Infancy

• Four principles of child development


  -child development proceeds along a predictable pathway

  -range of normal development is wide

  -various physical, social, and environmental factors, as well as diseases, can affect child development and health

  -developmental level affects how you conduct the history and physical exam
• Developmental milestones during infancy

  
• Cognitive and Language development


  exploration fosters increased understanding, learn cause and effect, recognize strangers, seek comfort from parents, actively manipulate reachable objects, language development from cooing at 2 mns to 1 to 3 words by 1 yr
• Social and Emotional development


  understanding of self and family, social tasks, attachment to indvs, temperaments, response to new stimuli varies, observe interactions w/ caregivers
• Birth history questions


  problems during pregnancy, how close was birth to due date, any problems during labor or birth, vaginal or c-section birth
• Tips for examining infants

  approach infant gradually using toy or object for distraction, perform much of exam in parent's lap, speak softly, make sure well-fed to prevent cranky, save mouth and ear exam for last
• Things to assess for in infants

  gross motor, fine motor, cognitive, communication, personal/social domains
• An infant should start to sit up at around what age?

  5 months
• What position should a child under age 2 be in to measure their length?


  supine
• Avg heart rate from birth to 2 months


  -140 bpm

  -range: 90-190
• Avg heart rate from 0-6 months

  -130 bpm

  -range: 80-180
• Avg heart rate from 6-12 months

  -115 bpm

  -range: 75-155
• Tachypnea


  rapid breathing

  -birth to 2 mns = >60/min

  -2-12 mns = >50/min
• Eyelid patch

  
• Salmon patch

  
• Cafe-au-lait spots

  
• Congenital dermal melanocytosis

  
• Erythema toxicum

  
• Neonatal Acne

  
• Atopic dermatitis

  
• Candidal diaper dermatitis

  
• Contact diaper dermatitis

  
• Generalized cyanosis

  
• Perioral cyanosis

  
• Bluish lips, giving appearance of cyanosis

  
• Newborn's head

  -1/4 of body length

  -1/3 of body weight

  -soft and flat, pulsations normal

  -anterior: closes at 4-26 mns

  -posterior: closes by 2 mns
• Hydrocephalus


  accumulation of fluid in the spaces of the brain

  
• Micrognathia


  abnormally small chin

  
• Face that appears upslanting can identify

  down syndrome
• Face that appears downslanting can identify

  noonan syndrome
• face that appears short can indentify

  fetal alcohol effects
• Congenital Hypothyroidism

  
• Congenital syphilis

  
• Battered child syndrome

  
• Perennial allergic rhinitis

  
• Esotropia


  cross eyed

  
• Exotropia


  outward turning of the eye

  
• Acuity for 12 month old child

  20/80
• Brushfield spots


  salt and pepper speckling on the iris associated with Down Syndrome

  
• Strabismus

  lazy or cross eyed