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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.

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Presentation on theme: "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."— Presentation transcript:


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

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

15 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 16 Gain in head circumference During 1 st year = 12 cm. During 2 nd year = 2 cm. During 3 rd year = 1.5 cm. From 3 to 14 years = 2.5 cm

17 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 1 st 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 6 th 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 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 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 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 35 Piaget’s Cognitive Stages

36 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 37 Infants’ imitation of facial expressions

38 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 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 40 Play Solitary Play: When a child plays alone even when with other children

41 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 42 2-3 months

43 43 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 Gross Motor Development

44 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 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 46 Tenth month – Stands w/ little support – Cruises the room. Eleventh month – Stands alone Twelfth month – Walks

47 47 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 Fine Motor Behavior

48 48

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

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

51 51 Become functioning at 2 months. Produce both IgG & IgM antibodies by the first year. Immune System

52 52 Emotional At 6 weeks: social smile. At 4 months: recognize his primary caregiver. At 7-8 months: stranger anxiety, continue until 12 months. At 8 months: separation anxiety, continue until preschool period. Both are related to infant’s ability to discriminate between familiar and nonfamiliar people

53 53 Dentation First tooth erupt 5-7 months Has 6-8 deciduous teeth by the first year of age. The sequence of eruption is: – At 6 months: lower central incisors. – At 7 months: lower lateral incisors. – At 8 months: upper central incisors. – At 9 months: upper lateral incisors.

54 54

55 55 GI System Can digest protein at birth. Amylase deficiency until 3 rd month of age ( cannot digest complex CHO) Lipase deficiency during entire 1 st year. Infant needs frequent feedings. Extrusion reflex exists until 3-4 months. Introduction of solid food 4-6 months.

56 Handling and Feeding Infants

57 Gentle Handling of an Infant Never shake a baby Shaken baby syndrome- when someone severely shakes the baby usually to make them stop crying – Damages the brain – Learning problems – Mental retardation – Blindness – Deafness – death

58 Gentle Handling of an Infant continued Safe ways to handle a stressful situation with crying: – Put baby down in a safe place and calm down – Ask a friend or relative to care for the baby – Take deep breaths – Talk out your problems

59 59 Energy Requirement AgeEnergy requirement < 6 monthsWt (kg) x 108/ day 6mo-1 yearWt (kg) x 98/ day

60 60 Water requirements = amt in foods + fluids Age Amount 3 days80-100 ml/kg/day 10 days125-150 ml/kg/day 3 mo140-160 ml/kg/day 6 mo130/155 ml/kg/day 9 mo125-145 ml/kg/day With BF and formula: none additionally needed in first 4 to 6 months

61 Feeding Methods

62 62 Infant Nutrition Birth through 4-6 months  Breast milk OR  Iron-Fortified infant formula

63 63 Breast- Versus Bottle-Feeding Debate focused on whether breast-feeding is better for the infant than bottle-feeding American Pediatric Association strongly endorses breast- feeding throughout the first year of life Benefits – Appropriate weight gain – Fewer allergies – Fewer illnesses – Reduced childhood cancer and reduced incidence of breast cancer in mothers and their female offspring – Lower incidence of SIDS – Stronger attachment bond

64 Breastfeeding Basics

65 Why Breastfeed? Healthy Free Bonding Natural Builds immune system Mom burns more calories and loses weight quicker

66 How long should you breastfeed? Recommend 1 st 6 months First milk- colostrum – High in fat, protein, antibodies 20 minutes on each breast Feed on demand 5-6 wet diapers 3-4 dirty diapers Feeding-Positions.htm Feeding-Positions.htm

67 Nutrition Avoid gassy foods: – Broccoli, green leafy vegetables, spicy foods Mom’s diet becomes baby’s diet

68 Video Clips and Pictures up_video.aspx?id=LatchOnEnglish up_video.aspx?id=LatchOnEnglish eo_4_bf_positions.html eo_4_bf_positions.html eos/18_how_baby_sounds_bfing.html eos/18_how_baby_sounds_bfing.html decoder decoder

69 How to Feed with a Bottle Hold baby is semi-upright position Support neck and head with the head held above the stomach Hold the bottle at an angle – Prevents swallowing air Never prop a bottle – Choking hazard, tooth decay, digestive problems

70 Burping a Baby Burping helps expel air the baby swallowed You should burp a baby once during feeding and once after

71 71 4 through 7 months  Breast milk OR  Iron-Fortified infant formula  Iron-Fortified infant cereal  Vegetables  Fruit Infant Nutrition

72 Types of Formula Powder, concentrate, ready to feed (RTF)

73 73 8 through 11 months  Same as 4 through 7 months PLUS  Meat  Egg yolks Infant Nutrition

74 74 11 months  Finger foods  Cup Infant Nutrition

75 75 Tips for Introduction of Solid Foods  Start slowly  Only 1 new food every 4-5 days  Hold baby during feeding  First food: Iron-Fortified infant rice cereal

76 76 Tips for Introduction of Solid Foods  Use single-ingredient foods  Read food labels  Avoid desserts  Avoid foods that can choke infants

77 Introducing New Foods Introduce solids around 4-6 months Cereal first – Mix with breast milk or formula to make it runny – Feed with a spoon, never in a bottle Vegetables, then fruits – 1 new food at a time for at least 3 days – Feed with a spoon, never in a bottle Never feed straight from the jar 8-10 months, start using fingers; eventually move to spoons

78 What Infants Need to Stay Healthy Enough calories to provide rapid growth Protein, iron, vitamins B, C, and D Food that is easy to digest Adequate amounts of liquid

79 79 Feeding Problems Colic (<3months): gas production, and bloating – Cause? Not always known: formula fed! (high in carbohydrate) – Overfeeding : swallowing too much air. – Breastfeeding? Foods in the mother’s diet Cow’s milk, or other items Spitting up – Normal occurrence: after meals, mouthful of milk. – Unless projectile vomiting: Organic problem: pyloric sphincter closure

80 Sleep Newborns sleep 12-20 hours a day – By 1 year has 2-3 sleep periods including naps Preparation for sleep: – Change diaper and clothes, wash face/hands – Rock to calm the baby – Put the baby in the bed on it’s back – Follow the same routine to provide comfort each time

81 81 Common Health Concerns Teething: gum sore, tender can lead to decreased intake and cry. Thumb sucking: does not deform the jaw as long as it stops by school-age. Diaper dermatitis: prolong contact with urine or feces. Constipation: increased with formula fed. Sleep problems: as a result of colic or other health problems.

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