Prenatal Period to 1 year Chapter 6

What are the two main factors that influence growth and development? Stress and Family Environment and Stress Environment and Heredity Heredity and Gender

Heredity: Zygote formation Sperm + ovum Zygote 23 chromosomes 

Heredity: Zygote formation Gender X & Y Chromosomes Ovum Always X Sperm X or Y

Dominant & Recessive Genes Capable of expressing traits over other genes Traits only appear if they exist in pairs

Karyotyping: Eye Color B = Brown b = blue MOM DAD B b BB Bb Karyotyping: Eye Color B = Brown b = blue MOM has brown eyes but has recessive blue gene. Bb Dad has brown eyes with no recessive gene. BB All the kids would have brown eyes The Punnett Square for eye color The Punnett Square is a visual representation of Mendelian inheritance. Punnett Square

Karyotyping: Eye Color B = Brown b = blue MOM DAD B b BB Bb bb Karyotyping: Eye Color B = Brown b = blue MOM has brown eyes but has recessive blue gene. Bb Dad has brown eyes with a recessive blue gene. ¾ kids would have brown eyes. Punnett Square

Karyotyping: Eye Color B = Brown b = blue MOM DAD b B Bb bb Karyotyping: Eye Color B = Brown b = blue MOM has blue eyes bb Dad has brown eyes with a recessive blue gene. Bb ¾ kids would have brown eyes. Punnett Square

Recessive disorders >700 recessive gene diseases Sickle-cell disease Tay-Sachs disease Hemophilia Tay–Sachs disease, it causes a relentless deterioration of mental and physical abilities that commences around six months of age and usually results in death by the age of four

Environment “From the moment life begins, the environment begins to exercise its influence on the newly formed entity.”

For you personally, when does life begin? Conception Implantation When there is a heart beat When the fetus is viable if it was born When the baby is born

Environment: Healthy Pregnancy Rest Exercise

What is the best form of exercise for a pregnant women? Bicycling Walking Swimming Jogging Kick-boxing

Teratogens Tobacco i birth weight Growth restrictions Teratogens – chemical or physical substances that can adversely affect the unborn = bad for the baby

Teratogens Alcohol *1st trimester Fetal Alcohol Syndrome (FAS) Miscarriages Growth restriction CNS damage No alcohol while pregnant

Teratogens Bacteria, viruses Rubella

What is the estimated length of human pregnancy? 28 weeks 38 weeks 40 weeks 42 weeks 48 weeks

Physical Characteristics

Neonate Apgar score Activity Pulse Grimace Appearance Respiration Although the Apgar score was developed in 1952 by an anesthesiologist named Virginia Apgar, you may have also heard it referred to as an acronym for: Activity, Pulse, Grimace, Appearance, and Respiration. The Apgar test is usually given to your baby twice: once at 1 minute after birth, and again at 5 minutes after birth. Rarely, if there are concerns about the baby's condition and the first two scores are low, the test may be scored for a third time at 10 minutes after birth. Five factors are used to evaluate the baby's condition and each factor is scored on a scale of 0 to 2, with 2 being the best score: activity and muscle tone pulse (heart rate) grimace response (medically known as "reflex irritability") appearance (skin coloration) respiration (breathing rate and effort)

What is the highest score a neonate can get on a Apgar score? 2 3 10 12 15

Head & Skull Head ¼ of total body length

Skull 6 bones Separated by cartilage Sutures Fontanels Anterior Posterior

Which fontanel is smaller? Anterior Posterior

When does the posterior fontanel “close” by? 2 months 4 months 6 months 8 months 12 months or more

When does the anterior fontanel usually “close” by? 6 months 12 months 18 months 2 years 3 years

What is the normal lengths of a full-term neonate? 12 inches 18 inches 20 inches 24 inches 36 inches

How much does a normal infant grow in the first year? ½ inch a month 1 inch a month 1 ½ inch a month 2 inch a month 2 ½ inch a month

Normal Physiological Weight Loss Normal Physiological Weight Loss. How much weight on average does a neonate loss in the first few days of life? 5-10 % of birth weight 15-20% of birth weight 25 – 30% of birth weight There is no such thing as normal physiological weight loss in a neonate

Skin Acrocyanosis Pigmentation Thin & pale

Mongolian Spot Usually fads by… Age 4 years 6 month old

Lanugo

Vernix Cascosa

Milia

Physiological Jaundice

What causes physiological jaundice? High RBC count in newborns Increased RBC destruction after birth High bilirubin levels All of the above None of the above

Genitals Breasts Swollen Scrotum Large

Pseudomenstruation Blood-tinged vaginal discharge

What is the cause of most genital physiological anomalies in newborns? High / elevated maternal hormone levels High / elevated paternal hormone levels High / elevated neonate hormone levels

Cryptorchidism Undescended testicle/s

Cryptorchidism h risk of Testicular CA Infertility

Genital Circumcision

What STD causes blindness in newborns? Syphilis HIV Gonorrhea Chlamydia Herpes

Face Eye Erythromycin Silver nitrate

When do baby teeth start to come in? Deciduous teeth 2 months 4 months 6 months 8 months 12 months

Which teeth normally erupt first? Two lower central incisors Two upper central incisors Two lower lateral incisors Two upper lateral incisors

By age 12 months the baby will have 6-8 teeth

Abdomen Umbilical cord Falls off When? 10 days What should the baby not do / have until the umbilical cord “falls off” No tub bath Neonate Lg and flabby

Why do you have to “burp” the neonate? Cardiac sphincter Under-developed

Bowel movement Meconium Green-black Meconium Duration 1-2 days Characteristics Green-black Tarry Odorless

Bowel movement, Stool or Feces Formula Fed Breastfed Pasty yellow or tan Odor Mustard seed color Sweet odor

Why is a newborn not given cows milk (whole milk) to drink? Cows milk does not have the necessary vitamins and minerals for a newborn human Cows milk is too complex for a newborn to metabolize Cows milk contains protozoans that are harmful to infants What are you talking about – it’s OK to give a newborn cows milk.

