Pedi/OB: Growth & Development of Infant
6-9
between ___ months infants are able to say mama/dada sounds
10-12
between ___ months infants say mama/dada specific
no
does thumb sucking affect the jaw line?
3-4 months
infants should be able to turn their heads towards noise by ___
1 years old
infants should not have whole milk until ___ because there is bacteria within milk that the baby is not able to digest
aspiration
it is not recommended to include rice cereal in bottles because this increases the risk for ___
6
it is recommended to not have additional fluids for the first ___ months of life
botulism spores
parents should never use honey as a sweetener because it may contain ___ and never use cow's milk because it can cause microscopic intestinal bleeding.
-double -triple
As a rule, most infants ___ their birth weight by 4 to 6 months and ___ it by 1 year
4-8 months
Separation from parents begins around ___
two thirds
By the end of the first year, the brain already reaches ___ of its adult size. Head circumference increases rapidly during the infant period to reflect this rapid brain growth.
6 months
A 5-month-old infant can be seen to straighten his or her back when held or propped in a sitting position. By ___, infants can sit momentarily without support. They anticipate being picked up and reach up with their hands from this position.
8-month-old
A 7-month-old child can sit alone but only when the hands are held forward for balance. An ___ child can sit securely without any additional support (Fig. 29.6). This is a major milestone in development that should always be considered in an assessment.
4
A ___-month-old child reaches an important milestone by no longer demonstrating head lag when pulled to a sitting position.
22 months
A child has until about ___ of age to walk and still be within the normal limit
pincer grasp
A major milestone at 10 months is the ability to bring the thumb and first finger together in a ___
10 months
A major milestone at ___ is the ability to bring the thumb and first finger together in a pincer grasp (Fig. 29.10). This enables children to pick up small objects such as crumbs or pieces of cereal from a high chair tray. They use one finger to point to objects. They offer toys to people but then cannot release them.
2 tablespoons (30 ml)
A newborn's stomach can hold approximately ____. By 1 year, a stomach can hold no more than about 1 cup (240 ml). For this reason, when they begin eating solid food, infants rarely take more than this amount at a time.
toilet paper roll
A test of whether a toy could be dangerous if an infant puts it inside the mouth is whether it fits inside a ___. If it does, it is small enough to be aspirated. When solid foods are introduced, encourage parents to offer small pieces of hot dogs or grapes, not large chunks for this reason. Children under about 5 years of age should not be offered popcorn or peanuts because of the danger of aspiration.
primary circular reaction
By the third month of life, a child enters a cognitive stage identified by Piaget (1952) as ___. During this time, the infant explores objects by grasping them with the hands or by mouthing them
first
Although heredity plays a role, a baby who is overweight during the ___ year of life is more likely to become an adult who is obese than one whose weight is within normal limits. Such long-term effects occur because overfeeding in early life may produce large numbers of excess fat cells (adipocytes) used to store fat.
50%
An infant increases in height during the first year by ___, or grows from the average birth length of 20 in. to about 30 in. (50.8 to 76.2 cm)
1 year
As infants reach ___ of age, they are capable of reproducing new events (they deliberately hit a mobile once, it moves, and they hit it again). They drop objects from a high chair or playpen and watch where they fall or roll. This is a frustrating activity for parents because it involves a great deal of reaching and picking up. It is an important activity for infants, however because it confirms their awareness of the permanence of objects and how they are able to control events in their world.
parachute reaction
At 6 to 9 months, an infant also demonstrates a ___ from a ventral suspension position. This means that when infants are suddenly lowered toward an examining table, the arms extend as if to protect themselves from falling.
9 months,
At ___ infants sit so steadily that they can lean forward and regain their balance. They may still lose their balance if they lean sideways, which is a skill not achieved for another month.
12 months
At ___, infants can hold a crayon well enough to draw a semi-straight line. They enjoy putting objects such as small blocks in containers and taking them out again. They can hold a cup and spoon to feed themselves fairly well (if they have been allowed to practice) and can take off socks and push their hands into sleeves (again, if they have been allowed to practice). They can offer toys and release them.
