Chapter 3: Growth and Development of the Newborn and Infant

The nurse enters her patient's room to find the new mom crying softly. The nurse asks what is wrong. The mom says, "I had my heart set on breast-feeding and now my baby has a cleft lip. My dreams of breast-feeding him are destroyed." What should the nurse tell her patient about breast-feeding an infant with this diagnosis?

" You can still attempt breast-feeding; let me call a lactation consultant for you." Explanation: The nurse should be therapeutic in her response and reassure the mother that breast-feeding may still be an option. Infants with cleft lips may still successfully breast-feed. The infant's feeding must be assessed, their weight monitored, and the feeding may be slower. The other responses are not therapeutic and supportive to the new mother.

A teen mom asks the discharge nurse if it is okay to sleep in bed with the baby. She says her mom always did it with her siblings and it seemed okay. The nurse should respond how?

"Bed sharing has positive effects on babies, let me get you information." Explanation: The nurse should enforce that bed sharing is sometimes a positive experience if the parents are safe and responsible. When done properly, the effect can be positive on infant nutrition and physiology. The other responses do not promote safety or educate the teen.

Martha asks the nurse if her 2-month-old could have baby bananas yet. The nurse would respond and educate Martha on the nutrition stages of infants by which of these responses?

"In two months you can try bananas if you think she is ready." Explanation: The nurse should choose this response because no solid foods are recommended for infants until 3 months of age. The age of 4 to 6 months is the age recommended to introduce solid foods. The other responses are the incorrect age or are letting the parent decide the appropriate answer.

Patty calls the hospital nursing hotline and asks, "My 8-week-old daughter cries 8 hours a day, and she is hard to console, is that normal?" What should the nurse's response be to this mother?

"Let me ask you some more questions to see if there are symptoms of colic." Explanation: The nurse should seek more information to assess the infant's symptoms. The symptoms suggest colic, which is characteristic of an infant who cries more than 3 hours a day and is fussy and hard to console. The other responses are non-therapeutic and do not seek further information to gather a history.

Julie is an 18-year-old new mother. When the nurse discharges the mom and infant, she notices that the car seat is in the front seat of the car. What is the appropriate response for the nurse to make regarding the car seat?

"Let me go over car seat safety with you, so you can install your car seat properly." Explanation: The nurse should notice this is not the proper place for a car seat. The car seat should be rear facing and in the center of the back seat of the car. The nurse would review car seat safety with Julie and have Julie install the seat properly. The nurse should provide written materials if available. The other responses are not appropriate and do not ensure that proper installation will occur and that infant safety will be maintained.

The nurse goes in to check on Lilly and how breast-feeding is going with her new son. The nurse observes the infant is on her lap with the blanket unwrapped, and Lilly is washing his face, and gently stroking the baby. Lily has had trouble breast-feeding the last few times. What is the appropriate response from her nurse?

"Lilly, you are doing a wonderful job attempting to waken the baby." Explanation: The nurse should be emotionally supportive to the new mom. The mom's techniques are commonly used in breast-fed infants who are sleeping. The encouragement from the nurse will support the mom through this learning period. The other responses do not emotionally support the mom or contribute to a positive learning environment.

The nurse is reinforcing teaching related to the nutritional needs of the infant with a group of caregivers. One caregiver asks why her 6-month-old infant needs to have solid foods when breast milk is such a good source of nutrition. Which of the following would be the best response by the nurse?

"Milk does not provide adequate amounts of iron which are found in solid foods." Explanation: At about four to six months of age, the infant's milk consumption alone is not likely to be sufficient to meet caloric, protein, mineral, and vitamin needs. In particular the infant's iron supply becomes low, and supplements of iron-rich foods are needed.

A young breastfeeding mother calls the telephone nurse because she is concerned about her 3-month-old's stools. Which statement is of concern?

"The stools are foamy and smell terrible." Explanation: This may indicate a digestive problem or illness. The physician or nurse practitioner should be contacted. All the other statements describe normal stooling.

Bob and Nancy have financial issues and ask the nurse if a borrowed crib would be okay to use for their new twin boys. Which response should the nurse use in educating the parents?

"You can use the crib, but there are guidelines to follow." Explanation: The nurse would educate the parents on the latest guidelines for using baby cribs and provide them with available safety and information pamphlets. All cribs made after 1973 have specific safety guidelines and standards. The other responses do not provide the correct available information or educate the parents on safety standards.

