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INFANCY

INFANCY. The First Year of Life. Time of rapid growth and development. Growth in the first year is extremely rapid. It occurs in spurts, called saltatory growth. Infant Weight. At birth: 2.7 – 4.0 kg At 5 months: 2X birth weight. At 12 months: 3 X birth weight.

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INFANCY

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  1. INFANCY

  2. The First Year of Life • Time of rapid growth and development. • Growth in the first year is extremely rapid. • It occurs in spurts, called saltatory growth.

  3. Infant Weight • At birth: 2.7 – 4.0 kg • At 5 months: 2X birth weight. • At 12 months: 3 X birth weight. • At 2 years: 4 X birth weight. • At 3 years: 5 X birth weight. • At 5 years: 6 X birth weight. • At 7 years: 7 X birth weight. • At 8 years: 8 X birth weight. • At 9 years: 9 X birth weight. • At 10 years: 10 X birth weight.

  4. Weight Gain (per day) AGEWEIGHT GAIN • 0-3 months: 30 g/day • 3-6 months: 20 g/day • 6-9 months: 15 g/day • 9-12 months: 12 g/day • 1-3 years: 8 g/day (2.8kg/yr) • 3-6 years: 6 g/day (2 kg/yr)

  5. Weight Gain (per month) AGEWEIGHT GAIN • 0-3 months: 900 g • 3-6 months: 600 g • 6-9 months: 450 g • 9-12 months: 360 g • 1-3 years: 240 g/month(2.8 kg/yr) • 4-6 years: 180 g/month (2 kg/yr)

  6. Formula For Weight • During Infancy WT (Kg) = [ Age (months) +9] /2. • During 2-6 Years WT (Kg) = Age (yrs) X 2+ 8. • During 7-12 Years WT (Kg) = [Age (yrs) X 7-5] /2.

  7. Length/ Height • Supine length is measured for children of less than two years of age. • After two years of age, standing height is taken as a measure of stature.

  8. Length • At Birth: • At birth: 48 – 53 cm • At one year = 75 cm. • At two years = 87.5 cm. • At four years = 100 cm.

  9. Length Gain AGE GAIN • 0-3 months: 3.5 cm/ month • 3-6 months: 2 cm / month • 6-9 months: 1.5 cm/ month • 9-12 months: 1.2 cm/ month • 1-3 years: 1 cm/month(12 cm/yr) • 3-6 years: 0.25 cm/month (3 cm/yr)

  10. Gain In Length • 1st year = 25 cm • 2nd year = 12 cm • 3rd year = 10 cm • 4th year = 3 cm • At puberty: • Girls = 6-11 cm • Boys= 7-12 cm

  11. Formula for Calculating Height From 1- 6 Years Height (cm) = Age (Yrs) X 6 + 77

  12. Head Circumference • At birth: 35.3 ± 1.2 cm. • Increases by 6 cm during the first 3 months. • Further increases by another 6 cm during 3- 12 months.

  13. Gain in head circumference • During 1st year = 12 cm. • During 2nd year = 2 cm. • During 3rd year = 1.5 cm. • From 3 to 14 years = 2.5 cm

  14. Changes in head circumference AGE GAIN • 0-3 months: 2 cm/ month • 3-6 months: 1 cm / month • 6-12 months: 0.5 cm/ month • 1-3 years: 0.25 cm/month • 3-6 years: 1 cm/year

  15. VISION blurry • An infants vision is at first, visual acuity 20/100-20/400 • Within a week they can focus on objects that are 15-30 cm away • Binocularity: fixation of two ocular images into one cerebral picture begins to develop by 6 weeks and established by 4 months. • Lack of binocular vision results in strabismus • Have visual preference for looking at the human face

  16. Vision • Depth perception (stereopsis) begins in the 2nd – 3rd month, well developed by age 7 months. • What is Depth Perception? Recognizing that an object is three-dimensional, not flat. • With this improved vision they develop hand-eye coordination. • Why is the development of hand eye coordination important? Important for skills such as eating, catching, coloring, tying shoes, etc

  17. Hearing • Birth: • Responds to loud noise by startle or Moro • Responds to sound of human voice more readily than to any other sound • 8-12 weeks: • Turns head to side when sound is made at level of ear • >12 weeks: • Locates sound by turning head to side and then looking up or down • 24-32 weeks: • Responds to own name

  18. Smell and Taste • The sense of smell does not develop much before birth because baby is surrounded by amniotic fluid until birth. • Within 10 days they can distinguish the smell of their mother from another person. • The sense of taste develops rapidly. • During the 1st year, babies learn about the world through their mouth, putting everything in sight in it. Parents need to make sure the objects are clean, not too small, and without edges.

  19. Development During the First Year Teeth • Development of the baby’s teeth usually begin about the 6th week of pregnancy • The first baby teeth appear at about 6 or 7 months (primary teeth). • Teething often causes pain and swelling and makes for a cranky baby

  20. Language Acquisition • Cooing: Repetition of vowel sounds by infants • Babbling: Repetition of meaningless language sounds (e.g., babababa) • Single-Word Stage: The child says one word at a time • Telegraphic Speech: Two word sentences that communicate a single idea (e.g., Want yogurt)

  21. Language development 12 weeks cooing, smiles when talked to 16 weeks turns head in response to human voice 20 weeks makes vowels and consonant sounds 6 months babbling (all sounds) 8 months repeat certain syllables (ma-ma) 12 months understands and says some words

  22. Psychosocial development • Erik Erikson: First Psychosocial Stage: Trust vs. Mistrust • Consistent loving care by a mothering person is essential to build a trust relationship. • Mistrust develops when basic needs are inconsistently met.

