INFANCY

1. INFANCY

2. The First Year of Life • Time of rapid growth and development. • Growth in the first year is extremely rapid. • It occurs in spurts, called saltatory growth.

3. Patterns of Physical Development • Head to toe • Lift head to see object • Muscle control: pick up • Walk towards • Near to far: trunk outward • Wave arms • Grab with palm of hand • Pick up with thumb and fingers • Simple to complex • Eating with fingers • Spoon and fork

4. Weight • Lose some after birth2.7 – 4.0 kg • 20-30 g/day/month 1st 6 months • 15g/day/month in 2nd 6 months • Birth weight: • Doubled by 6 month • Tripled by 1 yr • Heredity, feeding habits, and physical activity

5. Weight Gain (per month) AGEWEIGHT GAIN • 0-3 months: 900 g • 3-6 months: 600 g • 6-9 months: 450 g • 9-12 months: 360 g • 1-3 years: 240 g/month(2.8 kg/yr) • 4-6 years: 180 g/month (2 kg/yr)

6. Infant Weight • At birth: 2.7 – 4.0 kg • At 5 months: 2X birth weight. • At 12 months: 3 X birth weight. • At 2 years: 4 X birth weight. • At 3 years: 5 X birth weight. • At 5 years: 6 X birth weight. • At 7 years: 7 X birth weight. • At 8 years: 8 X birth weight. • At 9 years: 9 X birth weight. • At 10 years: 10 X birth weight.

7. Weight Gain (per day) AGEWEIGHT GAIN • 0-3 months: 30 g/day • 3-6 months: 20 g/day • 6-9 months: 15 g/day • 9-12 months: 12 g/day • 1-3 years: 8 g/day (2.8kg/yr) • 3-6 years: 6 g/day (2 kg/yr)

8. Formula For Weight • During Infancy WT (Kg) = [ Age (months) +9] /2. • During 2-6 Years WT (Kg) = Age (yrs) X 2+ 8. • During 7-12 Years WT (Kg) = [Age (yrs) X 7-5] /2.

9. Length/ Height • Supine length is measured for children of less than two years of age. • After two years of age, standing height is taken as a measure of stature.

10. Height • Avg newborn =20 inches 48 – 53 cm • Avg 1 year =30 inches 75 cm • Heredity: influences height more than weight

11. Length • At Birth: • At birth: 48 – 53 cm • At one year = 75 cm. • At two years = 87.5 cm. • At four years = 100 cm.

12. Length Gain AGE GAIN • 0-3 months: 3.5 cm/ month • 3-6 months: 2 cm / month • 6-9 months: 1.5 cm/ month • 9-12 months: 1.2 cm/ month • 1-3 years: 1 cm/month(12 cm/yr) • 3-6 years: 0.25 cm/month (3 cm/yr)

13. Gain In Length • 1st year = 25 cm • 2nd year = 12 cm • 3rd year = 10 cm • 4th year = 3 cm • At puberty: • Girls = 6-11 cm • Boys= 7-12 cm

14. Formula for Calculating Height From 1- 6 Years Height (cm) = Age (Yrs) X 6 + 77

15. Head Circumference • At birth: 35.3 ± 1.2 cm. • Increases by 6 cm during the first 3 months. • Further increases by another 6 cm during 3- 12 months.

16. Gain in head circumference • During 1st year = 12 cm. • During 2nd year = 2 cm. • During 3rd year = 1.5 cm. • From 3 to 14 years = 2.5 cm

17. Changes in head circumference AGE GAIN • 0-3 months: 2 cm/ month • 3-6 months: 1 cm / month • 6-12 months: 0.5 cm/ month • 1-3 years: 0.25 cm/month • 3-6 years: 1 cm/year

18. Proportion • Large: head and abdomen • Short/small: arms and legs • Head grows rapidly b/c brain development • Soft spots allow head to grow and close

19. Soft Spots

20. 1st Year Physical Developments

21. Sight: Improves Rapidly • Blurry at first, within week can focus on object 7-10 inches away 15-30 cm away • 1 month, focus on objects 3 feet away • By 3 ½ months, vision almost as good as an adult • Prefer patterns with high contrast and faces • alternating stripes, bull’s eyes • Prefer color red

22. Depth Perception 2nd month: recognize that object is three-dimensional, not flat Binocularity: fixation of two ocular images into one cerebral picture begins to develop by 6 weeks and established by 4 months

23. Hand-Eye Coordination • Develop hand-eye coordination: • Move hands and fingers in relation to what is seen • 3-4 months: reach for what they see • Essential for: • Eating • Catching a ball • Coloring • Tying shoes

24. Hearing • develops before birth • At birth, can tell general direction sound is coming from • Prefer human voice • soothing voice calms • loud voice alarms

25. Smell and Taste • Within 10 days can tell mom’s smell • Can distinguish taste by 2 weeks old • show preference for sweet taste • Learn about world by using mouth

