Post natal Development

1. Post natal Development

2. The Baby’s Adaptation to Labor and DeliveryNewborn’s appearance

3. The Newborn Baby • Newborn are called Neonate. • First four weeks of life (neonatal period) • A time of transition from the uterus, where a fetus is supported entirely by the mother  to an independent existence. • When neonate are first born: • Covered by fluid from amniotic sac • Blood from placenta • Brownish fluid from own faeces. • Covered with lanugo (fuzzy prenatal hair) • Covered with vernix caseosa (cheesy varnish)

4. The Newborn Baby • Size and Appearance • New babies have distinctive feature a large head and a receding chin • On the head  Fontanels (the soft spots) • Newborns have a pinkish cast  skin so thin that it barely covers the capillaries through which blood flows. • Boys tend to be slightly longer and heavier than girls, and a firstborn child is likely to weigh less at birth than later-borns

5. The Newborn Baby • Weight : 2.8 -3.2 kg • Length : 51-53 cm (Boy > girl) • Head Circumference: 30-33 cm • Breathing: • Initially fast, short & irregular • Later  more stable & with rhythm • Blood pressure become stable in 10 days.

6. Is the Baby Healthy? • Medical and Behavioral Screening • Apgar Scale • The Brazelton Neonatal Behavioral Assessment Scale • Checks are also done for any structural or physical deformities (eg. spinal defect, cleft palate) • Silver nitrate or tetracycline is usually dropped into neonate eyes to prevent from bacterial infection while passing through birth canal.

7. Apgar Scale • Apgar Scale isa standard measurement of a newborn’s condition • Introduced by Dr. Virginia Apgar • Access newborn • 1 min after birth • 5 min after birth • Assess: • Appearance (colour) • Pulse (heart beat rate) • Grimace (reflex) • Activity (muscle tone) • Respiration (breathing)

8. APGAR SCALE

9. Brazelton Neonatal Behavioral Assessment Scale • The Brazelton Neonatal Behavioral Assessment Scale (NBAS) (Dr. Berry Brazelton) serves 3 purpose: • As an index of neurological integrity after birth • To predict future development • To assesses neonates' responsiveness to their physical and social environment • Screening done on 3rd day and repeat again after several days.

10. Brazelton Neonatal Behavioral Assessment Scale (NBAS) • Test on four distinct areas: • Social behavior (interactive behaviors in the home) • Motor behaviors (reflexes & muscle activities) • Control of physiology (baby’s ability to quiet himself) • Stress response (startle reaction) • High score  a neurologically well developed infant • Low score  a sluggish infant who need help in responding to social situations, or possible brain damage.

11. Babies In-born Reflexes Reflexesan inborn, automatic response to a particular form of stimulation. Full term newborns come equipped with a variety of reflexes for use in dealing efficiently with stimuli present in their environment. Some reflexes are necessary for survival (eg. Rooting & sucking reflexes) Reflexes are probably genetic in origin & include a timing mechanism that allows them to fade away after a period of time.

12. Examples of Newborn Reflexes • Eye Blink • Withdrawal • Rooting • Sucking • Swimming • Moro • Palmar Grasp • Tonic Neck • Stepping • Babinski

13. In-born Reflexes

14. Rooting • Stroke cheek near corner of mouth or object brushes the area • Infant respon by turning head toward stimulation • Disappears at 3 weeks when child begins to be able to voluntarily turn head • Helps infant find nipple

15. Moro Reflex • Hold infant horizontally on back and let head drop slightly or produce sudden loud sound against surface supporting infant • Infant response is to make an embracing motion by arching back, extending legs, throwing arms outward and then bringing them in toward the body • Disappear at 6 months • Probably in human evolution helped baby cling to mother

16. Palmer Grasp • Spontaneous grasp of adult’s finger • Disappears at 3-4 months to allow reaching and grasping • Prepares infant for voluntary grasping

17. Tonic Neck Reflex • Turn baby's head to one side while lying on back • Infant responds by lying in a “fencing position” with one arm extended in front of eyes on side to which head is turned other arm is flexed • Disappears at 4 months • May prepare infant for voluntary reaching

18. PATTERNS OF GROWTH • Children grow faster during the first years, especially during the first few months. • This rapid growth rate tapers off during the second and third years • Physical growth and development follow the maturational principles of the cephalocaudal principle and proximodistal principle.

