Growth & Development

1. Growth & Development 3m head held up 5m- grasps voluntarily 7m sitting w/ hands as support 10m- “pincer” 8m sit well unsupported 11m- puts objects in container 10m from prone to sitting 1yr- stacks Rolling- turn from abd to back at 5m turn from back to abd at 6m Pgs. 504-506, 527-531, 528, 530, 552-559

2. Growthquantitative change • Occurs in spurts • Examples (measurable) • Height • Weight • Number of teeth • Bone density

3. Developmentqualitative change • Combination of growth, maturation, and learning • Simple to complex (ex: learning to write… scribble -> write -> cursive) • Generally, measured by observation

4. Directional trends • Bilateral and symmetrical (growth at same rate/time) • Cephalocaudal(cephalo- head, caudal- tail) • Head-to-tail • Motor control over head before trunk and extremities • Proximodistal(proxim- near, distal- far) • Near-to-far (control of center first) • Motor control over arm before fingers (palm to fingers)

5. 1 month- just floppin’ around Cephalocaudaldevelopment Know age for basic motor skills. (roll, crawl, sit-up) 3 months- needs help 8 months Mosby, 2001

6. Sequential trend “In-order trend” • Predictable sequence Crawl 6-9m ▼ Stand ▼ Walk

7. Developmental pace • Each child grows at their own pace • Body systems develop at different rates • Alveoli continue to bud until 8-years-of-age • Females mature faster than males

8. Sensitive period • Periods in life when the person is more susceptible to positive or negative influences • Example • Normal development of the central nervous system requires adequate nutrition during the first two years of life (adequate amount of fat/nutirtion req’d)

9. Infant Birth – 1 year Trust vs mistrust- Erickson Oral stage- Fraud Sensorimotor period- Piaget

10. Appearance • 1 – 6 months • 1 ½ pounds per months • 6 months • Double birth weight • 12 months • Triple birth weight

11. Psychosocial theoryerikson Emphasizes a healthy personality Key conflicts during critical periods in personality development Have to complete one to move on to the next.

12. Task of infancy • “The main task of infancy is to acquire a favorable ratio of trust to mistrust” (miller, pg 161) • Trust is “the sense that there is some correspondence between your needs and your world.” (Miller, pg 161)

13. Trust versus mistrust • Crucial elements • Quality of the parent – child relationship • Care the infant receives • If trust wins, then that child has a sense of security that’ll help them onto the next stage. • If mistrust wins, then they will not develop that sense of trust. (Fear, frustration, no confidence)

14. Characteristics • Narcissism • A degree of egocentrism • Total concern for self • Transitional object • Aka security object- child will keep it close for comfort (blanket)

15. Psychosexual theoryFreud Regions of the body assume psychological significance as A source of pleasure

16. Oral stage • Age • Birth – 1 year • Source of pleasure seeking • Oral activities • Sucking, biting, chewing, vocalizing

17. Nonnutritive sucking • Not satisfied by feeding, the baby’s need to suck on something. Sometimes a new parent will see this and mistake it for hunger. • Pacifier • Sturdy, one-piece construction is best • Handle • Two ventilating holes • No detachable ribbon or string

18. Make sure you get a pacifier cannot be pulled into parts. Also do not attach pacifier with a string/line else risk for strangulation. Mosby 2001

19. Thumbsucking • Most stop by 4- to 5-years-of-age • Malocclusionmay occur if persists beyond 5 • Abnormal contact of opposing teeth that negatively affects chewing “bad closing” • Social consequences for the school-age child who sucks their thumb

20. Piaget’s theory of cognitive development

21. Definitions- what infant does when they meet a new challenge • Assimilation- taking current skills and applying them to new situations. • Interpreting new experiences in terms of existing ideas or skills • Accommodation- adapt behavior to a new situation • Previous experience is modified to explain a current situation • From punching girls to opening doors.

22. Sensorimotor period • Birth – 24 months • Six sub-stages • Development of intellect and knowledge of environment gained through the senses • Behavior pattern Reflexive to repetitive to imitation

23. Modification of reflexes(sensorimotor period) 1stsubstage • Birth – 1 month • Think of baby as a “bundle of reflexes”- their behavior is a reflex. • Stop crying once food hits stomach.

24. Definitions • Circular reaction • Action that is repeated over and over • Often viewed as pleasurable by infant • Primary • Centered on or around the infant’s body • Secondary • Orientation to the environment • Interest in sounds/environment

25. Primary circular reactions 2ndsubstage • 1 – 4 months • Centered around body • Beginning to replace reflexive behavior with voluntary action (ex: mom’s voice -> food is on the way) • A rattle is a good toy

26. Secondary circular reactions 3rdsubstage • 4 – 8 months • Greater awareness of the environment • About 6 months-of-age • Imitation • Increased affect (this helps family bond w/ baby. More emotion: laugh, interaction) Erikson’s trust vs mistrust • Object permanence(baby looks for things they cannot see) ex: a dropped ball, peek-a-boo

27. Coordination of secondary schemes 4thsubstage • 8 – 12 months • Planning emerges-getting toy from far away • Anticipation of events- • baby only sees peas and they right away clamp their mouth. • Or they know when you’re about to leave when you pick up the keys.