12 months
At ___, the child can stand alone at least momentarily. Some parents expect children to walk at this time and may be disappointed to see their child is merely standing still.
secondary circular reaction
At about 6 months of age, infants pass into a stage Piaget (1952) called ___. Now when infants reach for a mobile above the crib, hit it, and watch it move, they realize it was their hand that initiated the motion, and so they hit it again.
11 months
At around ___, an infant learns to "cruise" or move about the crib or room by holding onto objects such as the crib rails, chairs, walls, and low tables
taste
Babies have distinct taste preferences even at young ages and may spit out a food because they do not like the ___. Even after the extrusion reflex has faded, some infants continue to spit out food.
2 years
Backward-facing car seats should continue to be used without interruption until age ___ or until the child reaches the highest weight or height allowed by the car safety seat's manufacturer. If parents are firm about keeping infants in car seats even when they are fussy or impatient, children will eventually become more comfortable and accepting of car seats.
1
Because ___-month-olds can fix their eyes on an object, they are interested in watching a mobile over their crib or playpen. Mobiles are best if they are black and white or brightly colored and light enough in weight so they move when someone walks by.
A. Children at 12 months usually say two words beside "ma-ma" and "da-da." They are not incapable of understanding, but they cannot express their needs verbally.
Beginning verbal communication is one of the most important tasks that infants need to achieve. The nurse teaches Bryan's mother that by 12 months of age he should display which characteristics? a. "Children this age can usually say around two words, plus 'ma-ma' and 'da-da.'" b. "One-year-olds can usually say more words than they are able to understand." c. "A 12-month-old child can express his or her basic needs verbally." d. "An infant who is this age usually can't understand spoken words."
C. Infants sit steadily at 8 months of age.
Bryan is 2 months old, and the nurse is collaborating with the occupational therapist in his care. When planning care, the nurse identifies that John should sit securely at what age? a. 2.5 months b. 6 months c. 8 months d. 12 months
11
By ___ months, children have learned to cruise or walk by holding on to low tables. They often find this so absorbing that they spend little time doing anything else during the month. Twelve-month-old infants enjoy putting things in and taking things out of containers. They like little boxes that fit inside one another or dropping small blocks into a larger box. As soon as they can walk, they will be interested in pull toys. A lot of time may be spent listening to someone saying nursery rhymes or listening to music.
2
By ___ months, infants are very talkative, cooing, babbling, and gurgling when spoken to.
2
By ___ months, infants can hold their head fairly steady when sitting up, although their head does tend to bob forward and will still show head lag when pulled to a sitting position.
10
By ___ months, infants can recognize their name and listen acutely when spoken to.
12
By ___ months, most children have overcome their fear of strangers and are alert and responsive again when approached. They like to play interactive nursery rhymes and rhythm games and "dance" with others. They also like being at the table for meals and joining in family activities.
10 months
By ___, an infant looks under a towel or around a corner for a concealed object (the beginning of object permanence, or an awareness that an object out of sight still exists).
10 months
By ___, infants are ready for peek-a-boo and will spend a long time playing the game with their hands or with a cloth over their head that they can easily reach and remove. They can clap, so they are also ready to play patty-cake. These games have a positive value, just as laughing out loud did for the 3-month-old. They make the baby feel like an active part of the household. A family feeling begins to grow as the baby begins to actively participate in this type of game.
3 months
By ___, infants reach for attractive objects in front of them. Their grasp is unpracticed so they usually miss them. You can assure parents this is part of normal development so they do not think their child is nearsighted or farsighted or has poor coordination.
100 calories
Calorie allowances can be gradually reduced during the first year from a level of 120 calories per kilogram of body weight (50 to 55 calories per pound) at birth to approximately ___ per kilogram (45 calories per pound) of body weight at the end of the first year to prevent babies from becoming overweight.
