Growth and Development of Newborns and Infants

6 to 9 months

From 6 to 9 months, an infant can roll from back to stomach and stomach to back; sit unsupported (by 8 months); transfer objects from hand to hand, point at objects, and pick them up (by 9 months); play pat-a-cake; and look at image in mirror.Also, by 9 months infants display stranger anxiety and object permanence.

3 to 6 months

supports head plays w hands and moves objects towards mouth begins to drool expresses self through babbling By 6 months of age, infants should double in weight (from birth weight); raise and support their head (by 4 months); grasp objects and bring them to their mouth; play with their toes; open their mouth for a spoon; begin to drool and chew on toys; roll from stomach to back; sit with some support; support some weight while standing, and begin to babble and recognize familiar objects or people.

Cleft lip and palate postsurgical nursing interventions

After a cleft lip or palate repair on an infant, nursing interventions include using a special nipple or bottle to aid in bottle feeding, while avoiding breastfeeding immediately after surgery; avoiding having the infant lying supine, which may disturb sutures; and feeding the infant in an upright position and burping frequently. The infant may be restrained for approximately 2 to 3 weeks with soft elbow restraints to keep their hands from disrupting the suture line; restraints should be removed every 2 hours, one arm at a time, to make sure the skin underneath and circulation are not compromised and to allow the infant free use of the arm while the caregiver closely monitors the suture line.

9 to 12 months

At 9 to 12 months, infants should be triple birth weight, have head and chest circumference equal to one another, know their name, creep along furniture (and may take first steps), drink from a cup and begin weaning from bottle, eat with a spoon (but prefer using fingers), develop security objects, such as a blanket, enjoy books, understand simple communication, and know two or three words beyond mama and dada. At around 12 months of age, infants can transition to whole milk.

What nursing intervention is most appropriate when caring for an infant who has just arrived on the unit after a cleft palate repair?

Avoid breastfeeding

Which of the following findings are normal in a newborn? Select all that apply.

Diamond-shaped anterior fontanel sunken fontanels are common at rest Slight pulsations in fontanels may be felt

Can you differentiate the various developmental milestones of a newborn or infant up to 1 year of age? Drag and drop the statements that apply to each age range stated. Birth to 3 months

Grows 1 inch per month Grasps an object smiles on purpose, coos when spoken to During the first 3 months of life, the infant will gain weight at a rate of 5 to 7 ounces per week for the first month, then 1 to 2 pounds per month, doubling weight by 6 months. Height will increase at a rate of 1 inch per month for 6 months. Infants should be fed every 2 to 3 hours if breastfed or every 3 to 4 hours if bottle fed. Newborns will grasp objects, kick, and turn their head to the side, but they won't raise their head independently. By 2 months, the infant should coo when spoken to, blow bubbles, and smile on purpose.

Nursing interventions for hyperbilirubinemia

Nursing interventions for hyperbilirubinemia include observing the skin over the face and nose then progressing down to the trunk and extremities, noting high-risk infants, using Coombs' test with a heel stick for direct and indirect bilirubin levels, covering genitalia and eyes when phototherapy is applied, allowing mother to hold during feedings only, and working with a lactation consultant for breastfeeding mothers and encourage early feedings.

Hyperbilirubinemia risk factors

The risk factors associated with hyperbilirubinemia include mother with diabetes; ABO incompatibility; Rh incompatibility; prematurity; delayed feeding; birth trauma; liver immaturity; stress in neonate, such as cold stress, asphyxia, and hypoglycemia; use of Pitocin in labor; being of East Asian, Native American, or Mediterranean descent; sibling history of jaundice; and breastfeeding.

The labor and delivery nurse transfers a baby to the newborn nursery. After the nurse receives report, they should begin their assessment of the newborn. What prophylactic medications should the nurse prepare to give? Select all that apply.

Vitamin K Erythromycin eye ointment Hepatitis B vaccine

Growth and Development of Newborns and Infants Videa Transcript

When a fetus leaves its mother's womb and enters the larger world, it becomes a newborn infant. As the infant's nurse, you help to ensure proper transition to extrauterine life. This process begins with clearing the airway, determining the Apgar score, and administering vitamin K, which prevents hemorrhage by forming clots, and the hepatitis B vaccine, which is given in a series of three doses and prevents associated liver disease. You'll also apply erythromycin eye ointment, which prevents the infant from contracting sexually transmitted diseases regardless of whether the mother delivered vaginally or via cesarean section. Next comes the head-to-toe assessment. Listen for breathing difficulties and assess for color changes. Assess the fontanels; the anterior, diamond-shaped fontanels and the posterior, triangular-shaped fontanels should be flat, not sunken or bulging. Molding of the head is normal. You may feel slight pulsations. You may find caput succedaneum, which is the cone shape to the back of the head that crosses suture lines, and cephalohematoma, which is unilateral or bilateral swelling of the sides of the head that does not cross suture lines. Eyes may be edematous, but pupils should be equal and reactive to light. Check the ears for position and abnormalities and the nose for patency; note if the infant is a nose breather. Assess the mouth for symmetry; hard and soft palates should be intact. Report deviations, such as a cleft lip or palate, as these findings can have an impact on nutrition and feedings. As you continue with your assessment, you may notice common characteristics such as acrocyanosis, or mottling. Mongolian spots may appear as bluish discolorations on the buttocks. Milia or white papules appear on the face, and a fine downy hair may be present over different body parts depending on the newborn's gestational age. Newborns are also covered in vernix caseosa, which is a protective substance secreted from sebaceous glands. If you notice jaundice, or yellowing of the skin, notify the provider as it may warrant further intervention. You may also incorporate the Ballard tool into your assessment. This tool, which allows for scores from negative one to positive five, utilizes six areas of both neuromuscular and physical maturity to assess gestational age. Physical maturity scoring should be completed within the first 2 hrs of birth, and neuromuscular scoring should be completed within the first 24 hrs. Scores can range from negative ten, which represents a gestational age of 20 weeks, all the way to fifty, which represents a gestational age of 44 weeks. Also assess the reflexes. The Moro or startle reflex is initiated to see the response to a loud noise and the response when the head slightly drops back. Check the rooting and sucking reflexes to see if the infant turns toward the direction of the stimulus and sucks on a gloved finger or nipple. Palmar and plantar grasps determine grasps of the fingers and toes when placing a thumb or finger in either the hand or foot. The Babinski reflex causes a hyperextension and fanning of toes, while the stepping-dancing reflex elicits a step up and down position of feet when held upright touching a flat surface. By properly performing these assessments, you'll be helping to determine complications, normal growth, and development patterns—and most importantly, the newborn's healthy transition to extrauterine life.

The nurse is performing a head-to-toe assessment on a newborn delivered vaginally 22 minutes ago. What finding is concerning, requiring immediate attention?

bluish discoloration on buttocks