During the first year of life, infants experience rapid growth and development physically, cognitively, and psychosocially. They gain weight and double their birth length. Teething begins around 6 months as they develop the 20 primary teeth. Fine motor skills like grasping emerge around 2-3 months and crawling starts at 8-10 months. Language comprehension grows from babbling to understanding simple words. Parents are guided to meet infants' needs for love, feeding, and stimulation while introducing solid foods and anticipating stranger anxiety.

1. 2- Normal Infant
Definition of infancy period:
Infancy period starts of the end of the first
month up to the first year of life. Infant's growth
and development during this period are
characterized by being rapid growth.

2. Physical Growth
I- Physical Growth:
Nurse can detect physical growth through measurement of:
Weight:
birth to 4 months > 3/4 kg / month
5 to 8 months >1/2 kg / month
9 to 12 months > 1/4 kg /month
- The babies will double his birth weight by the time he is 5 to 6
months old. And, weight gain slows during the second 6 months ,
has tripled birth weight by 12 months old to 9.75 kg.
Length:
The baby will grow about 2.5 cm each month. So, he should be 2
times longer than at birth by 10 to 12 months old.

3. Physical Growth
Head:
The baby's head will continue to look large compared to the rest of his
body.
- - But, with time his body's growth catches up. Your baby's head will grow
about a 2 cm every month for the first 3 months and 1 cm per month from 4
to 6 months
- - Then 0.5 cm /month during the second 6 months. Average size 43 cm at
6 months and 46cm by 12 months.
- Posterior fontanel closes by 6 to 8 weeks of age.
- Anterior fontanel closes by 12 to 18 months of age. (average, 14 months
old).
Chest circumference:
By the end of the first year, it will be equal to head circumference.

4. Physical Growth
Teething
- One of the more difficult periods in infants' (and parents')
lives is the eruption of the deciduous (primary) teeth
- Teething begins around 6 -10 months and infant will have
6 to 8 teeth by the end of his 1st year.
- Approximately 2 years of age, when all 20 baby teeth are
pre-sent.
- Generally, the first tooth to erupt comes in at 6 months.
This tooth is the bottom front incisor.
- When a child is teething they tend to be irritable, drool, chew
on everything and the gums may be red.

5. Teething
ERUPTS BY
LOWER
ERUPTS BY
UPPER
6-10 months
Central Incisor
8-12 months
Central Incisor
10-16 months
Lateral Incisor
9-13 months
Lateral Incisor
17-23 months
Cuspid
16-22 months
Cuspid
14-18 months
First Molar
13-19 months
First Molar
23-31 months
Second Molar
25-33 months
Second Molar

6. II- Physiological Growth
Nurse can detect physiological growth through measurement of
Vital signs:
- Temperature …………36.5- 37.5C
During infancy, thermoregulation becomes more efficient
- Pulse rate ……………… 110-150b/min.
The heart rate slows, and the rhythm is often sinus arrhythmia
(rate increases with inspiration and decreases with expiration).
- Respiratory rate………….30-40c/m.
- Also the respiratory rate slows somewhat and is relatively
stable, Respiratory movements continue to be abdominal.
- Blood pressure……………80/50mmhg.

7. Systems Maturation
1- The Digestive System
The digestive processes are relatively immature at birth. Although term
newborn infants have some limitations in digestive function, human milk
has properties that partially compensate for decreased digestive
enzymatic activity, thus enabling breastfed infants to receive optimal
nutrition during the first several months of life.
The enzyme amylase (also called ptyalin) is present in small amounts
but usually has little effect on the foodstuffs because of the small
amount of time the food stays in the mouth.

8. Systems Maturation
2- Immunologic System
The immunologic system undergoes numerous changes during the first
year.
- Full-term newborns receive significant amounts of maternal
immunoglobulin G (IgG),
- Which, for approximately 3 months, confers immunity against
antigens to which their mothers were exposed.
- During this time, infants begin to synthesize IgG but in limited
amounts. Therefore, infants are at higher risk for infection during the
first 12 months of life.
- Auditory acuity is at adult levels during infancy.