7 to 9
Chewing movements do not begin until ___ to ___ months. Therefore, foods that require chewing should not be given until this age.
extrusion reflex
Until age 3 or 4 months, an ___ (food placed on an infant's tongue is thrust forward and out of the mouth) prevents some infants from eating effectively if they are offered solid food this early (not recommended)
-2 lb -1 lb
During the first 6 months, infants typically average a weight gain of ___ per month. During the second 6 months, weight gain is approximately ___ per month.
eighth month
Fear of strangers reaches its height during the ___, so much so that this phenomenon is often termed eighth-month anxiety, or stranger anxiety (Levine, 2011). Remember that an infant at the height of this phase will not go willingly from a parent's arms to a nurse's arms. Taking a few minutes to talk to the child and parent first so you are perceived as a friend, not a stranger, is time well spent.
rice cereal
Fortified cereal costs no more than unfortified cereal, so remind parents to buy the fortified product. The first cereal introduced is usually ___ because fewer children are allergic to rice products than to wheat and corn products.
ventral suspension, prone, sitting, and standing
Four positions—_____—are used to assess gross motor development.
32 oz (960 ml)
Generally speaking, parents can tell infants are physiologically ready for solid food when they are nursing vigorously every 3 to 4 hours and do not seem satisfied or when they are taking more than ___ of formula a day and do not seem satisfied.
6 months.
How long mothers continue to breastfeed is an individual choice, although it is recommended that infants be exclusively breastfed for ___
100 to 120
In the cardiovascular system, heart rate slows from 110 to 160 beats/min to ___ beats/min by the end of the first year.
B vitamins and iron.
Infant cereal is fortified with ___ vitamins and ___
physiologic anemia
Infants are prone to develop a ___ at 2 to 3 months of age. This occurs because the life of a typical red cell is 4 months, so the cells the child had at birth begin to disintegrate at that time, yet new cells are not yet being produced in adequate replacement numbers
6 months
Infants demonstrate they have an acute sense of taste by turning away from or spitting out a taste they do not enjoy. When infants are introduced to solid food at about ___, urge parents to make mealtime a time for fostering trust as well as supplying nutrition by being certain feedings are done at an infant's pace and the amount offered fits the child's needs and not the parent's idea of how much should be eaten.
vitamin C and iron
Infants who are changed to cow's milk before 1 year of age should receive a supplementary form of ___ and ___ and possibly fluoride to make up for the deficiency of these components in cow's milk. However, the practice of switching to cow's milk is not recommended because the protein in it is difficult for an infant to digest, possibly leading to such intestinal irritation that slight but continuous gastrointestinal bleeding occurs, which results in anemia.
4 to 6
It's best if infants are exclusively breastfed for 4 months (recommended 6) so infants typically are ready for solid food at ___ to ___ months of age.
2 months
Language develops step by step the same as motor development. Infants begin to make small, cooing (dovelike) sounds by the end of the first month. By ___, they can differentiate their cry. For example, parents can begin to distinguish a cry that means "hungry" from one that means "wet" or from one that means "lonely."
6 months
Many communities offer infant swim programs for babies as young as ___. If an infant is enrolled in one of these programs, parents may become overconfident about their infant's ability to operate safely in water. Urge them to think carefully before enrolling their infant in such a program, because, although infants can dog paddle momentarily in a swimming pool, this action does not mean they can sustain that position for any length of time in a bathtub or pool by themselves.
every 4-7 days
New food should be introduced in what intervals
D. A mother who "always has a hot cup of coffee in her hand" could easily spill that on the infant while giving care or holding the infant.