A 6-month-old arrives for a well-baby visit with a case of diaper rash. The baby's mother tells the nurse she is not concerned and believes this to be normal. She reports that she changes the baby's diaper when he wakes up and before she puts him in his crib for naps or bedtime. It would be important to teach this mother that she should start checking his diaper to see if it needs changing every

2-4 hours Explanation: To prevent diaper rash, soiled diapers should be changed frequently. Check every 2-4 hours while the infant is awake to see if the diaper is soiled. Waking the baby to change the diaper is not necessary.

The infant weighs 7 lbs. 4 oz. at birth. If the infant is following a normal pattern of growth, which of the following would be an expected weight for this child at the age of 12 months?

21 lbs. 12 oz. Explanation: By one year of age, the infant has tripled his or her birth weight and has grown 10 to 12 inches.

The infant measures 21 ½ inches at birth. If the infant is following a normal pattern of growth, which of the following would be an expected height for this child at the age of six months?

27 ½ inches Explanation: Most infants double their birthweight by 4 months of age and triple their birthweight by the time they are 1 year old. By 12 months of age, the infant's length has increased by 50 percent.

The nurse is helping the mother of a 5-month-old boy understand the importance of developmentally appropriate play. Which one of the toys best meets the needs of this child?

A yellow rubber duck for the bath Explanation: The rubber duck is most appropriate. It is safe, is visually stimulating while bobbing on the water, and adds pleasure to bath time. A push-pull toy promotes skill for a walking infant. Pots and pans from the kitchen cupboard are played with successfully after sitting is mastered. A 5-month-old does not have the fine motor coordination to use stacking toys.

Which of the following would you include when teaching the parents of an infant about colic?

Colic symptoms will probably fade at 3 months of age. Explanation: Colic symptoms typically fade at 3 months of age, probably because children begin to maintain a more upright position at that time.

Infant development is best described by which of the following statements?

Development proceeds cephalocaudally. Explanation: Growth and development both proceed from head to toe, or in a cephalocaudal sequence.

An infant is breastfed. When assessing her stools, which of the following data would be typical?

Breastfed infants are less likely to be constipated than bottle-fed infants. Explanation: The stools of breastfed infants tend to be yellow and looser than those of bottle-fed babies.

The nurse is providing anticipatory guidance regarding the respiratory development of a 4-week-old girl for her mother. Which of the following is accurate?

Explaining to the mother the risk for infection is high due to the lack of antibodies Explanation: Attributing frequent infections to a lack of antibodies is accurate. The infant lacks IgA in the mucosal lining of the upper respiratory tract. The infant's respiratory rate drops to 20 to 30 breaths per minute by the end of the first year. Abdominal breathing persists until 6 to 12 years of age. The respiratory system matures by age 7 years.

Which measure would you suggest an infant's parents use to relieve teething discomfort?

Give her a cold teething ring to chew. Explanation: Cold can be very soothing for the tender gum lines during teething. A sedative is not necessary for normal teething discomfort.

The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify?

Increased biting and sucking Explanation: The nurse would advise the mother to watch for increased biting and sucking. Mild fever, vomiting, and diarrhea are signs of infection. The child would more likely seek out hard foods or objects to bite on.

Which of the following does Erikson describe as the psychosocial development task upon which other psychosocial development is built?

Learning to trust Explanation: Erikson's primary psychosocial developmental task for the infant is learning to trust. This task creates the foundation for the developmental tasks of the next stages of the child's life. If the infant does not receive food, love, attention, and comfort, the infant learns to mistrust the environment and those who are responsible for caring for the child.

A staff nurse is talking about Piaget's theory with a nursing student. Infants are in the sensorimotor stage of cognitive development during which object permanence is mastered. An example of an infant displaying this ability is:

Looking for a toy in her crib at the last place she saw it Explanation: Looking for the toy where it was last seen indicates object permanence. The infant knows the object still exists even though she cannot see it. All the rest of the infant behaviors show use of her senses and motor activity but do not illustrate object permanence.

The nurse is providing helpful feeding tips to the mother of a 2-week-old boy. Which recommendations will best help the child feed effectively?

Maintain a feed-on-demand approach Explanation: The best way to ensure effective feeding is by maintaining a feed-on-demand approach rather than a set schedule. Applying warm compresses to the breast helps engorgement. Encouraging the infant to latch on properly helps prevent sore nipples. Maintaining proper diet and fluid intake for the mother helps ensure an adequate milk supply.

