Coping with Concern Related to Growth and Development of Infant

1. Coping with Concern Related to Growth and Development of Infant : https://encrypted.google.com/search?q=infant+drawing&source=lnms&tbm=isch&sa=X&ved=0ahUKEwiFtqj40PvWAhUIfhoKHb9HDlAQ_AUICigB&biw=1366&bih=662

2. Separation and Stranger Fear

3. Objectives By the end of this topic the students will be able to: • Identify the major concerns during infancy. • Out line developmental considerations that are related to separation anxiety and Stanger fears sleep and rest, and immunization • Provide anticipatory guidance to parents regarding common concerns during infancy.

4. Separation and Stranger fear • Between ages 6 to 8 months: • Infants demonstrate attachment to one person • They exhibit less friendliness to others • Stranger anxiety become prominent • Infants ability to discriminate between familiar and unfamiliar person

5. Separation and Stranger Fear False Interpretation Normal development Important components of a strong, healthy parent-child attachment Enhance the child's optimum emotional development. It is important for infant to safely experiences strangers • A sign of undesirable behavior • Antisocial behavior

6. Separation and Stranger Fear • Children exhibit behaviors like clinging to parents, crying and turning away from the stranger • Separation anxiety and stranger fear present difficulty to parent. • They may confined to the home.

7. Separation anxiety and Stranger Fear Anticipatory Guidance • What parents can Do???? • Encourage Patents to have close friends or relative visit often • ( whom the child is comfortable)

8. Separation Anxiety and Stranger Fearanticipatory guidance • Best approach for strangers (e.g., the nurse) is to talk softly, meet the child at eye level • Maintain safe distance between the infant

9. Separation Anxiety and Stranger FearAnticipatory Guidance 3. Parents should recognized that clinging behavior is healthy and needed for emotional development of the infant 4. Avoid sudden, intrusive gestures such as smiling broadly.

10. Separation Anxiety and Stranger Fear Anticipatory Guidance 5. Encourage parents to reassure the infant of their presence by following approaches: • Talk to infants when leaving the room • Allowing them to hear own voice on telephone • Using transitional object Presence

11. Separation Anxiety and Stranger Fear Anticipatory Guidance • If parents encourage the child's clinging, dependent behavior, Discuss Are they encourage "spoiling“?????????????

12. Alternate Child Care Arrangements Alternate Child Care Arrangements means that children being cared for in group in kindergartens ,centers or other settings.

13. Alternate Child Care Arrangements • Types of child care arrangements: A. In-home care: either in the parents' or caregivers' home (family day care) 1. Full-time baby-sitter: who lives in the home 2. Full-time baby-sitter: who comes to the home and family day care.

14. Alternate Child Care Arrangements 3. Small family child care home (licensed): provides formal care for up to five children 4. Large family child care home(licensed): provides formal care for up 8-12 children • Many family day care homes operate without a license and may care for large numbers of infants without adequate staff and facilities.

15. Alternate Child Care Arrangements B. Child Center-based care: a licensed day care facility that provides care for six or more children, for 6 or more hours in a 24-hour day. C. Work-based group care: the employers recognize the benefit of providing quality and convenient child care to their employees. D. Sick-child care (community hospitals or in work settings): is available for times when the infant is ill.

16. Alternate Child Care Arrangements Anticipatory Guidance Nursing responsibility is guiding parents in locating suitable facilities considering the following: a. Teachers qualifications b. The nurturing qualities of care givers c. Child –to staff ratio d. Discipline policy e. Environmental safety precautions

17. Alternate Child Care Arrangements f. Provision of meals g. Sanitary conditions h. Adequate indoor and outdoor space for each child i. Fees schedule

18. EBP • Evidence showed that children (less than 6 year of age) in day care centers have more illness(e.g., diarrhea, otitis media, respiratory tract infection, hepatitis A, meningitis) than children who cared for in their homes

