 Determined at time of birth  Teratogen  Any substance that adversely affects the developing chld  Tobacco  Alcohol  Certain drugs (tetracycline)  Viruses

 Assessment at 1 min and 5 min  Color  Reflex  Heart rate  Respiratory rate  Muscle tone

 Large compared to rest of body  Skull bones soft  Anterior fontanel closes by months  Posterior closes by 4 months  Teeth by 6-7 months

 Average weight 7.5 pounds  Average length 20 inches  Boys > girls  Skin is thin and delicate – vernix  Skin may have hair- lanugo  May be jaundiced  First stool – meconium - yellow to green then pasty yellow if breast fed

 Swallowing  Gagging  Sneezing  Blinking  Rooting (4-6 months)  Babinski- (3 months)  Tonic neck – (head turned to one side, arm and leg will follow) (5 months)  Sucking (6 months)  Palmar Grasp-6 weeks to 3 months

 Large muscle groups  Growth and development progress downward for head to toe  2 months control head  3 months sits with support  7 months sits alone  10 months creeps  9-11 months stands with support  months – walks

 Completing the task of trust  Emotional bonds are known as attachment = engrossment  Encourage both parents to attach  Temperament is inborn  Parenteral guidance  Saying NO  Substituting

 Cause and effect method – responding to new environment  Infant communicates by babbling and smiling  Infants learn to talk by mimicking words and building a vocabulary  By 1 year should say 4-6 words

 Refers to use hands and feet  Follows proximodistal pattern  Shoulder movement before hands and finger movement  6 months hold a bottle  5 months purposeful reaching  7 months preferred hand  Grasping and releasing small objects  9 months drink from a cup

 They react to pain and love and judge behavior on how it affects them

 Crying (fingers in mouth – hungry/ pulling up les –gas/ high pitched noise 0 CNS injury)  Momma, dada

 Breast milk or formula  Solids around 5 months  Add one new food at a time  Wean from bottle about 8/9 months (teeth)

 Breast  NO prep  Free  Mothers must be present  Moe easily digested  Low in fat  Promotes bonding  Immunity  Uterus contracts  Weight loss  Bottle  Requires prep  More costly  Frees up Mother’s time  NOT  High in fat  Dad can bond  Mother can eat whatever  Amount taken can be measured

 20 hours for newborn  Light sleep marked by stirring movements  SIDS linked to sleep patterns (first 5 months)  Put to sleep on back

 Help infants learn about their environment  Play is solitary  Bright toys  No small parts

 Most accidents are preventable  Supervision at all times  Regular check-ups – immunizations  Good health habits NEVER USE ASA FOR FEVER OR DISCOMFORT = MAY LEAD TO REYE’S SYNDROME

 Fever >  Difficult or labored breathing  Absence of stools or urine  Persistent vomiting or diarrhea  Extreme lethargy or hyperirritability