Scalding injuries occur in infants when caretakers spill hot beverages while holding them in their lap or, toward the end of the first year, the infant is able to pull a pan of hot liquid off the stove. To confirm the incidence of this type of injury, researchers studied the admission records of an urban pediatric emergency department in Ireland. Of 280 children seen for burns, 161 (57%) were scalds. Of these, 79% occurred in children under 5 years of age, 65% were caused by hot beverages, 16% were caused by hot water, and 16% by hot food. The areas of children most affected were upper limbs and upper trunks. The researchers concluded that more parent education as to the danger of scalding is needed to reduce the number of these very painful injuries in young children. Based on the study, the nurse is most concerned about which remark by Bryan's mother? a. "I never drive without a cup of coffee in my cup holder." b. "I'm going to switch to drinking tea to reduce my caffeine intake." c. "I drank coffee during Bryan's pregnancy; it's why he's so high strung." d. "I'm a coffee addict; I always have a fresh cup in my hand."
tummy time
Some infants' heads appear asymmetric until the second half of the first year, especially if they are always placed on their back to sleep (which they should be), causing the skull bones to flatten in the back. Suggest to parents they continue to place the infant on the back to sleep but to spend "___" daily with the infant placed in a prone position to prevent this flattening.
natal teeth
Some newborns (about 1 in 2,000) may be born with teeth (___) or have teeth erupt in the first 4 weeks of life (neonatal teeth)
3-6 months
between ___ infants are able to laugh and squeal
2 months
Teach parents to be prepared for their infant to turn over by ___ of age. From that time on, they must be especially vigilant not to leave the baby unattended on a changing table or counter.
9-month-olds
The ___-month-old infant needs the experience of creeping. This means time out of a crib or playpen so there is room to maneuver. Many begin to enjoy toys that go inside one another, such as a nest of blocks or rings of assorted sizes that fit on a center post. Some are more interested in pots and pans that stack rather than toys.
6 months
The ability to adjust to cold is mature by age ___. By this age, an infant can shiver in response to cold (which increases muscle activity and provides warmth) and has developed additional adipose tissue to serve as insulation. The amount of brown fat, which protected the newborn from cold, decreases during the first year as subcutaneous fat increases.
cephalocaudal
The acquisition of gross motor skills precedes the development of fine motor skills. Both processes occur in a ___ fashion (Head control preceding arm and hand control, followed by leg and foot control.)
400 IU of vitamin D
The best food for an infant during the first 12 months of life (and the only food necessary for the first 6 months) is breast milk (see Chapter 19 for tips on breastfeeding). A breastfed or partially breastfed infant should receive ___ or ___ supplement starting at 2 weeks of age
2 cm.
The circumference of the chest is generally less than that of the head at birth by about ___
6 months
The first baby tooth (typically a central incisor) usually erupts at age ___, followed by a new one monthly.
A. Infants understand permanence when they look for someone or something out of sight.
The nurse is discussing object permanence with Bryan's mother. Which action by her infant best illustrates that he understands object permanence? a. The child looks for the mother after she walks away. b. The child cries when either hungry or lonely. c. The child prefers a large yellow ball to a small red one. d. The child smiles when the mobile on the crib jingles.
D. Aspiration and falls are the most frequent unintentional injuries in infants
The nurse reviews infant safety with Bryan's mother. It is most important to teach his mother about preventing which common injuries among infants? a. Drowning and hypersensitivities b. Poisoning and suffocation c. Auto accidents and burns d. Aspiration and falls
20 to 30
The respiratory rate of an infant slows from 30 to 60 breaths/min to ___ breaths/min by the end of the first year.
8 to 15
There is a wide variation in the age at which children take a first step, typically ranging from ___ to ___ months.
5 to 6
Toward the end of pregnancy, parents need to begin preparing for their infant's arrival by childproofing their home. As soon as infants begin teething at ___ to ___ months, they chew on any object within reach to lessen gumline pain. Remind parents to thoroughly check for possible sources of lead paint, such as painted cribs, playpen rails, or windowsills before this time to avoid lead poisoning
binocular vision
Two-month-old infants focus well (from about age 6 weeks) and so are able to follow moving objects with the eyes (although still not past the midline). The ability to follow and focus in this way is a major milestone in development, indicating that an infant has achieved ___, or the ability to fuse two images into one
social smile
When an interested person nods and smiles at a 6-week-old infant, the infant smiles in return. This is a ___ and is a definite response to the interaction, not the faint, quick smile that younger infants, even newborns, demonstrate. It is a major milestone because it reflects growing maturity in a number of areas, most notably vision, motor control, and intelligence. Cognitively challenged children or children with spasticity may not demonstrate a social smile until much later in the infant year.