  23. Piaget’s Cognitive Stages

  24. Sensorimotor Stage (0-2) • Stage One (birth-1 mo.) • Use of reflexes • Stage Two (1 - 4 mos.) • Primary circular reactions: Actions that are at first random and activate a reflex are attempted again to try and induce the experience again (recognition of causality). The interesting events are occurring within the body (plays with hands, fingers, feet). • Stage Three (4 - 8 mos.) • Secondary circular reactions: The interesting events in this case are located in the external world (Making Interesting Sights Last) • Beginning of object permanence: shows separation anxiety • Able to imitate selective activity

  25. Infants’ imitation of facial expressions

  26. Sensorimotor Stage, Cont’d • Stage Four (8 - 12 mos.) • Coordination of secondary schemata • New Adaptations and Anticipation • Intentionality occurs in interactions with the environment and the infant is moving towards goal directed behavior: works to get toy that is out of reach • Fully developed object permanence

  27. Moral development (Kohlberg) • Level 1: Preconventional morality (0-9y) • Stage 1: the punishment-and-obedience orientation. • Children determine the goodness or badness of an action in terms of its consequences. • They avoid punishment and obey unquestioningly those who have the power to determine and enforce the rules • They have no concept of the underlying moral order

  28. Play • Solitary Play: When a child plays alone even when with other children

  29. Principles of Motor Development • Gross movements before fine movements • Pattern of development is usually the same, but the rate differs greatly from child to child and from culture to culture.

  30. 2-3 months

  31. Gross Motor Development • First Month • Turns head to clear nose from bed • Keeps hands fisted or slightly open • Head lag when pulled from lying to sitting • Second month • Holds head up while on tummy almost 45 degrees • Third month • Lift head and chest of the bed • Turns head to sounds • Reaches for objects with both hands

  32. Fourth month • Rolls from back to side • Able to raise head and chest off surface to angle of 90 degrees • Fifth month • Rolls from abdomen to back • May sit if supported • When supine, puts feet to mouth • Sixth month • Transfer toy from one hand to next • army crawl on tummy • Rolls from back to abdomen

  33. Seventh month • Pushes up on hands and knees • Sits w/ little support • When held in standing position bounces actively • Eighth month • Sit without support • Creeps • Stands leaning against something • Ninth month • May crawl upstairs

  34. Tenth month • Stands w/ little support • Cruises the room. • Eleventh month • Stands alone • Twelfth month • Walks

  35. Fine Motor Behavior • At 4 month: brings hands together and shake rattle. • At 6 month: palmer grasp. • At 7 month: pass object from hand to another. • At 8 month: advanced eye-hand coordination. • At 10 month: pincer grasp. • at 12 month: holds cup or spoon

  36. Hematologic System • Hgb A production largely replaces Hgb F by 4 months (physiologic anemia due to fetal RBCs destruction)

  37. Respiratory System • RR slows. • Upper respiratory infections tend to be more severe due to small lumen of respiratory tract and inefficient mucus production.

  38. Immune System • Become functioning at 2 months. • Produce both IgG & IgM antibodies by the first year.

  39. Emotional • At 6 weeks: social smile. • At 4 months: recognize his primary caregiver. • At 7-8 months: stranger anxiety, continue until 12 months. • At 8 months: separation anxiety, continue until preschool period. • Both are related to infant’s ability to discriminate between familiar and nonfamiliar people

  40. Dentation • First tooth erupt 5-7 months • Has 6-8 deciduous teeth by the first year of age. • The sequence of eruption is: • At 6 months: lower central incisors. • At 7 months: lower lateral incisors. • At 8 months: upper central incisors. • At 9 months: upper lateral incisors.

  41. GI System • Can digest protein at birth. • Amylase deficiency until 3rd month of age ( cannot digest complex CHO) • Lipase deficiency during entire 1st year. • Infant needs frequent feedings. • Extrusion reflex exists until 3-4 months. • Introduction of solid food 4-6 months.

  42. Energy Requirement AgeEnergy requirement < 6 months Wt (kg) x 108/ day 6mo-1 year Wt (kg) x 98/ day

  43. Water requirements = amt in foods + fluids AgeAmount • 3 days 80-100 ml/kg/day • 10 days 125-150 ml/kg/day • 3 mo 140-160 ml/kg/day • 6 mo 130/155 ml/kg/day • 9 mo 125-145 ml/kg/day • With BF and formula: none additionally needed in first 4 to 6 months

  44. Infant Nutrition • Birth through 4-6 months • Breast milk OR • Iron-Fortified infant formula

  45. Breast- Versus Bottle-Feeding • Debate focused on whether breast-feeding is better for the infant than bottle-feeding • American Pediatric Association strongly endorses breast-feeding throughout the first year of life • Benefits • Appropriate weight gain • Fewer allergies • Fewer illnesses • Reduced childhood cancer and reduced incidence of breast cancer in mothers and their female offspring • Lower incidence of SIDS • Stronger attachment bond

  46. Infant Nutrition • 4 through 7 months • Breast milk OR • Iron-Fortified infant formula • Iron-Fortified infant cereal • Vegetables • Fruit

  47. Infant Nutrition • 8 through 11 months • Same as 4 through 7 months PLUS • Meat • Egg yolks

  48. Infant Nutrition • 11 months • Finger foods • Cup

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