Chapter 25: Growth and Development of the Newborn and Infant

During the first visit to the pediatrician's practice the nurse is performing an admission interview and assessment of a 4-week-old infant. The mother states, "I am sure my baby girl knows my smell because she is much more settled in my arms rather than my mother's arms when she is upset." What is an appropriate response by the nurse? "Maybe she just knows your voice better than your mother's." "Babies really can't tell the difference between people at that age." "I'm not sure a 4-week-old infant can tell their mother from another woman's smell." "You may be right, since infants can sense their mother's smell as early as 7 days old."

"You may be right, since infants can sense their mother's smell as early as 7 days old." The sense of smell develops rapidly: the 7-day-old infant can differentiate the smell of his or her mother's breast milk from that of another woman and will preferentially turn toward the mother's smell.

The nurse is assessing a 1-year-old at the well-child annual visit and notes the child is meeting the growth parameters. After noting the birth weight was 8 pounds (3.6 kg) and length was 20 inches (50.8 cm) long, which measurements reflecting height/weight would the nurse expect to document for this visit? 20 lb (9.1 kg) and 28 inches (70 cm) 24 pounds (10.8 kg) and 30 inches (75 cm) 28 pounds (12.7 kg) and 32 inches (80 cm) 16 lb (7.2 kg) and 26 inches (65 cm)

24 pounds (10.8 kg) and 30 inches (75 cm) By 1 year of age, the infant should have tripled his or her birth weight and grown 10 to 12 inches (25 to 30 cm). If this infant was 8 pounds (3.6 kg) at birth, at 1 year, this child should weigh 24 pounds (8 x 3 = 24) and grown to 30 to 32 inches (20 + 10 to 12 = 30 to 32 inches). Most of the growing occurs during the first 6 months with the infant's birth weight doubling and height increasing about 6 inches (15 cm). Growth slows slightly during the second 6 months but is still rapid.

A parent takes the 4-month-old infant to the health care provider. The parent asks what type of baby cereal to provide now that the infant is starting solid foods. How should the nurse respond? "You should buy barley cereal." "You should buy oat cereal." "You should buy wheat cereal." "You should buy rice cereal."

"You should buy rice cereal." The rice cereal should be first. The infant should be monitored for food allergies by following the rice cereal with oats, barley, and wheat. Wheat has the highest allergy reaction in infants.

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? Encourage the infant to latch on properly. Maintain adequate diet and fluid intake. Apply warm compresses to the breast. Maintain a feed-on-demand approach.

Maintain a feed-on-demand approach. 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.

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? If she is safe, they lie her down and leave. They put her to bed when she falls asleep. The child has a regular, scheduled bedtime. They sing to her before she goes to sleep.

They put her to bed when she falls asleep. 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 assesses a 4-month-old child during a well-child visit (above). Which assessment finding should the nurse report to the primary health care provider? not rolling over not smiling or tracking faces occasionally spitting up after breastfeeding waking 3 times per night to feed

not smiling or tracking faces Preterm infants should be assessed developmentally based on their corrected age. For a 2-month-old infant, corrected waking at night, spitting up, and not rolling over are all normal findings. Not smiling or tracking faces are concerning findings that could indicate problems with vision. This requires follow-up by the health care provider.

The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify? frequent loose stools choosing soft foods over hard foods running a mild fever or vomiting increased biting and sucking

increased biting and sucking 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.

The best way for an infant's parent to help the child complete the developmental task of the first year is to: expose the infant to many caregivers to help the infant learn variability. talk to the infant at a special time each day. keep the infant stimulated with many toys. respond to the infant consistently.

respond to the infant consistently. The developmental task of an infant is gaining a sense of trust. The infant develops this sense from the caretakers who respond to the child's needs, such as feeding, changing diapers, being held. It is a continuous process. 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. An infant is too young to have variability in caretakers. This causes mistrust. The parents or caretakers do not need a special time to talk to the infant each day. It should be done with each interaction. Providing too much stimulus before the infant develops gross motor skills causes frustration from the child and not enjoyment.