Growth and development, nutrition, assessment & PREP U

infant milestones

*0-28 days= eye blink *1-4 months= attends to noises *4-8 months=recognizes words *8-12 months= enjoys rhymes and songs

Infant feeding

-Breast milk is nutritionally superior -Cognitive benefits associated with breastfeeding -Many U.S. infants are exclusively or predominantly formula fed -Formula feeding results in negative outcomes in underdeveloped countries "Milk will not fully provide the child's needs for iron, which is found in solid foods."

Erikson Developmental Theory

-Infancy- 1 yr.: Trust vs. mistrust 1-3 yrs.: Autonomy vs. shame and doubt 3-6 yrs.: Initiative vs. guilt 6-puberty: Competence vs. inferiority Teen years-into 20's: Identity vs. role confusion 20's-early 40's: Intimacy vs. isolation 40's-60's: Generativity vs. stagnation 60's-up: Integrity vs. despair

Language Development infant

0-12mos early vocalizations are spontaneous, cooing (vowels) or crying. then babbling sounds (phonemes) begin with sounds morel ike patterned speech with consonant vowel strings (dadada)

Babinski reflex disappears

1 year Reflex in which a newborn fans out the toes when the sole of the foot is touched

school aged child avg sleep

10-12hrs

language development toddler

1yr-18mos first words spoken. usually familiar objects or people. simple monosyllabic words such as momma or byebye

infant milestones

2 months - holds up head 4 months - rolls from abdomen to back 7/8 months - sits alone 9 months - crawls 8 - 15 months - standing with support & walking neonate - palmer grasp reflex teething at 6 months

Head lag disappears

4 months

Rooting reflex disappears

4 months Movement of the tongue, mouth and/or head toward the stimulus a baby's tendency, when touched on the cheek, to turn toward the touch, open the mouth, and search for the nipple

Moro reflex disappears

4 months (Moro reflex is symmetric abduction and extension of the arms followed by adduction of the arms, sometimes with a cry)

Moro reflex disappears

4 months (Moro reflex is symmetric abduction and extension of the arms followed by adduction of the arms, sometimes with a cry) Reflex in which a newborn strectches out the arms and legs and cries in response to a loud noise or an abrupt change in the environment Infant reflex where a baby will startle in response to a loud sound or sudden movement.

The step reflex disappears by age?

6 weeks This reflex is also called the walking or dance reflex because a baby appears to take steps or dance when held upright with his or her feet touching a solid surface.

birth weight doubles by, triples by

6mo, 1y

anterior fontanelle closes by...posterior by..

AF -18 months, PF - 6-8 weeks

Infant weight gain

Birth weight doubles by 4 to 6 months Birth weight triples by 1 year

Breastmilk composition

Carbs, Proteins, Fats, Vitamins, Minerals, Immunoglobulins & antigens, enzymes, anti-inflammatory components.

vaccine schedule

DTaP, Hib, pneumococcal, meningococcal by 6m Start influenza and 6m MMR at 1y and 5y HBV and HPV at 12y

Hearing development

Fetuses (26-28 weeks) are sensitive to sound Babies show recognition of sounds they heard in utero repeatedly after they are born By 18 months, babies can detect the direction of a sound Noises must be 10 to 20 decibels louder for babies to hear it Children are 13 before they develop an adult-level of sound sensitivity

teeth development

First teeth usually erupt 6-8 months lower central incisors usually first Some infants fussy during teething from swollen, inflamed gums Cold teething ring may alleviate some discomfort begins b/w 6m and 2 1/2 yrs age in months - 6 = # of teeth 20 deciduous(baby teeth) lost by 6-12 yrs

Vaccinations at a six-month well-child visit.