9. Development
 Gross Motor Development
At 4 months old, infant should be able to lift his head up
when he is on his stomach. But, continue to support his
head until his neck muscles are stronger at about 6
months old.
At 4 months old, infant should be able to sit with some
support.
Newborns may turn from the abdomen to the back
occurs around 5 months old, and the ability to turn from
the back to the abdomen occurs at approximately 6
months old

10. Motor Development cont
At 8 months old, infant should be able to hold his
head up and sit without support.
At 8 to 10 months old, infant should start to crawl.
And, he starts pulling himself to a standing position
while holding onto furniture.
At 10 to 12 months old, infant starts to "cruise"
which means walking while holding onto furniture.
And, your baby may start to walk alone but may not
have very good balance

11. Gross Motor Development

12. Gross Motor Development cont

13. Motor Development
Fine Motor development (Hand and Finger Skills):
 Grasping occurs during the first 2 to 3 months as a reflex and
gradually becomes voluntary
 At 4 to 6 months old, infant has developed some hand-eye
coordination (see and grab things). He grabs the objects and
brings his hands or the objects close to his face to mouth. He
also opens and closes his hands so that he can pick up and look at
objects, and can Points to objects
 By 7 months old, they transfer objects from one hand to the other
 At 9 months old, should be able to tell if infant is right or left handed.
 At 12 months old, infant can put an object into a container and can turn
pages in a book.

14. Language Development
- Infant learns to talk by copying the words and sounds you make. Talk, read, and sing to
infant using a soft, gentle voice. And, use different tones of voice also.
- Infant will have learned some basic language skills by the end of his 1st year. And, he
should be able to speak few simple words.
During early infancy, your infant gets your attention by crying, smiling, laughing, and
using body movements.
- By 2 months old, infant tries sounding out vowels, like a, e, i, o, and u.
- He starts cooing and babbling or monosyllabic babbling at around 4 months old.
And, then infant starts copying the sounds of consonants, like n, k, g, p, and b.
At around 6 months old, infant begins to imitate (copy) sounds in one syllable words, like
example, ma, da, and hi. Soon your baby can put 2 syllables together, like dada,
mama, baba
.
- By 9 to 12 months, infant begins to understand the meaning of some simple word and
commands. He soon understands what you mean when you say "no" or "give it
to me."

15. Cognitive Development According To Piaget (Sensorimotor Phase)
-The period from birth to 24 months is termed the
sensorimotor phase.
- During this period the infants progress from reflex
behaviors to simple repetitive acts to imitative
activity.
- The first event involves separation, in which
infants learn to separate themselves from
other objects in the environment.

16. Psychosocial Development According To Erikson
Erikson’s Phase 1(Trust vs. Mistrust)
(birth to 1 year) is concerned with acquiring a sense
of trust while overcoming a sense of mistrust.
- Trust that develops is a trust of self, of others, and
of the world. Infants “trust” that their feeding,
comfort, stimulation, and caring needs will be met.
- Mistrust can result either from too much or too little
frustration.

17. Psychosexual Development According To Freud Phase 1
( Oral stage)
- Infant obtain pleasure though mouth
- The infant sucks for enjoyment as well as nourishment &
also gains gratification by swallowing ,chewing ,&biting
- In this stage the infants meet the world orally by crying ,
taste ,eating &early vocalizing
- The infants using biting to get hold on the environment &to
gain a greater sense of control .
- they use grasping &touching to explore variation in the
environment

18. Separation Anxiety
- As infants demonstrate attachment to one person, they
correspondingly exhibit less friendliness to others.
- Between 6 and 8 months old, fear of strangers and stranger
anxiety become prominent and are related to infants' ability
to discriminate between familiar and unfamiliar people.
- Behaviors such as clinging to the parent, crying, and turning
away from the stranger are common

19. Promoting Optimal Health During Infancy
1- Infant Nutrition
- Despite adequate availability of optimum nutrient sources,
experts are concerned that infants are not fed appropriately.
Infants may be given solid foods when their digestive
systems are not ready to completely absorb such foods.
- In addition infants are risk for iron-deficiency anemia, vitamin
D deficiency, and rickets. A survey of infant feeding practices
found that about 20% of infants had consumed solid foods
before 4 months old despite recommendations that such
foods not be introduced until 4 to 6 months old

20. Infant Nutrition at the First 6 Months
The First 6 Months Human milk is the most desirable complete diet for
infants during the first 6 months. A healthy term infant receiving breast
milk from a well-nourished mother usually requires no specific vitamin
and mineral supplements with a few exceptions.
Daily supplements of vitamin D and vitamin B12 may be indicated if the
mother's intake of these vitamins is inadequate.
- The American Academy of Pediatrics recommends that all infants
(including those exclusively breastfed) and receive a daily
supplement of 400 IU of vitamin D beginning in the first few days of
life to prevent rickets and vitamin D deficiency.
- formula should also receive a daily vitamin D supplement of 400 IU .