Extremities Finger / foot prints

Gluteal fold asymmetry Is an indication of… Congenital hip dysplasia

Neurological Characteristics Protective reflexes Blinking Sneezing Swallowing Gag Newborns Reflexes Posture Movement Muscle tone

Moro / Startle Reflex Sudden movement Extension & Abduction of extremities http://www.youtube.com/watch?v=PTz-iVI2mf4 Disappears 3-4 months

Tonic Neck Reflex Turn head to one side  extend arm and leg on that side http://www.youtube.com/watch?v=XMCw7IKN0xI Disappears 5 months

Rooting reflex Stroke cheek  enfant turns toward that side and open mouth Disappears 4-6 months

Sucking Reflex Sucking movement when anything touches their lips Diminishes 6 months

Babinski When sole is stroked  hyper-extended of the toes Disappears 3 months

Palmar grasp Grasp anything placed in hand Appears 6 wks Disappears 3 months

Spinal Bifida

Vision Newborn Primitive Nystagmus

Vision An infant's vision isn't as sharp as an adults until children are about 3 years Optometrists, or "eye doctors", usually ask adults to read rows of letters in order to determine how well we can see, but how do they test an infant's vision? Although babies can not tell us what they see, they can choose to look (or not look) at interesting patterns with lots of contrast, like stripes or checkerboards. To determine how well babies can see, cognitive scientists show babies a plain gray image next to an image of a wide black and white stripe. Usually, babies will choose to look at the stripes. The fact that they show this preference means that babies can see the difference between the plain gray image and the black and white stripe. Once they've tried a very big stripe, the scientist can make the stripe narrower and narrower, each time placing it next to a plain gray image. At some point, the stripe will be so narrow that, to a baby, it will just look like a grey blur. At this point, the baby will look equally long at both images, because s/he can't tell the difference between them. When this happens, the scientist knows exactly how sharp the baby's vision is. For a newborn, only stripes bigger than 1/3 of an inch are preferred over plain grey. By three months, babies can see stripes bigger than 1/8th of an inch, and by six months, they're able to see 1/16th inch stripes. An adult can see a stripe that is only 1/80th of an inch across. An infant's vision isn't quite as sharp as an adults until children are about 3 years of age. http://legacy.mos.org/discoverycenter/livinglab/air/mobiletwo

Hearing 6 wks 1 year Recognize mom and turn to respond ID sounds and source

Vital Signs - Newborn Temp Pulse Resp Initially 120 – 160 / min low Pulse 120 – 160 / min Resp 30 – 60 / min Temp- Initially low- Stabilized 97.7 -99.5 - Axillary Pulse 120 – 160 / min Apical BP 64 / 40 Resp 30 – 60 / min Irregular apnea

Gross motor skills 2 months 4 months 6 months 8 months 10 months Control head 4 months Sit w/ support 6 months Roll 8 months Sits alone 10 months Creep 11 months Pulls self up 12 months walks Neonate Purposeless uncoordinated 2 months Control head 4 months Sit with support Roll belly to back 6 months Roll both ways 8 months Sits alone 10 months Laying to sitting Creep 11 months Pulls self up 12 months walks

Fine motor skills Neonate 5 months 6 months 7 months 9 12 months Grasp reflex 5 months Purposeful reaching 6 months Hold bottle 7 months Hand preference Pincer grasp 9 Cup Spoon 12 months Scribble Tower – two blocks

Psychosocial Development: What theorist are we going to discuss? Freud Erikson Paiget Kohlberg Maslow

What stage of psychosocial development is a neonate? Autonomy vs shame & doubt Trust vs mistrust Initiative vs guilt Industry vs inferiority Identity vs role confusion

Parent-child relationship Attachment Engrossment

Parent guidance / discipline 0-6 months Distraction 6-12 months Direct More direct discipline

Moral Development Neonate No conscience 100% ID

Cognitive development: Who’s theory are we going to be applying? Freud Erikson Paiget Kohlberg Maslow

What stage of cognitive development is an infant? Preoperational Concrete operational Sensorimotor Formal operational

Communication: What “name” or word to baby’s say first (usually) MaMa DaDa

Communication Birth 2 months 4-6 months 8 months 10 months 12 months Crying 2 months Smile 4-6 months Babbling 8 months Dada 10 months Mama 12 months 4-6 words

Nutrition Breastfeeding Bottle feeding Colostrum immunoglobulins

Sleep & Rest Neonate 1 year 20 hours/day 12 hours / day

Play Non-symbolic Solitary

Safety: Aspiration Avoid small objects

Shaken Baby Syndrome

Burns

Drowning Bathtub never alone

Falls Mattress lowest position firm Infant seat with restraint Infant seat on the ground Safe gaits Slide Not accordion

Poisoning Lead paint Plants Safety locks Medicine CO monitor

MVA Read facing car seat 12 months