The Newborn

Chapter 4 Part 2

The Fetus/Newborn

Decreased oxygen supply during contractions is termed anoxia —insufficient oxygen to fetus/newborn

Noradrenaline Stress hormone secretion protects from oxygen deficiency, prepares infant for birth.

Vernix (skin grease) protects against heat loss.

Breathing

Soon after birth the child must take a first breath Lungs filled with fluid

that is rapidly expelled The baby’s system

must adjust to getting oxygen independently rather than from the mother.

At-Risk Infants: A Different Beginning

Prematurity and Birth Weight Premature or preterm infant: an infant born

before 37 weeks’ gestational ageGestational age: age as measure in weeks

from the first day of the mother’s last menstrual cycle

Low birth weight (LBW): birth weight below 5 lbs 8 oz.

Very low birth weight (VLBW): birth weight below 3 lbs 5 oz.

Extremely low birth weight (ELBW): birth weight below 2 lbs 3 oz.

Neonatal intensive care unit (NICU): hospital unit that specializes in the treatment of at-risk newborns

Incubator: a heat- controlled unit for preterm infants

Causes and Treatments of Prematurity

More common in multiple-birth pregnancies

Mothers who have a history of miscarriages

Mothers who have had previous premature births

Mothers with high blood pressure, diabetes, clotting disorders, obesity, infections during pregnancy, and alcohol, nicotine, or drug use

Low Birth Weight in the Developing World

Prematurity and Developmental Outcomes

Prematurity is the leading cause of death in newborns; complications may include: Chronic illness Developmental delays Attention-deficit disorder Physical and behavioral problems

Early Intervention for At-Risk Newborns

Individualized Developmental Care: care that is sensitive to the particular status and needs of each infant

Kangaroo care: an intervention often used with preterm newborns in which the newborn is placed in skin-to-skin contact on the mother’s breast to promote thermal regulations, breastfeeding, and bonding

Neonatal Mortality

Infant mortality rate: the overall death rate among babies during their first year

Neonatal mortality rate: the death rate among newborns; often used as an indicator of general maternal and newborn health

The Newborn

Anoxia: lack of oxygen

Apgar score: assesses the condition of newborn infants; it measures respiratory effort, heart rate, muscle tone, reflex irritability, and color

Screening tests: tests designed to identify certain harmful or potentially fatal disorders that are not otherwise apparent at birth.

Apgar Scale

The Neonatal Behavioral Assessment Scale

NBAS: a neurobehavioral assessment scale that describes infants’ functioning in seven key areas: Habituation Orientation Motor activity Range of state Regulation of state Autonomic stability Reflexes

Newborn Reflexes and Behavioral States

Reflexes: unlearned involuntary movements or actions that are controlled by neural structures below the level of the cerebral cortex Rooting reflex: The head turns toward gentle

stimulation of the skin at the corner of the mouth. Sucking reflex: When a finger is placed in the infant’s

mouth with the pad toward the palate, the baby sucks rhythmically.

Moro reflex: often called the startle reflex; the baby arches his back, flings arms outward, and stretches his legs outward, then closes his arms back in toward his body.

Grasping reflex: elicited by placing pressure on the baby’s palms with your fingers; his fingers will flex around the finger in a grasp-like movement.

Stepping reflex: When the baby is held under the arms in a standing position on a flat surface, she is able to support her weight and take a few steps forward; also called the walking reflex.

Crawling reflex: When the infant is placed on her stomach, her legs and arms move in a crawling motion.

Babinski reflex: When the sole of the baby’s foot is stroked from toe to heel, the toes fan out and curl, and the foot twists inward.

Newborn Behavioral States

Sensory Capacities and the Social Newborn

What Can Newborns See?

Visual acuity: The ability to see detail clearly

Newborns can focus on objects that are between 10 and 12 inches away.

They can track moving objects.

They especially like faces.

They prefer curves to straight lines.

They attend most to high contrast.

The Importance of Faces

Newborns can learn to identify a face in eight-tenths of a second.

Preference for the human face suggests that nature has programmed humans for social contact.

What Do Newborns Hear

Young infants can hear people talk to them and prefer their mother’s voice.

Newborns can turn to and locate a sound.

Child-directed speech: a style of speech typically used with infants, characterized by a higher-than-normal pitch, exaggerated intonation and rhythm, and simplified structure; also called motherese or parentese.

The Importance of Touch

Touch is critical for newborn development.

Massaging newborns lowers stress levels and assists weight gain by triggering hormones, which helps them absorb their food.

Touch can alleviate pain in newborns.

Newborn Smell and Taste

The newborns’ sense of smell is as good as that of an adult; they can recognize the smell of their mother.

Newborns have a well-developed sense of taste, which began in the womb; the amniotic fluid contains a range of tastes that reflect the mother’s diet.

The Developmental Tasks of the Newborn Period

The Parent–Infant Bond Bonding theory: a theory

suggesting that the period immediately after delivery is a sensitive one in the development of a close emotional bond between mother and child

Bonding is much more flexible than was first believed.

Breastfeeding: A Developmental Issue

Breast milk generally offers the best nutrition for babies.

Colostrum: a precursor to mature breast milk that consists primarily of enzymes, anti-infective agents, hormones, and growth factors

Benefits both mother and baby

Developmental Challenges

Emotional and Psychological Adjustments‘Baby Blues’

Begins days after birth; can last monthsLasts 1–2 weeks without treatment

Postpartum depressionMajor depressive episode: feelings of anxiety, depression, and despairGets worse without treatment