21. Infant Nutrition at the First 6 Months cont
- If the infant is being exclusively breastfed after 4 months old
(when fetal iron stores are depleted), iron supplementation
(1 mg/kg/day) is recommended until appropriate iron-
containing complementary foods (such as, iron-fortified
cereal) are introduced. Infants, whether breastfed or bottle
fed, do not require additional fluids, especially water or juice,
during the first 4 months of life.

22. 2- Administration of Iron Supplements
• Ideally, iron supplements should be administered between meals for
greater absorption.
• Liquid iron supplements may stain the teeth; therefore, administer
them with a dropper toward the back of the mouth (side).
. • Avoid administration of liquid iron supplements with whole cow's milk
or milk products, because they bind free iron and prevent absorption.
• Educate parents that iron supplements will turn stools black or tarry
green.
• Iron supplements may cause transient constipation.
Caution parents not to switch to a low-iron containing formula or whole
milk, which are poor sources of iron and may lead to iron-deficiency
anemia
.

23. Infant Nutrition at the Second 6 Months
Introduction of Solid Foods When the spoon is first introduced, infants often push it
away and appear dissatisfied.
Food that is placed on the front of the tongue and pushed out is simply scooped up
and refed.
- One food item is introduced at intervals of 4 to 7 days to allow for identification of
food allergies.
- New foods are fed in small amounts.
- As the amount of solid food increases, the quantity of milk is decreased to less
than 1 L/day to prevent overfeeding.
- Because feeding is a learning process, as well as a means of nutrition, new foods
are given alone to allow the child to learn new tastes and textures.

24. Characteristics of Food at Second 6 Months
 May begin to add solids by 4 to 6 months old.
 First foods are strained, pureed, or finely mashed.
 Finger foods such as teething crackers, raw fruit, or vegetables can
be introduced by 6 to 7 months old.
 Chopped table food or commercially prepared junior foods can be
started by 9 to 12 months old.
 With the exception of cereal, the order of introducing foods is
variable; a recommended sequence is fruit, then vegetables, and
then meat.
 Introduce one food at a time, usually at intervals of 4 to 7 days, to
identify food allergies.
 Introduce solids when the infant is hungry.

25. 3- Weaning
• Defined as the process of giving up one
method of feeding for another, weaning
usually refers to replacing the breast or bottle
for a cup.

26. Weaning cont
Weaning should be gradual by replacing one bottle or breastfeeding
session at a time.
- It is advisable to never allow a child to take a bottle of milk to bed;
this is a major cause of caries in deciduous teeth.
- If breastfeeding is terminated before 5 or 6 months old, weaning
should be to a bottle (not in bed) to provide for the infant's continued
sucking needs.
- If discontinued later, weaning can be directly to a cup, especially by
12 to 14 months old.
- Any sweet liquid, such as fruit juice, should be given in a cup and
should not be given at bedtime.

27. Reasons For Starting Weaning
The child cannot tolerate more than one of
fluid per day so his increased needs for
energy more solid foods should be added
 With growth the baby require more food
items
 To train GIT to digest the solid food
 To educate the child independence using
spoon

28. 4- Infant Sleep and Activity
- Sleep patterns vary among infants, with active
infants typically sleeping less than placid
children.
- The total daily sleep for 2-month-old infants is
approximately 15 hours
- The total daily sleep for 6- to 12-month-old
infants is approximately 13 hours

29. Activity for the Infant
- Most infants are naturally active and need no encouragement
to be mobile.
- Problems can arise when devices such as play yards,
strollers, commercial swings, and mobile walkers are used
excessively.
- These items restrict movement and prevent infants from
exploring and developing gross motor skills.
- Type of play is : Solitary play

30. 5- Anticipatory ( Parental) Guidance
From 1st To 6 Months
I - Teach care of infant assist parent need.
2- Give health teaching about importance of immunization.
3- Help parent to understand infant needs for stimulation in
environment.
4-Prepare for introduce solid food.
From 6 To 12 Months:
I - Prepared parent for child "stranger anxiety".
2- Encourage parent to negative voice & eye contact.
3- Discuss weaning & injury prevention.

31. Needs For Infant
Love & security
Feeding
Suckling reflex
Warmth & comfortable
Sensory stimulation

32. Care for Infant
Eye care
Nose care
Bathing
Diaper care
Clothes bright Color
Exercise
 Sleeping