A 3-month-old still has a Moro reflex. Which statement is most true of this reflex?

Most 3-month-olds still have a Moro reflex. Explanation: Typically, Moro (startle) reflexes last until 5 to 6 months and then fade.

The mother of a 3-month-old is concerned because her daughter does not yet sit by herself. Which of the following statements best reflects average sitting ability?

Most babies do not sit steadily until 8 months; she is normal. Explanation: Many infants sit steadily by 8 months of age.

While evaluating the development of 10-month-old boy, a nurse hides the boy's stuffed animal behind her back. The boy crawls around the examination table to look behind the nurse's back for the stuffed animal. Which of the following developmental phenomena has this infant demonstrated?

Object permanence Explanation: By 10 months, an infant looks under a towel or around a corner for a concealed object (beginning of object permanence, or become aware an object out of sight still exists). Hand regard, which is typically demonstrated by 3-month-olds, is phenomenon that involves the infant holding his hands in front of his face and studying them. Binocular vision, which is the ability to fuse two images into one, is demonstrated by 2-month-olds when they follow moving objects with their eyes. Depth perception allows 7-month-olds to transfer toys from hand to hand.

The best way for an infant's father to help his child complete the developmental task of the first year is to

Respond to her consistently. Explanation: A sense of trust is difficult to learn if things are constantly changing. Consistently responding to an infant's needs helps to build a sense of trust.

A nurse is preparing discharge teaching for a client being discharged with her newborn baby. What is the highest priority item that must be included in the teaching plan?

Restrain the baby in a car seat. Explanation: The client should restrain the baby in a car seat when driving. Infants are especially vulnerable to injuries resulting from falling off changing tables or being unrestrained in automobiles. Locking the cabinets and giving warm bottles of formula to the baby are secondary teachings.

A new mother, when asked by a nurse, explains that her 4-month-old infant has been nursing regularly every 3 to 4 hours but seems satisfied. However, the mother recently introduced solid food in the form of unbuttered popcorn to the baby as a supplement, to "get her used to eating solid food." She felt that the popcorn would be safe because it is soft on the baby's gums. Which of the following should be the primary nursing diagnosis in this situation?

Risk for aspiration related to feeding the infant an inappropriate food

Lea is 3 months old. At what age would it be okay for Lea's mother to introduce carrots to her for dinner?

Solid food can be introduced at 4 to 6 months of age. Explanation: Solid food may be introduced at 4 to 6 months of age. The infant must be ready to handle spoon-feeding. The first food should be rice cereal. Rice cereal is bland and usually does not cause an allergic reaction.

The nurse is teaching healthy eating habits to the parents of a 7-month-old girl. Which recommendation is the most valuable advice?

Serve new foods several times Explanation: When introducing a new food to an infant, it may take multiple attempts before the child will accept it. Parents must demonstrate patience. Letting the child eat only the foods she prefers, forcing her to eat foods she does not want, or actively urging the child to eat new foods can negatively affect eating patterns.

The nurse conducting a 6-month well-baby check-up assesses for the presence/absence of the asymmetric tonic neck reflex. At this age the reflex:

Should have disappeared Explanation: This primitive (not protective) reflex should be present at birth and disappear around age 4 months.

Place these primitive protective reflexes of infancy in the order in which they will disappear as the child matures.

Step Root Moro Plantar Babinski

A father mentioned to the nurse that his usually smiling, happy 8-month-old boy was clingy and intensely serious when his grandmother visited from a distant city. The nurse explained the child was experiencing:

Stranger anxiety Explanation: Stranger anxiety occurs around 8 months and manifests as the father described. This behavior indicates the infant sees himself as a separate person. The other options are incorrect and not related to social/emotional development.

In working with the infant age child, the nurse recognizes which of the following as a characteristic of the infant.

The child grows and develops skills more rapidly than at any other time in their life Explanation: The infant grows and develops skills more rapidly than he or she ever will again. The toddler insists they can do things one minute and then becomes dependent the next minute. The preschool age child soaks in information and asks "why" and "how" over and over. The school-age child has a longer attention span and can become absorbed in a craft or activity for several hours.

A father asks you what symptoms he can expect with normal teething in his infant. Which of the following would you tell him?

