitive advancement, and social
expansion.

40. Aspect Growth Pattern
Weight Gains about 2–3 kg (4.4–6.6 lb) per year.
Height
Increases about 5–6 cm (2–2.5 in) per
year.
Body
proportions
Body becomes leaner; legs lengthen;
posture improves.
Teeth
Begins to lose deciduous teeth;
permanent teeth erupt (around 6 years).
Puberty
May begin near end of this period —
earlier in girls (10–12 years).
Physical Growth of School Age

41. Type Milestones
Gross
Motor
Increased coordination, balance,
and strength; enjoys running,
jumping, team sports.
Fine
Motor
Improved handwriting, crafts,
musical instruments, and computer
use.
Developmental Domains
A. Motor Development

42. B. Cognitive Development (Piaget: Concrete
Operational Stage)
 Thinks logically about concrete events.
 Understands cause and effect, time, and
reversibility.
 Learns classification, seriation, and
conservation concepts.
 Problem-solving improves, but thinking is
still concrete (not abstract).

43. C. Language Development
Vocabulary expands rapidly (up to
50,000 words by age 12).
Uses complex sentences and improved
grammar.
Can read, write, and explain ideas
clearly.
Enjoys jokes, riddles, and stories.

44. D. Psychosocial Development (Erikson:
Industry vs. Inferiority)
 Main task: Develops sense of industry
(competence) through achievement and
recognition.
 Gains confidence through school
performance and peer approval.
 Failure or lack of encouragement may
result in feelings of inferiority.

45. E. Social and Emotional Development
 Strong peer relationships emerge; friends
become important.
 Prefers same-sex friendships (early school-
age).
 Understands rules and fairness.
 Develops moral reasoning (right vs. wrong).
 Values belonging to groups (sports teams,
clubs).

46. F. Moral Development (Kohlberg: Conventional
Level)
 Morality guided by rules, laws, and authority
figures.
 Understands intentions behind actions.
 Seeks approval from others and follows rules to
maintain order.

47. Age Physical/Motor Cognitive Psychosocial Social
6–7 years
Improved
balance; rides
bike
Concrete
thinking;
learns
reading/writi
ng
Seeks praise;
follows rules
Same-sex play
8–9 years
Increased
strength,
coordination
Understands
cause/effect
Strives for
competence
Group play, peer
loyalty
10–12
years
Prepubertal
changes
Logical
reasoning;
problem-
solving
Develops self-
concept
Values friends,
team identity
Summary Table of Schoolage Milestones

48. pediatric NURSING
Prepared by:
ADOLESCENCE
ELENITA C. TAN RN,RM,MAN

49. Stage Age Range Key Characteristics
Early Adolescence 10–13 years
Pubertal changes begin; increased
self-consciousness; peers gain
importance
Middle
Adolescence
14–16 years
Rapid physical growth; search for
identity; emotional instability
Late Adolescence 17–19 years
Maturity in thinking; clearer sense
of identity; preparation for adult
roles
Stages of Adolescence

50. Physical Development of Adult
 Pubertal growth spurt (height and weight
increase)
 Secondary sexual characteristics develop
 Girls: breast development, menarche
 Boys: voice deepens, facial hair growth
 Hormonal changes: Increased estrogen and
testosterone
 Brain maturation: prefrontal cortex
continues to develop (decision-making,
impulse control)

51. Cognitive Development (Piaget’s
Formal Operational Stage)
Abstract and logical thinking
Problem-solving and hypothetical
reasoning
Increased ability to plan and think
about the future

52. Psychosocial Development (Erikson’s Stage:
Identity vs. Role Confusion)
Main task: Develop a stable sense of
identity
Exploration of values, beliefs, and career
choices
Influence of peer relationships is strong
May experience role confusion or
uncertainty about the future

53. Emotional Development
 Heightened emotions due to hormonal changes
 Struggle for independence from parents
 Development of self-concept and self-esteem
Social Development
 Peer groups become central
 Development of intimate relationships begins
 Influence of social media and culture increases
 Desire for acceptance and belonging

54. References
World Health Organization (WHO)
Department of Health (DOH)
Potter & Perry – Fundamentals of
Nursing
Hockenberry – Wong’s Essentials of
Pediatric Nursing

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