12-18 months
When does the anterior fontanel close?
head lag
When placed on his or her back and then pulled to a sitting position, a newborn has extreme ___; this lag is present until about 1 month (Fig. 29.4). In a sitting position, the back appears rounded and an infant demonstrates only momentary head control.
4 months
When they reach ___, infants bring their hands together and pull at their clothes. They will shake a rattle placed in their hand. Thumb opposition (ability to bring the thumb and fingers together) begins, but the motion is a scooping or raking one, not a picking-up one, and is not very accurate. This limits the infant to handling large objects. Palmar and plantar grasp reflexes have disappeared.
extrusion reflex
With the ___ intact, when anything is placed on the anterior third of an infant's tongue, it is automatically extruded or thrust out of the mouth by the tongue (Fig. 29.18). This is a lifesaving reflex in early infancy because it prevents infants from swallowing or aspirating foreign objects that touch the mouth. The reflex fades at *3 to 4 months* at about the same time the gastrointestinal tract has matured to be ready to digest solid food.
Falls
___ are a second major cause of infant injuries. As a preventive measure, no infant, beginning with a newborn, should be left unattended on a raised surface. Normal wiggling can bring even a newborn to the edge of a bed, couch, or table top, resulting in a fall.
deciduous teeth
___ are the 20 teeth that begin to erupt around the age of 6 months. Eventually pushed out by the permanent teeth.
Breastfed
___ infants gain less weight than those who are formula fed and so usually tend to be somewhat lighter in weight and have less risk of becoming overweight
One-month-old
___ infants still have a strong grasp reflex so they hold their hands in fists so tightly that it is difficult to extend their fingers. As the grasp reflex fades, a 2-month-old infant will hold an object for a few minutes before dropping it. The hands are held open, not closed in fists.
brainstem auditory evoked response (hearing screening) (BAER)
___ is a hearing test done at birth
pacifier use
___ is proven to decrease the risk of SIDS; after 2-3 years it can cause problems with the teeth
Erikson
___ proposed that the developmental task of the infant period is to form a sense of trust (see Chapter 28). Infants who have numerous caregivers, who may be fed 1 day on a rigid schedule and the next only when they are hungry, who sometimes are treated roughly and sometimes gently, or who don't always have their needs met can have difficulty learning to trust.
Fluoride
___ supplementation should be administered at 6 months of age (AAP, 2017). However, teething patterns can vary greatly among children.
Deciduous
___ teeth are essential for allowing proper growth of the dental arch. If they are injured, children need conscientious follow-up to be certain there is space for permanent teeth to erupt effectively or that permanent teeth are not discolored
Ventral suspension
____ refers to an infant's appearance when held in midair on a horizontal plane and supported by a hand under the abdomen (Fig. 29.2A). In this position, the newborn allows the head to hang down with little effort at control. One-month-old infants lift their head momentarily and then drop it again. Two-month-old infants hold their head in the same plane as the rest of their body, a major advance in muscle control. By 3 months, infants lift and maintain their head well above the plane of the rest of the body
6
a baby is usually referred to a dentist by ___ months of age
communicate
the ability to hear correlates with the ability to ___ words properly
2 months
the posterior fontanel closes by ___
2-week, 2-month, 4-month, 6-month, 9-month, and 12-month
what are the standard healthcare visit times of an infant
rice cereal
what is the first solid food that should be introduced
rice cereal > vegetables > fruits > meats
what is the recommended order of foods that can be introduced
9 months
when are infants able to comprehend the word "No"?
4 months
when does thumb opposition (ability to bring the thumb and fingers together) begin?