HBV, DTaP, Hib, IPV, PCV

Newborn vital signs

HR 100-160 R 40-60 BP 60-80 systolic; 40-50 diastolic respirations of 1 mo old infant are irregular and periodically pause

Newborn vaccine

Hep B- HBsAg recombinant

Infant Nutrition

Nutrition a. The infant may breast-feed or bottle-feed (with iron-fortified formula), depending on the mother's choice; however, human milk is the preferred form of nutrition for all infants, especially during the first 6 months. 6 b. All infants should receive daily vitamin D supplementation (200 IU) starting in the first 2 months of life to prevent rickets and vitamin D deficiency. c. Iron stores from birth are depleted by 4 months of age; if the infant is being only breast-fed, iron supplementation usually with iron-fortified cereal is needed. d. Whole milk, low-fat milk, skim milk, other animal milk, or imitation milk should not be given to infants as a primary source of nutrition because these food sources lack the necessary components needed for growth and have limited digestibility. e. Fluoride supplementation may be needed at about 6 months of age, depending on the infant's intake of fluoridated tap water. f. Solid foods (strained, pureed, or finely mashed) are introduced at about 5 to 6 months of age; introduce solid foods one at a time, usually at intervals of 4 to 5 days, to identify food allergens. g. Sequence of the introduction of solid foods varies depending on physician's preference and usually is as follows: iron-fortified rice cereal, fruits, vegetables, then meats. h. At 12 months of age, eggs can be given (introduce egg whites in small quantities to detect an allergy); cheese may be used as a substitute for meat. i. Avoid solid foods that place the infant at risk for choking, such as nuts, foods with seeds, raisins, popcorn, grapes, and hot dog pieces. j. Avoid microwaving baby bottles and baby food. k. Never mix food or medications with formula. l. Avoid adding honey to formula, water, or other fluid to prevent botulism. m. Offer fruit juice from a cup (12 to 13 months or at a prescribed age) rather than a bottle to prevent nursing (bottle-mouth) caries; fruit juice is limited because of its high sugar content.

infant weight

Should double weight by 6 months and triple it by 1 year old.

Infant vital signs

Temp: 98.6F FHR: 120-160 BP: 75/49 Resp: 30-60 respirations of 1 mo old infant are irregular and periodically pause

Newborn stomach capacity

at birth 1/2 to 1 oz 15-30 mL growing by 15 mL dy

Newborn age range

birth to 1 month

infant=

birth to 12mo

premature fontanelle closure means

brain growth impairment

preschool milestones

brushes teeth, uses scissors, ties shoes, buttons, letters numbers, climbs well Less reliant on mom, develops rivalries with siblings, increases in cooperative play, asks TONS of questions, more active imagination, becomes sexually curious

Smell development

can smell most odors, can tell who their mother is

Hib vaccine

hepatitis B vaccine

HBV

hepatitis B virus

extrusion reflex

involuntary response in which a young infant thrusts its tongue forward when a solid or semisolid object is placed in its mouth

vision development

least well developed at birth. birth= 20ft, 6mo= normal development depth perception: kinetic cues, binocular, pictoral newborns like high contrast. adults- difficulty focusing on close objects by 40yrs -interference with daily activities by 65yrs -loss of acuity, depth, color, light sensitive, visual search, following moving objects, visual processing

Asymmetric Tonic Neck Reflex

may indicate cerebral palsy or other neurological problem Onset age: 37 wks gestation Integration age: 4-6 months Stimulus: Fully rotate infant's head and hold for 5 seconds. Response: Extension of extremities on the face side, flexion of extremities on the skull side. Relevance: Promotes visual hand regard.

newborn milestones

moves all extremities, reacts to sound by blinking turning, sense of smell, likes high pitched voices, reflexes, tonic neck, palmar grasp, babinski response, rooting awake and asleep, suck, calmed by feeding, cuddling, responds to cries of other neonates,

Infant height

one and half times longer at age one 0-6m: grow 1inch/mo 6-12m: 0.5 inch/mo

Length growth=

should increase by 50% at 1 year old

Newborn Development

sleep, eat, cry and specific reflexes such as sucking, rooting and moro reflex Newborns usually double their birth weight in the first 4 months Greatest increase in height and weight occurs during the first year of life At birth, brain is ¼ of its adult weight In first year, brain triples in weight

toddler milestones

walking, climbing, hopping, running, pulling, holding on tight temper tantrums toilet training at 18-24 months praise success/ignore accidents can feed self by 15 months 20 teeth by 30 months

head lag

when the infant is lifted from the bed, the head will fall back, because newborn cannot maintain neutral position of the head