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 toeLift head to see objectMuscle control: pick upWalk towardsNear to far: trunk outwardWave armsGrab with palm of handPick up with thumb and fingersSimple to complexEating with fingersSpoon and fork
4 Weight Lose some after birth2.7 – 4.0 kg 20-30 g/day/month 1st 6 months15g/day/month in 2nd 6 monthsBirth weight:Doubled by 6 monthTripled by 1 yrHeredity, feeding habits, and physical activity
21 Sight: Improves Rapidly Blurry at first, within week can focus on object 7-10 inches away cm away1 month, focus on objects 3 feet awayBy 3 ½ months, vision almost as good as an adultPrefer patterns with high contrast and facesalternating stripes, bull’s eyesPrefer color red
22 2nd month: recognize that object is three-dimensional, not flat Depth Perception2nd month: recognize that object is three-dimensional, not flatBinocularity: 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 seen3-4 months: reach for what they seeEssential for:EatingCatching a ballColoringTying shoes
24 Hearing develops before birth At birth, can tell general direction sound is coming fromPrefer human voicesoothing voice calmsloud voice alarms
25 Smell and Taste Within 10 days can tell mom’s smell Can distinguish taste by 2 weeks oldshow preference for sweet tasteLearn about world by using mouth
26 Voice Cry becomes softer as lungs mature Physical growth of throat muscles, tongue, lips, teeth, and vocal cordsTongue 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 ageComplete set by 20 months (1 year, 8 months)Teething can be painful processCan refuse food or drool a lot, increased desire for liquid, coughing, and feverhow to help minor teething pain:teething biscuits or rubber teething ringsrub ice cube on gums to ease pain temporarilyteething medication
28 Motor Skills Abilities that depend on use and control of muscles Mastering motor skills requires intellectual, social, emotional, and physical developmentControl head by 1 month2-3 months can lift their chestBy 9 months crawling- adds opportunity for learning
30 Rules to Build a Brain By Keep it simple and naturalRich environment- lots of loving interaction and talkingMatch experiences to the child’s mental capacitiesLearn by physical experiencesPractice makes perfectRepetition
31 Rules to Build a Brain By continued Make sure the child is actively involvedLearn by doingProvide variety, but avoid overloadingGive range of experiences, avoid being overwhelmedAvoid pushing the childLearn 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 timeTelegraphic 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 voice20 weeks makes vowels and consonant sounds6 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. MistrustConsistent loving care by a mothering person is essential to build a trust relationship.Mistrust develops when basic needs are inconsistently met.
36 Sensorimotor Stage (0-2) Stage One (birth-1 mo.)Use of reflexesStage 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 anxietyAble to imitate selective activity
38 Sensorimotor Stage, Cont’d Stage Four ( mos.)Coordination of secondary schemataNew Adaptations and AnticipationIntentionality occurs in interactions with the environment and the infant is moving towards goal directed behavior: works to get toy that is out of reachFully 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 rulesThey have no concept of the underlying moral order
40 PlaySolitary Play: When a child plays alone even when with other children
41 Principles of Motor Development Gross movements before fine movementsPattern of development is usually the same, but the rate differs greatly from child to child and from culture to culture.
43 Gross Motor Development First MonthTurns head to clear nose from bedKeeps hands fisted or slightly openHead lag when pulled from lying to sittingSecond monthHolds head up while on tummy almost 45 degreesThird monthLift head and chest of the bedTurns head to soundsReaches for objects with both hands
44 Fourth month Fifth month Sixth month Rolls from back to side Able to raise head and chest off surface to angle of 90 degreesFifth monthRolls from abdomen to backMay sit if supportedWhen supine, puts feet to mouthSixth monthTransfer toy from one hand to nextarmy crawl on tummyRolls from back to abdomen
45 Seventh month Eighth month Ninth month Pushes up on hands and knees Sits w/ little supportWhen held in standing position bounces activelyEighth monthSit without supportCreepsStands leaning against somethingNinth monthMay crawl upstairs
46 Tenth month Eleventh month Twelfth month Stands w/ little support Cruises the room.Eleventh monthStands aloneTwelfth monthWalks
47 Fine Motor BehaviorAt 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 SystemHgb 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.
51 Immune System Become functioning at 2 months. Produce both IgG & IgM antibodies by the first year.
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 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.
55 GI System Can digest protein at birth. Amylase deficiency until 3rd month of age ( cannot digest complex CHO)Lipase deficiency during entire 1st year.Infant needs frequent feedings.Extrusion reflex exists until 3-4 months.Introduction of solid food 4-6 months.
57 Gentle Handling of an Infant Never shake a babyShaken baby syndrome- when someone severely shakes the baby usually to make them stop cryingDamages the brainLearning problemsMental retardationBlindnessDeafnessdeath
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 downAsk a friend or relative to care for the babyTake deep breathsTalk out your problems
59 Energy Requirement Age Energy requirement < 6 months Wt (kg) x 108/ day6mo-1 year Wt (kg) x 98/ day
60 Water requirements = amt in foods + fluids Age Amount3 days ml/kg/day10 days ml/kg/day3 mo ml/kg/day6 mo 130/155 ml/kg/day9 mo ml/kg/dayWith BF and formula: none additionally needed in first 4 to 6 months
62 Infant Nutrition Birth through 4-6 months Breast milk OR Iron-Fortified infant formula
63 Breast- Versus Bottle-Feeding Debate focused on whether breast-feeding is better for the infant than bottle-feedingAmerican Pediatric Association strongly endorses breast-feeding throughout the first year of lifeBenefitsAppropriate weight gainFewer allergiesFewer illnessesReduced childhood cancer and reduced incidence of breast cancer in mothers and their female offspringLower incidence of SIDSStronger attachment bond
69 How to Feed with a Bottle Hold baby is semi-upright positionSupport neck and head with the head held above the stomachHold the bottle at an anglePrevents swallowing airNever prop a bottleChoking 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 Infant Nutrition 4 through 7 months Breast milk OR Iron-Fortified infant formulaIron-Fortified infant cerealVegetablesFruit
72 Types of FormulaPowder, concentrate, ready to feed (RTF)
73 Infant Nutrition 8 through 11 months Same as 4 through 7 months PLUS MeatEgg yolks
75 Tips for Introduction of Solid Foods Start slowlyOnly 1 new food every 4-5 daysHold baby during feedingFirst food: Iron-Fortified infant rice cereal
76 Tips for Introduction of Solid Foods Use single-ingredient foodsRead food labelsAvoid dessertsAvoid 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 runnyFeed with a spoon, never in a bottleVegetables, then fruits1 new food at a time for at least 3 daysNever feed straight from the jar8-10 months, start using fingers; eventually move to spoons
78 What Infants Need to Stay Healthy Enough calories to provide rapid growthProtein, iron, vitamins B, C, and DFood that is easy to digestAdequate amounts of liquid
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 dietCow’s milk, or other itemsSpitting upNormal occurrence: after meals, mouthful of milk.Unless projectile vomiting: Organic problem: pyloric sphincter closure
80 Sleep Newborns sleep 12-20 hours a day Preparation for sleep: By 1 year has 2-3 sleep periods including napsPreparation for sleep:Change diaper and clothes, wash face/handsRock to calm the babyPut the baby in the bed on it’s backFollow the same routine to provide comfort each time
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.