19. Limit Setting and Discipline • Infants and toddler do not understand the cause and effect relation ship between dangerous object and physical harm • Parents are faced with the need to set safe limits to protect the infants due to advancement in their motor skills: • To protect child from hazards • To establish a positive and supportive parent-child relationship

20. Limit Setting and Discipline Anticipatory Guidance • Parents should understand that that their child behavior is exploratory in nature and centered at basic needs of infant for warmth, love, food, security, and comfort • Parents need to encourage explorations by providing safe alternatives

21. Limit setting and discipline Anticipatory Guidance • Put dangerous household items away • give child consistent discipline and nurturing • Effective injury prevention should begin in infancy by helping parents understand the nature of child’s growth and development

22. Why child is crying Infants cry because a need is not being met, not to intentionally irritate an adult. • If parents may not understand the nature of crying: • The irritable or fussy infant is a potential victim of shaken baby syndrome .

23. Assignment What is Shaken Baby Syndrome

24. Thumb sucking and Use of Pacifier

25. Thumb sucking and Use of Pacifier • Sucking is the infant chief pleasure and may not be entirely satisfied by breast or bottle feeding • Some newborn infant are born with sucking blister on their hands from in utero sucking activity • Sucking pleasure can be increased by prolonging feeding time

26. EBP • There is an association of pacifier use and decrease duration of breastfeeding in observational studies only (Nelson,2012 ) • American Academy of Pediatric (AAP): reported strong evidence for the pacifier use and its protective effect on SIDS reduction • Pacifier use is associated with an increased risk of otitis media( Salah etal., 2013) • Pacifier should be cleaned and replaced regularly

27. Thumb sucking and use of pacifier • The effect of pacifier on language and speech development is unknown • The pacifier use may decreases the child's desire to imitate sounds and affect intelligence • There is no need to restrain non nutritive sucking of the fingers

28. Thumb sucking and use of pacifier • Thumb sucking reaches its peak at age of 18-20 month and most prevalent when the child is hungry, tired or feeling insecure • Malocclusion may occurs when thumb sucking persist to 4-6 years of age or when permanent teeth erupt

29. Thumb sucking and use of pacifier • Thumb sucking in apathic and listless child need investigation: Causes: • An emotional problem between child and parents, • Child boredom • Lack of stimulation

30. Teething (deciduous or primary teeth) • The age of tooth eruption is varied among children, but the order of their appearance is regular and predictable • By age of 6-8 months • The eruption of The first primary teeth (the lower incisors)

31. Teething • followed by upper central incisor • Teething may cause discomfort because the crown of the tooth breaks through the periodontal membrane • Children may show minimum evidence of teething such as: • Drooling • Swollen gum • Increased fingers sucking biting on hard object

32. Teething • Other children may show: • Irritability • Difficulty in sleeping • Refused to eat • Signs of illness such as fever, vomiting, or diarrhea are not symptoms of teething

33. Teething Anticipatory Guidance • Giving the child frozen teething ring or an ice cube wrapped in a washcloth helps relieve the inflammation • Because teething pain is a result of inflammation, cold is soothing • Use of nonprescription anesthetic ointment of the infants’ gum

34. Infant Shoes

35. Infant Shoes Anticipatory Guidance • Changes in the feet occur during infancy and early childhood as locomotion and weight bearing progress • Footwear should begin when infants are 6 months old—well before they are walking.

36. Infant Shoes Anticipatory Guidance • At birth the feet are flat because the arches are protected by fat pads on the soles of the feet • As the bones in the arches develop, the pads disappear and the feet begin to assume a mature shape

37. Infant Shoes Anticipatory Guidance • Many parents are unaware of the type of shoes that are appropriate for the older infant • Inflexible shoes that have hard soles can be harmful by: • Delaying walking • Aggravating in-toeing or out-toeing, • Delaying the development of supportive foot muscles.

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39. References Hockenberry, M. J.,Wilson, D. & Rodgers, C., (2017). Wong's Essentials of Pediatric Nursing (10th ed.). St. Louis, MO: Elsevier Mosby