19. Influences on Growth Genes interact with environment, i.e. nutrition and living conditions,  general health and well-being Well-fed, well-cared-for children grow taller and heavier than less well nourished and nurtured children Better medical care, immunization and antibioticsbetter health

20. Growth And Nutrition • Nourishment • Breast milk is almost always the best food for newborns and is recommended for at least the first 12 months • Parents can avoid obesity and cardiac problems in themselves and in their children by adopting a more active lifestyle for the entire family--and to breastfeed their babies

21. The Brain First 3 years of life is critical to baby’s brain development. Before & after birth  brain growth is fundamental to future development. It is estimated that about 250,000 brain cells are form every minute in the uterus. By birth, almost 100 billion nerve cell are formed, but not fully develop.

22. Molding the Brain: The Role of Experience Smiling, babbling, crawling, walking, and talking are possible due to rapid development of the brain, particularly the cerebral cortex

23. …BRAIN Middle brain: Limbic System • Covers motivation, emotions, & long term memory, aggressive behavior, body temperature, hunger, nerve system activities, hormon secretion • Outer Brain: Cortex & neocortex • Divided into lobes/sections (folds) with specific functions. • Placement of ‘intelligence’ & higer mental process, learning, memory, thinking, language (last to develop) • Also control vision, hearing, inventing. • Each part of the brain is very important in infuencing a child development  integration between child emotions and behavior. • Brain stem • Contro process such as breathing, heartbeat muscle movement, kidney process, reflex behavior, sleep, arousal, attention, balance/movement etc.

24. Thin layer on the brain’s surface that include lobes or sections: Occipital lobe Process vision. Temporal Lobe Process hearing Parietal Lobe Process sensory stimuli Frontal Lobe Critical thinking & problem solving Frontal cortex  area of the cortex that controls personality and the ability to carry out plans Regions of the Cerebral Cortex

25. Molding the Brain: The Role of Experience Early experience can have lasting effects on emotional development and the capacity of the central nervous system to learn and store information Sometimes corrective experience can make up for past deprivation

26. Brain and Neurons ...OTAK & NEURON • First 3 years of life  children’s brain are actively building and developing connections between the neurons cells. • Connections are developed when the brain are actively receiving stimulus  process between receiving and sending impulses between the cells. • Through axons/dendrites send signals to other neurons & receive incoming message through connection called synapses.

27. Infant States of Arousal • States of arousal are different degrees of sleep and wakefulness • Infants move in and out of 5 states throughout the day and night: • Regular sleep • Irregular sleep • Drowsiness • Alert Activity • Waking activity and crying • Striking individual differences in daily rhythms exist that affect parents’ attitudes toward and interactions with baby.

28. Ways to Soothe a Crying Baby • Hold on shoulder and rock or walk • Swaddle • Pacifier • Ride in carriage, car, swing • Combine methods • Let cry for short time

29. Adjustments to Parenthood • Physical • Schedule • Financial • Time • Gender roles • Parents’ relationship • Pre-birth counseling • Interventions for high-risk couples

30. Early Sensory Capacities Touch Hearing Vision Taste Smell

31. Touch and Pain • Touch seems to be the first sense to develop • Sensitivity to touch, pain, and temperature change is well-developed at birth. • Pain experienced during the neonatal period may sensitize an infant to later pain, perhaps by affecting the neural pathways that process painful stimuli • Relieve pain with anesthetics, sugar, gentle holding • Reflexes reveal sensitivity to touch, for example touch on mouth, palms, soles, genitals • Touch helps stimulate physical and emotional development.

