King saud universityCollege of nursingMaster program

NUR 543

Child Development

Infant Development Stage

Done by : maha alonazi

Objective

At the end of this lecture the master student able to :

-Know what is the infant period.-Know physical & physiological growth in thisage .-Discussed the health promotion component forthis age .-Identify common health problem in this age .

Outline: -Infant period . -Physical growth . -Physiological growth . -Motor development . -Language development . -Cognitive development . -Emotional development . -Social development . -Promotion optimum health during infancy . -Common health problem .

Infant period

Infancy :it is a latine word means on speech or speechlessness .

Infant period start from the end of first month up to the first year of live .

Physical growth:

-Weight :the infant well double his birth weight by 4-5 month & triple by 10-12 month.

The infant weight well increased by : Birth to 4 month 3/4 kg/month . 5 to 8 month 1/2 kg/month . }+ birth wt. 9 to 12 month 1/4 kg/month.

Height :increased by 3cm/month in the first 3 month then increased 2cm/month at age 4-6 month then 1.5 cm/month at age 6-12 month ( +birth length ) .

Head circumference :increased 2cm/month in the first 3 month then increased 0.5 cm/month at age 4-12 month ( + birth H.C ) .

Chest circumference: it well be equal to the head circumference by the end of the first year .

Physiological growth

Pulse : 110-150 b/min. Respiration :25-45 breath/min. Blood pressure :100/70 -60/40 mmhg.

Senses:

Visual :

Taste : by age of 6 month

2month When on the back follow a moving object beyoud the midline of vision.

3 month -when on back turn eyes to a moving object light or dangling object.

-turns head to look for voices & sounds .

4 month -staring to rattle in his hand .

-follow moving object well with eyes.

-beginning hand-eye coordination .

5 month -visual acuity 6/6.

9 month -follow objects through transition from one place to another .

Motor development:

Age in month

Groos Fine

2month - Hold head erect in mid position

-Turn from side to back -holds a rattle briefly when

placed in his hand.

3 month -Raises chest usually supported on forearm when

in prone position .

-hold head erect & steady.

-hold hands in front of face &

stares at them .

-reaches for bright objects but

miss them.

4 month -site with adequate support.

-rolls over from front to back.

-lift head & shoulders at 90 degree when in prone

position & looks around.

-brings hands together in

midline & plays with fingers.

-grasps object held near hand

but can not pick it up when

dropped.

–carry objects to mouth .

Age in month

Groos Fine

5 month -hold back straight when pulled to a sitting

position .

-balances head well when sitting .

-site with slight support.

-grasps objects with whole

hand.

-hold one object while looking to

another.

6 month -site alone briefly.

-turns completely over -Transfer objects from one hand

to another .

-hold own bottle .

7month -site alone .-imitates simple acts of others.

8month-pulls himself to standing position with help.

-hand eye coordination is perfect.

-drink from cup with help

9 month-raises to sitting position alone.

-crawls .

-holds own bottle with good hand-mouth coordination

10 month-move from prone to sitting position.

-creeps well.

-picks small objects up with index finger & thumbs .

11 month-walks holding on furniture (cruises ).-remove covers from boxes.

12 month -standing alone for variable length of time .

-site down from standing position alone .

-walks in few steps with help or alone .

-picks up small bits of food &

transfers to mouth .

-good pincer grasp .

-drinks from cup & eats from

spoon but still need some help.

Language development:

2 month –coos respond to mother voice ah ,uh . 3 to 5 month –laugh loudly . 6 month –vocalizes 7to 8 month –vocalizes da ,ma,ba . 9 month –associates word with person

mama ,dada . 10 month – can say one word like no . 12 month – may speak two or more word beside

mama ,dada .

Emotional development:

Infant express his felling through crying ,laughter and body movement .

His emotion not stable where it is rapidly change from crying to laughter and his love to the family member is appear by age 10 month he express several recognizable emotions like anger , anxiety ,pleasure and this emotion well be more clear by age of 12 month .

Cognitive development :

Infant learns through sensation and movement. he learn that object continue to exist even when they are out of sight .infant develop primitive grasp of cause & effect relationship but dose not learn to think which is beyond his sensorimotor experience

Social development:

by 2 MonthsA newborn infant will often quickly learn her mother’s voice andSmell and learn the crying brings attention. 3 to 4 MonthsHe show more interested to family member play more actively witha caregiver & smiling in response to smile of other

7 to 8 MonthsAt this stage show fear of stranger & response to his own name .