The child's gum line will be tender. Explanation: Normal teething creates tender gum lines but does not include an elevated temperature or constipation.

A 5-month-old infant being assessed was born at 32 weeks. The nurse doing the well-child check-up should compare the baby to what norms?

The development of a 3-month-old Explanation: The infant was born 8 weeks early. Two months are subtracted from the present age of 5 months. Both growth and development should be assessed using 3-month norms.

The nurse is assessing development of a 4-month-old boy during a well-child visit. Which of the following observations needs further investigation?

The infant responds to his mother when he sees her but not at other times when she is near. Explanation: If the infant does not respond to his mother's voice, it could indicate a hearing loss. Infants recognize parents' voices from 1 month of age. It is normal for the infant to turn his head in the direction of a squeak toy, to focus visually on near or high-contrast objects, and to make babbling sounds but no words by this age. Infants develop a social smile at 2 months.

The nurse is educating the mother of a newborn about feeding practices. The nurse correctly advises the mother:

The newborn's stomach can hold between one-half to 1 ounce. Explanation: The capacity of the normal newborn's stomach is between one-half and one ounce. The recommended feeding plan is to use a demand schedule. Newborns may eat as often as 1½ to 3 hours. Demand scheduled feedings are not associated with problems sleeping at night.

Sonograms demonstrate thumb sucking as early as in utero.

True

The nurse is caring for the family with a 2-month-old boy with colic. The mother reports feeling very stressed by the baby's constant crying. Which intervention would provide the most help in the short term?

Urging the baby's mother to take time for herself away from the child Explanation: Urging the parents to get time away from the child would be most helpful in the short term, particularly if the parents are stressed. Educating the parents about when colic stops would help them see an end to the stress. Observing how the parents respond to the child helps to determine if the parent/ child relationship was altered. Assessing the parents' care and feeding skills may identify other causes for the crying.

When teaching an infant's mother about bathing her, it would be important to instruct her that

bath time provides an opportunity for play. Explanation: Infants do not need a daily bath as long as the diaper area is washed with diaper changes. Soap is actually drying to an infant's skin. Washing the hair with soap can help remove excess oil.

The nurse is teaching the mother of a 5-month-old boy who is concerned about thumb sucking. Which of the following should be included in the teaching plan? Select all that apply.

• Advising the mother this behavior is a form of self-comfort • Assuring the mother this behavior won't cause malocclusion • Informing the mother that thumb sucking occurs more often during periods of stress • Telling the mother this behavior usually decreases by 6 to 9 months of age

The nurse comes into infant Lucy's room on the pediatric floor. She is going to try and feed her for the first time since her surgery. How does the nurse know what infant state Lucy is in by what Mom says and that it is okay to try and feed Lucy?

"Lucy has been a chatterbox and smiles just like her brother." Explanation: The best time to feed Lucy is when she is in the active alert state. Lucy is talking and smiling, which shows she is calm and actively awake. In the active alert state the infant has normal respirations, limited movement, and eyes that are bright and shiny and attentive. The other choices put Lucy in a crying state, quiet alert or deep sleep, or drowsing. These stages are not optimal for interacting with Lucy.

A frustrated mother comes to a 9-month well-baby checkup complaining to you that her son is refusing all of the solid food she gives him. When talking with this mother, the nurse discovers that she has struggled all her life with a weight problem. She attributes this problem to being forced to eat all of the food she was served as a child, even when she was full. Because she doesn't want to cause the same problem in her child, she tells the nurse that each time her son pushes food away with his tongue she believes that he doesn't want it. Which of the following statements would be most appropriate for the nurse to say to this mother?

"The baby needs to learn how to move the food to the back of the mouth for swallowing, so catch the food and offer it again until the baby learns this." Explanation: The infant knows only one way to take food: namely to thrust the tongue forward as if to suck. This is called the extrusion (protrusion) reflex and has the effect of pushing solid food out of the infant's mouth. The process of transferring food from the front of the mouth to the throat for swallowing is a complicated skill that must be learned. If the food is pushed out, the caregiver must catch it and offer it again. The baby soon learns to manipulate the tongue and comes to enjoy this novel way of eating.

The nurse is assessing the oral cavity of a 4-month-old infant. Which finding is consistent with a child of this age?