32. Newborn Senses of Taste and Smell • Prefer sweet tastes at birth • Quickly learn to like new tastes • Have odor preferences from birth • Can locate odors and identify mother by smell from birth

33. Taste Babies are born with the ability to communicate their taste preferences to caregivers. Infant facial expressions indicate they can distinguish among several tastes. Newborns' rejection of bitter tastes is probably another survival mechanism, since many bitter substances are toxic

34. Smell • The responsiveness of infants to the smell of certain foods is similar to that of adults  showed that some odor preferences are innate. • A newborn infant is attracted to the odor of her own mother’s lactating breast  helps to find food source and to identify own mother a survival mechanism. • Newborns can identify the location of an unpleasant odor and turn head away. • A preference for pleasant odors seems to be learned in utero and during the first few days after birth

35. Studies conducted: Smell and Taste Lipsitt, Engen & Kye (1963) : Baby showed negative response to the smell of ammonia. Steiner : Baby showed different facial expression when exposed to different type of scent. Mac Farlane (1977): Baby can differentiate between own mother’s milk and other mothers’ milk. Schmidt & Beauchamp (1988) : Baby’s ability to smell is almost equivalent to a 3 years old ability to smell. Harris & friends: By aged 4 months old, baby like the taste of salt

36. Baby likes the smell of: • Banana, • Margerine • Tangerine • Baby dislikes the smell of: • Amonia • Rotten egg

37. Hearing • Well developed at birth - sensitive to voices and biologically prepared to learn language • Hearing is functional before birth ability to discrimination sound develops rapidly after birth. E.g. Infants respond with changes in heart rate to loud sounds (even in the womb) • Can hear wide range of sounds but are more responsive to some than others – i.e. prefer complex sounds to pure tones • Newborns prefer complex sounds such as voices and noises to pure tones - learn sound patterns within days • Newborns prefer speech that is high-pitched and expressive. • There are only a few speech sounds that newborns cannot discriminate, and their ability to perceive speech sounds outside their language is more precise than an adult’s. • Hearing is a key to language development thus hearing impairments should be identified as early as possible

38. Developments in Hearing

39. Studies conducted:Hearing De Casper & Fifer (1980): Baby can differentiate mother’s voices from others  thru’ baby sucking pattern. Birnhold & Benacerraf (1983): 28th week baby showed his/her response thru facial expression. Wertheimer (1961) : Baby able to follow source of sound thru’ the “clicker” test.

40. Vision • Vision - the least developed sense at birth • Newborns cannot focus their eyes very well and their visual acuity fineness of discrimination, is limited • However, newborns explore their environment by scanning it for interesting sights & tracking moving objects. • They can’t yet discriminate colors but color vision will improve in a couple of months. • Visual perception is poor at birth  but improves to 20/100 by age 6 months • Binocular vision using both eyes to focus • Perception of depth & distance at 4 or 5 mth

41. Infants’ Scanning of Faces

42. Face-like Stimuli

43. Studies conducted: Sight Langlois & friends (1990): Babies are more attracted to attractive and beautiful human faces. Fantz (1993): Babies prefer to look at pictures of human. Aslin (1987): 4 days old babies can differentiate between green and red. Babies prefer blue and red as compared to other colors. Gibson & Walk (1960): Visual cliff experiment. 6 mth babies has already develop in-dept perception in visual.

44. Steps in Depth Perception

45. Steps in Pattern Perception

46. Improvements in Vision Brain development helps infants reach adult levels of vision skills: • 2 months: Focus and color vision • 6 months: acuity, scanning & tracking • 6–7 months: depth perception

47. Integrating Sensory Information By 1 month, can integrate sight and touch By 4 months, can integrate sight and sound 4- and 7-month-olds can match facial appearance (boy or man) with sound of voice

48. Motor Development • Maturity affect infant perceptual and motor abilities. • Milestones of Motor Development • Babies first learn simple skills and then combine them into increasingly complex systems of action • Week 1 : Motor ability progress • Month 1 : Chin lift • Month 2 : Reach for object • Denver Developmental Screening Testmeasures: • Gross motor skills (those using large muscles), such as rolling over and catching a ball, and • Fine motor skills (using small muscles), such as grasping a rattle and copying a circle. • Language development (for example, knowing the definitions of words) • Personality and social development (such as smiling spontaneously and dressing without help).

49. Motor Development Newborn are not able to control their body movement  no coordination. Most movements are due to inborn reflexes (rooting, moro, palmer grasp etc) Humans begin to walk later than other species, possibly because babies' heavy heads and short legs make balance difficult

50. Milestone in motor develpment