9 to 10 monthPlay simple games with adult like = peak a poo & imitates

facial expression .

12 monthsAt this age the infants begin to understand more clearly

the connection between the caregiver and the fulfillment of his needs, when he is hurt or hungry he may turn to his caregiver and fuss hoping that the caregiver will respond. The infant may also begin to speak single words and using simple non-verbal communication such as shaking the head.

Promoting optimum health during infancy 1- nutrition. 2- attachment . 3-immunization . 4-teeth eruption . 5-Play. 6-Safety measurement . 7-Hygiene . 8-Stranger anxiety. 9-Separation anxiety . 10-Fear .

Nutrition:

Weaning is the process of introducing the baby to solids food after being totally dependant on breast milk. Baby weaning begins at age of 6month with the introduction of various solid foods such as baby rice or vegetables. solids weaning foods it should be smooth purees not much thicker than milk. It should be given in addition to breast milk or formula but gradually babies reduce their milk intake and eat larger amounts of food. by age of one year able to eating a well-balanced and varied diet that is more or less the same as that of the rest of the family.

Principles of weaning:

-start weaning when infant free from any disease (GI). -food item is introduced at interval 4-7 days to allow

for identify allergies & to allow child to get to it . -offer new food while child hungry . -never force child to take a new food. -start with non-sweetened food before sweetened to

reduce the tendency to develop desire for sweets

Things to be avoided:

- food can cause chocking . -food that produce allergy like fresh milk . -artificial colors & flavors food . -salted food . -junk food as sweets . -highly spiced & fatty food .

Attachment:

Attachment and attachment behavior tend to develop between the age of 6 months and 3years .

The infant become attached to adult who are sensitive and responsive in social interaction with the infant and who remain as consistent caregivers for some time.

Immunization (vaccination ):

A vaccine is an antigenic preparation used to produce active immunity to a disease in order to prevent or reduce the effects of infection.

visit Vaccine At BirthBCG , Hep B

2 MonthsIPV(DTP, Hep B, Hib, PCV)

4 MonthsOPV(DTP, Hep B, Hib, PCV)

6 MonthsOPV(DTP, Hep B, Hib, PCV)

9MonthsMeasles (mono)

12 MonthsOPV, MMR, Varicella ,PCV

18 MonthsOPV (DTP, Hib)Hepatitis A

24MonthsHepatitis A

4 - 6 yearsOPV,DTP, (DT) ,MMR Varicella

Dentition:

Eruption of teeth started by 5-6 month it is called milky teeth or primary teeth

It’s important to note that eruption times can vary from child to child.

Teeth Eruption Timetable

Name of teethUpper jaw Lower jaw

Central incisors7-8 month5-7 month

Lateral incisors8-9 month9-11 month

cuspids16-20 month16-20 month

First molare14-16 month10-14 month

Second molare24-30 month16-20 month

Play

Play must provide interpersonal contact & educational stimulation .

By 6 month to 1 year playing involved sensorimotor skills & become mor sophisticated & interdependent .

Safety measurements

Falls : it is the most infant accident in the home.

-Never leave the baby alone on the table or high surface.

-Use gates or barriers to keep the baby away from

dangerous areas such as stairs

-The most safest place for the baby it is on the floor or the crib .

Choking-Be sure to keep all small items that could cause the baby

to choke out of the baby’s reach.

-Never feed your baby hard pieces of food.

-Avoid toys with cords.

-Never put your baby’s pacifier on a cord.

DrowningDrowning is the second most common cause of

accidental death among children.

- Children under age four are especially at risk ,

it takes only 1 inch of water and a few moments

for a child to drown.

-do not leave baby alone in the bathtub.

Burns

-Do not smoke or drink hot liquids near to or

while carrying the baby.

-Protect the baby from direct sun.

-Keep electrical cords out of baby’s reach.

-Use safety caps on electrical sockets.

Suffocation

-The safest position for sleeping babies is lying on one side do not place the baby face down or on his back .

-Never put the baby to sleep on a soft surface (e.g., pillow or water bed.)

Hygiene

babies born in the winter are bathed less often due to cold .some study advise bathing every day while others suggest fewer baths only 4 times a week.

Wash the diaper area last during the bathing. Remove diaper and wash bottom and genitals wash girls from front to

back toward the bottom & if boys have been circumcised clean area gently unless a dressing is still covering the surgery.