No teeth Explanation: Normally infants are not born with teeth. Occasionally there are one or more teeth at birth. These are termed natal teeth and are often associated with anomalies. The first primary teeth typically erupt between the ages of 6 and 8 months.

A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3.75 kg) at birth. Weight now is 20 pounds 8 ounces (9.3 kg). The nurse determines:

The child weighs less than expected for age. Explanation: Birth weight should triple by 12 months. The child should weigh near 24 pounds 12 ounces (11.25 kg). The child is underweight for age.

The nurse is conducting a physical examination of a 5-month-old boy. Which of the following observations may be cause for concern about the infant's neurologic development?

The infant displays an asymmetric tonic neck reflex (fencing reflex). Explanation: The tonic neck reflex normally disappears by age 4 months, the palmar grasp reflex by age 6 months, and the Babinski reflex (fanning of toes when sole of foot stroked) by 12 months. Retaining these primitive reflexes may indicate a neurologic abnormality. The anterior fontanel, which remains open for brain growth, closes between 12 and 18 months of age.

The caregiver of an infant tells the nurse that her dentist told her not to let the child go to bed with a bottle of milk. The caregiver states she doesn't understand the reason for this since her baby seems to enjoy the bottle. The most appropriate response to this caregiver would be:

"Bottles given at bedtime can cause erosion of the enamel on the teeth." Explanation: The sugar from formula or sweetened juice coats the infant's teeth for long periods and causes erosion of the enamel on the deciduous teeth. While giving water in a bottle at bedtime is acceptable (D) and a pacifier will satisfy the sucking need (C), the most appropriate response is B. Giving a bottle at bedtime is not a factor that leads to obesity.

Mark is a 2-month-old that has inconsolable crying, is gassy, and constantly draws his legs up. It has been determined that Mark has colic. What is the best intervention to treat colic?

He needs to try a different formula to assess for sensitivity. Explanation: Colic peaks between 3 weeks and 6 months of age. Treatment is a restful, soothing environment. Changing an infant's formula or having a breast-feeding mom decrease her intake of gassy foods may alleviate the symptoms.

The nurse enters her patient's room and finds the infant on a pillow with a bottle propped up while mom is dressing. What reaction should the nurse make?

"You should always hold your baby for feedings instead of propping the bottles." Explanation: The nurse should educate the mother on the risks of propping bottles with infants. Infants are at risk for aspiration of milk and for otitis media. The other choices do not point out the safety risks or educate the mother.

The infant measured 20 inches at birth. If the infant is following a normal pattern of growth, which of the following ranges would be an expected height for this child at the age of 12 months?

30-32 inches Explanation: By one year of age, the infant has tripled his or her birth weight and has grown 10 to 12 inches.

When weighing and measuring a child at her 1-year well-baby checkup, the nurse would expect to see that over the previous 6 months a baby who weighed 8 pounds and was 20 inches long at birth would have gained about

8 pounds and grown 4-6 inches Explanation: During the first 6 months, an infant's birth weight doubles and his or her height increases by about 6 inches. Growth slows slightly during the second 6 months but is still rapid. By 1 year of age, the infant has tripled his or her birth weight and has grown 10 inches to 12 inches.

A new mother asks for advice from the nurse about bathing her infant. Which of the following should the nurse tell her?

Be sure to wash the infant's face, hands, and diaper area daily. Explanation: Except in very hot weather, an infant does not need a bath every day. If a parent is tired and would not enjoy bath time or if some days are just too rushed, a complete bath can be omitted, with only the infant's face, hands, and diaper area washed. Some infants do need their head and scalp washed frequently (every day or every other day) to prevent seborrhea, a scaly scalp condition often called cradle cap. If seborrhea lesions do develop, they adhere to the scalp in yellow, crusty patches. The skin beneath them may be slightly erythematous. The patches can be softened by oiling the scalp with mineral oil or petroleum jelly and leaving it on overnight. The crusts can then be removed by shampooing the hair the next morning. A soft toothbrush or fine-toothed comb can be used to help remove them.

The nurse is examining a 6-month-old girl who was born 8 weeks early. Which finding is cause for concern?

Head size has increased 5 in (12 cm) since birth. Explanation: The child's head size is large for his adjusted age of 4 months, which would be cause for concern. Normal growth would be 3.6 in (9 cm). At 10 lb, 2 oz (12 cm), the child is the right weight for a 4-month-old adjusted age. Palmar grasp reflex disappears between 4 and 6 months adjusted age, so this would not be a concern yet. The child is of average weight for a 4-month-old adjusted age.