28. Separation anxiety&stranger anxiety Important component of A strong, healthy parent-child attachment

29. Theory & separation anxiety • 4 – 8 months • Begin to have some awareness of self and mother as separate beings • As object permanence develops the infant becomes aware the parent can be absent ▼ Separation anxiety

30. Behavior & separation anxiety- a normal behavior • An infant may cry, scream, search for parents with eyes, clings to parent, avoid and reject contact with strangers • Protest when placed in crib • Protest when mother leaves the room • May not notice the mother has left if absorbed in an activity ▼ When the infant realizes the mother is gone, protest (new person will want to extend hand first to develop trust)

31. Stranger anxiety • 6 – 9 months • Reemerges during toddler period • Related to infant’s ability to discriminate between familiar and non-familiar people • As the infant becomes attached to one person, they show less friendliness to others

32. What to do • Talk softly • Meet the child at eye level • Maintain a safe distance • Avoid sudden intrusive gestures • Reassure parents • Healthy behavior • Reassurance • Use transitional objects (ex: encourage child to talk to stuffed animal)

33. Dental health

34. Overview • Baby teeth, deciduous “falling off” teeth, primary teeth • Purpose • Baby teeth protect dental arch, thus paving the way for the permanent teeth. • Play a role in • Growth & development of the jaw and face • Speech development • If lost early the remaining teeth may • Drift out of position • Block eruption of the permanent teeth

35. Overview • Baby teeth are prone to decay because of • Thin enamel • Short distance from tooth surface to pulp • Clean an infant’s teeth with a damp cloth • No toothpaste, cause the baby will swallow it and the fluoride can be harmful

36. Early childhood caries “tooth disease” • This is where teeth have been bathed in carbohydrate rich solution • Prevention • Do not prop the bottle • Use pacifier for nonnutritive sucking • If nighttime bottle needed use water • Offer fruit juice from a cup

37. Teething • Rule of thumb: Age in months minus 6 months = # of teeth Ex: 9 months = about 3-4 teeth • Normal variation • 6 – 9 months • Genetic pattern

38. Teething order • Lower central incisors • Upper central incisors • Upper lateral incisors • Lower lateral incisors • Not sure if the discomfort is from teething? • Gently press on gum where the tooth should erupt

39. Signs of teething • Night wakening • Daytime restlessness • Increase in nonnutritive sucking • Excessive drooling • Anorexia tendency • Fever, nausea, diarrhea (total body response) • but when it comes to BOARDs -> don’t rely on it

40. Help for teething infants • Rub out initial swelling to help eat better • Cool liquids, hard foods, teethers • OTC medications • Beware! Many topical numbing medications contain benzocaine(in lrg amounts can cause burns, follow instructions!) • Acetaminophen • Absolute relief comes with tooth eruption

41. Nutrition More than taking in food 4-6m- Okay to start solids 6m- Juice okay (don’t heat cause it’ll lose Vit C) Portions- 1tbs per yr of age

42. More than taking in food • “Feeding an infant is more than offering food.” Which theoretical stage or period supports the above statement? • Oral stage- Freud • Sensorimotor period- Piaget • Trust versus mistrust stage- Erickson

43. The first 6 months • On demand schedule • Allowed to establish own feeding schedule(no longer than 4hrs w/out eating) • Should be fed until satisfied • Easy temperament babies may need a more planned schedule • Breast milk • Optimal • Formula • Acceptable alternative

44. Types of formula • Milk based • Remember: breast milk or formula w/in 1st yr. Whole milk after 1st yr. No skim milk until the 2nd yr, because of reduced amount of fat. • Infants without special nutritional needs • Soy based • Infants with protein sensitivity or lactose intolerant • Specialized • Available for A wide variety of needs (ex: anti-diarrhea formula)

45. Other types of formula • Ready to feed • Most expensive • Concentrate • Risk for incorrect measurement • Water supply (add it! If no dilution will harm kidneys!) • Powder • Risk for incorrect measurement • Water supply

46. Mixing formula • Improper dilution may increase protein intake • Can place heavy work load on immature kidneys • Water • Bottled (good- stay away from fluoride for < 6m) • Tap water (will have fluoride) • Run cold water for ~2 minutes before mixing formula, especially in older homes (to get lead out) • Well water (will not have fluoride) • Test for microorganisms

47. The second 6 months • Ready for solid food? • 4 months is acceptable if the baby is hungry all the time • 6 months is optimal • Infant is physiologically ready to eat • In your reading: Basic Principles of feeding. • When/How to introduce foods? • Introduce food every 7 days to examine for allergies. • Baby cereal until 18m • Juice- no more than 4oz/day • Rice best b/c of no allergies • Stop iron suppl when cereal is given • Microwave only fridge form. Heat only 4oz or more • 4oz = 30 sec and 8oz = 45sec Don’t shake, invert 10x • Formula/Breast Milk for 1yr, then whole milk

48. Iron supplement • During 3rd trimester unborn baby stores iron in its liver • Increased bioavailability of iron in human milk • Infants who are partially or not breastfed should receive iron fortified formula from birth to 12 months-of-age

49. Fluoride supplement • When & how • 6 months to 16 years • Usually in the community’s water supply • Fluorosis“excess fluorine  discoloration and pitting of the enamel” • Too much fluoride will lead to brittle teeth/cavities

50. Language Language reflects hearing If you can’t hear then you won’t speak