After remove baby from the water wrap him in the towel & clean eyes, ears, and nose with a cotton ball that's been dipped in water and squeezed. Don't forget to wipe in folds of neck and ears.

Apply baby lotion if his skin is dry. Make sure all areas especially genitals are completely dry before

putting on fresh clothing and a diaper. Clean under the nail & cut as needed .

Fear

As a child grows different fears may be noticed at different times Some are very specific to the age such as fear of falling for the 1year old. The bad experience falling as the child begins to walk may affect future attempts to walk.

Separation anxiety

Infants typically begin to feel the fear of separation between 7 and 8 months of age.

Infant separation anxiety tends to peak in the toddler stage.

It is normal for infants to experience fear when he separated from his parents.

Stranger anxiety

The child who develops an attachment to a parent or significant family member may show stronger anxiety toward unknown people or even toward a grandparent who is infrequently visited. This does not mean the child doesn't like Grandma or Grandpa. It means the child feels safe with some people and needs more time to slowly accept others.

Stranger anxiety is normal for a developing child. around 7 to 8 months of age the child is learning that people are different from his mother.

Most common health problem

Major Health Problem .

Minor Health Problem .

Major Health Problem

1-Dehydration.

2-Otitis media.

3-Infantile Rickets.

4-Malnutrition.

5-Febrile seizure.

Major Health Problem.

Dehydration :is defined as excessive loss of body fluid .Common cause : vomiting ,diarrhea .Dehydration is best avoided and treated by provide sufficient fluid .Nursing management :-correct cause of vomiting or diarrhea .-correct cause of dehydration by parental fluid .-in vomiting case place child on right side & elevate head of bedafter feeding.-for both charting color ,amount ,odor .-small frequent feeding are better tolerated then less frequent &large feeding.

Infection

Ear infections( otitis media ) are a common problem in children Causes bacteria or

the common cold virus. . The treatment :is complex and requires a combination

of antibiotics, corticosteroids and/or placement of tubes.

Nursing management:-relieve pain .-prevent complication or recurrence .-educate family in care of child .

Infantiale Rickets

Infantile Rickets :It is a metabolic disorder of infancy caused by vitamin D deficiency & affecting the growing bones ,the skeletal muscles & some times the nervous system .

Treated by vitamin D . Nursing management:

-the back should be supported when he site up.

-should handled gently & turned frequently.

-prevent falls .

Malnutrition

Malnutrition : it is a term referring to poor or inadequate nutrition .

For infant can happen during weaning process . Nursing management :

-provide diet high in quality of protein &

carbohydrates.

-provide vitamin & minerals supplementation.

-Weight daily & record .

Febrile seizure

Febrile seizure: it is abnormal body movement due to increased body temperature more then 38.9C .

Febrile seizures can occur in children ages 6 months to 5 years but are most common in toddlers ages .

Nursing management :-remain with child .

-loosen restrictive clothing.

-prevent child from hitting head .

-teach administration of medication .

- decrease body temperature to the normal range .

-provide emotional support to the child & family .

Minor problem

Dipper rash. Colic . Constipation .

Dipper rash

Diaper rash: is a common form of inflamed skin that appears as a patchwork of bright red skin on the baby's bottom .

results from prolonged contact with urine or stool .the heat and moisture make it easier for diaper rash to start and for germs to grow.

Nursing management :- Check the baby's diaper often and change it as soon as it's wet or soiled. - Carefully clean the baby's bottom between diaper changes.- Use warm water (not hot) with or without a very mild soap. - Allow the baby's skin to dry completely before putting on another diaper. - Use products that contain zinc oxide ointment or petroleum such as

Vaseline to protect the baby's skin from moisture.

Colic

Colic : acute abdominal pain with intense spasmodic cramping. the infant appear abnormally irritable or cry for no reason.

The causes : Infants swallow air while feeding.

Nursing management :-Feed the baby in an upright position. -Teach mother with breastfeeding to make small changes in her diet

by to limit spicy foods, citrus fruits or caffeine. -Teach mother to warming the formula to body temperature before

a feeding her baby.

Constipation

The definition of constipation includes the following :-Infrequent bowel movement 3times or fewer per a week.-Difficulty during defecation.

-Sensation of incomplete bowel movement . causes include: -insufficient dietary fiber intake.-inadequate fluid intake. -decreased physical activity . -side effects of medications .

cont

Nursing management :-increased fluid intake.

-Increased fiber intake.

-use of laxatives as doctor order.

-Used enema .