26. Voice • Cry becomes softer as lungs mature • Physical growth of throat muscles, tongue, lips, teeth, and vocal cords • Tongue and mouth interior change making speech development possible

27. Teeth • Begin to develop in 6th week of pregnancy • Primary teeth begin to appear between 6-7 months of age • Complete set by 20 months (1 year, 8 months) • Teething can be painful process • Can refuse food or drool a lot, increased desire for liquid, coughing, and fever • how to help minor teething pain: • teething biscuits or rubber teething rings • rub ice cube on gums to ease pain temporarily • teething medication

28. Motor Skills • Abilities that depend on use and control of muscles • Mastering motor skills requires intellectual, social, emotional, and physical development • Control head by 1 month • 2-3 months can lift their chest • By 9 months crawling- adds opportunity for learning

29. The Developing Brain

30. Rules to Build a Brain By • Keep it simple and natural • Rich environment- lots of loving interaction and talking • Match experiences to the child’s mental capacities • Learn by physical experiences • Practice makes perfect • Repetition

31. Rules to Build a Brain By continued • Make sure the child is actively involved • Learn by doing • Provide variety, but avoid overloading • Give range of experiences, avoid being overwhelmed • Avoid pushing the child • Learn better if emotionally involved

32. Language Acquisition • Cooing: Repetition of vowel sounds by infants • Babbling: Repetition of meaningless language sounds (e.g., babababa) • Single-Word Stage: The child says one word at a time • Telegraphic Speech: Two word sentences that communicate a single idea (e.g., Want yogurt)

33. Language development 12 weeks cooing, smiles when talked to 16 weeks turns head in response to human voice 20 weeks makes vowels and consonant sounds 6 months babbling (all sounds) 8 months repeat certain syllables (ma-ma) 12 months understands and says some words

34. Psychosocial development • Erik Erikson: First Psychosocial Stage: Trust vs. Mistrust • Consistent loving care by a mothering person is essential to build a trust relationship. • Mistrust develops when basic needs are inconsistently met.

35. Piaget’s Cognitive Stages

36. Sensorimotor Stage (0-2) • Stage One (birth-1 mo.) • Use of reflexes • Stage Two (1 - 4 mos.) • Primary circular reactions: Actions that are at first random and activate a reflex are attempted again to try and induce the experience again (recognition of causality). The interesting events are occurring within the body (plays with hands, fingers, feet). • Stage Three (4 - 8 mos.) • Secondary circular reactions: The interesting events in this case are located in the external world (Making Interesting Sights Last) • Beginning of object permanence: shows separation anxiety • Able to imitate selective activity

37. Infants’ imitation of facial expressions

38. Sensorimotor Stage, Cont’d • Stage Four (8 - 12 mos.) • Coordination of secondary schemata • New Adaptations and Anticipation • Intentionality occurs in interactions with the environment and the infant is moving towards goal directed behavior: works to get toy that is out of reach • Fully developed object permanence

39. Moral development (Kohlberg) • Level 1: Preconventional morality (0-9y) • Stage 1: the punishment-and-obedience orientation. • Children determine the goodness or badness of an action in terms of its consequences. • They avoid punishment and obey unquestioningly those who have the power to determine and enforce the rules • They have no concept of the underlying moral order

40. Play • Solitary Play: When a child plays alone even when with other children

41. Principles of Motor Development • Gross movements before fine movements • Pattern of development is usually the same, but the rate differs greatly from child to child and from culture to culture.

42. 2-3 months

43. Gross Motor Development • First Month • Turns head to clear nose from bed • Keeps hands fisted or slightly open • Head lag when pulled from lying to sitting • Second month • Holds head up while on tummy almost 45 degrees • Third month • Lift head and chest of the bed • Turns head to sounds • Reaches for objects with both hands

44. Fourth month • Rolls from back to side • Able to raise head and chest off surface to angle of 90 degrees • Fifth month • Rolls from abdomen to back • May sit if supported • When supine, puts feet to mouth • Sixth month • Transfer toy from one hand to next • army crawl on tummy • Rolls from back to abdomen

45. Seventh month • Pushes up on hands and knees • Sits w/ little support • When held in standing position bounces actively • Eighth month • Sit without support • Creeps • Stands leaning against something • Ninth month • May crawl upstairs

46. Tenth month • Stands w/ little support • Cruises the room. • Eleventh month • Stands alone • Twelfth month • Walks

47. Fine Motor Behavior • At 4 month: brings hands together and shake rattle. • At 6 month: palmer grasp. • At 7 month: pass object from hand to another. • At 8 month: advanced eye-hand coordination. • At 10 month: pincer grasp. • at 12 month: holds cup or spoon

49. Hematologic System • Hgb A production largely replaces Hgb F by 4 months (physiologic anemia due to fetal RBCs destruction)

50. Respiratory System • RR slows. • Upper respiratory infections tend to be more severe due to small lumen of respiratory tract and inefficient mucus production.