The nurse is observing a 6-month-old boy for developmental progress. For which typical milestone should the nurse look?

Puts down a little ball to pick up a stuffed toy Explanation: At 6 months of age, the child is able to put down one toy to pick up another. He will be able to shift a toy to his left hand to reach for another with his right hand by 7 months. He will pick up an object with his thumb and finger tips at 8 months, and he will enjoy hitting a plastic bowl with a large spoon at 9 months.

Which developmental milestone would the nurse expect an 11-month-old infant to have achieved?

Sitting independently Explanation: Infants typically sit independently, without support, by age 8 months. Walking independently may be accomplished as late as age 15 months and still be within the normal range. Few infants walk independently by age 11 months. Building a tower of three or four blocks is a milestone of an 18-month-old. Turning a doorknob is a milestone of a 24-month-old.

Which of the following milestones would you expect an infant to accomplish by 8 months of age?

Sitting without support Explanation: Most babies sit steadily at 8 months, creep at 9 months, and pull to standing at 10 months.

The mother of a 1-month-old infant voices concern about her baby's respirations. She states they are rapid and irregular. Which information should the nurse provide?

The respirations of a 1-month-old infant are normally irregular and periodically pause. Explanation: The normal respiratory rate for a 1-month-old infant is 30 to 60 breaths per minute. By 1 year of age the rate will be 20 to 30 breaths per minute. The respiratory patterns of the 1-month-old infant are irregular. There may normally be periodic pauses in the rhythm.

The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking?

They put her to bed when she falls asleep. Explanation: If the parents are keeping the child up until she falls asleep, they are not creating a bedtime routine for her. Infants need a transition to sleep at this age. If the parents are singing to her before she goes to bed, if she has a regular, scheduled bedtime, and if they check on her safety when she wakes at night, then lie her down and leave, they are using good sleep practices.

The nurse is promoting a healthy diet to the mother of a 6-month-old girl. Which of the following would have the most effect on the infant's neurologic development?

Promoting continuation of breastfeeding Explanation: Continuing to breastfeed ensures the proper level of nutritional fat for myelination of the nervous system. Having adequate dietary iron would help prevent anemia as the stores from fetal development are depleted. Promoting increased intake of solid foods is not necessary at 6 months and may diminish the amount of breast milk consumed. Fruit juice in the diet is not recommended. Fruits provide more nutrition and will soon be gradually added to the infant's diet.

A nurse places a toy car in front of a 6-month-old girl. She swats at it, and the car flies across the examination table and lands on the floor. She squeals with surprise and delight. When the nurse puts the toy car in front of her again, she immediately swats it again and laughs as it rolls across the table and falls to the floor again. Which of the following has the girl just demonstrated?

Secondary circular reaction Explanation: By the third month of life, a child enters a cognitive stage identified by Piaget as primary circular reaction. During this time, the infant explores objects by grasping them with the hands or by mouthing them. Infants appear to be unaware of what actions they can cause or what actions occur independently, however. At about 6 months of age infants pass into a stage Piaget called secondary circular reaction. Now when infants reach for an object, hit it, and watch it move, they realize it was their hand that initiated the motion, and so they hit it again. By 10 months, infants discover object permanence. Infants are ready for peek-a-boo once they have gained this concept. They know their parent still exists even when hiding behind a hand or blanket and wait excitedly for the parent to reappear. Binocular vision, which is the ability to fuse two images into one, is demonstrated by 2-month-olds when the follow moving objects with their eyes, although not past the midline.

A new mother complains that she is exhausted and that the little sleep she gets is determined by her baby's daytime naps and the few hours the baby sleeps during the night. The nurse discusses with this mother the importance of helping the infant establish healthy sleeping patterns. Which of the following would be most helpful for this mother to do to encourage healthy sleeping patterns? The mother should

Use the crib for sleeping only, not for play activities Explanation: A consistent bedtime routine is usually helpful in establishing healthy sleeping patterns and in preventing sleep problems. Using the crib for sleeping only helps the child associate the bed with sleep. Depriving the baby of sleep during the afternoon or evening will make the baby over-tired and less able to establish a healthy sleeping pattern. While letting a baby cry for a while is acceptable, this does not promote consistency in the baby's sleeping pattern.