INFANCY AND TODDLERHOOD

• Parturition


  Brings on labor
• Birth process


  1. 2 weeks before delivery

  2. Uterine contractions

  3. Braxton-Hicks contractions

  4. Dilation of cervix

  5. Descent and emergence of the baby

  6. Expulsion of the placenta

  
• Cesarean delivery


  Surgically removing baby from uterus through abdomen
• Cesarean delivery


  • Often used when labor progresses slowly
  • Common with first and/or large babies
  • Common with older moms
  • Common with mothers with previous C-sections
• Unmedicated delivery


  Natural childbirth, mother receives training in fitness, breathing and relaxation
• Unmedicated delivery


  Traditional cultures use of 'doula' - experienced helper provides emotional support to mother
• Medicated deliveries


  • Pudendal block - relaxing analgesic
  • Epidural
• Size and appearance of the newborn


  • Average neonate is 20 inches long and 7.5 pounds
  • Fontanels - soft plates of head
  • Lanugo - fuzzy prenatal hair
  • Vernix caseosa - oily protection against infection
  • Witch's milk - secretion that sometimes leaks from the swollen breasts of newborn boys and girls around the 3rd day of life
• Breathing


  Anoxia or hypoxia can lead to birth trauma
• Meconium


  Stringy waste in fetal intestinal tract
• Neonatal jaundice


  Yellowing of skin and eyeballs, caused by immaturity of the liver, half of all babies experience, usually baby does not need treatment
• Apgar scale


  • Appearance, pulse, grimace, activity, respiration
  • 7-10 good health
  • 5-7 needs help to establish breathing
  • 4 needs immediate medical attention or treatment, no long term damage
  • 0-3 neurological problems
• Brazelton Neonatal Behavioral Assessment (NBAS)


  Tests responses to physical and social environment, assesses motor organization, reflexes, attention and interactive capacity, CNS instability

  
• Postmaturity


  42 weeks or more
• Prematurity


  Low birthweight - less than 5 1/2 lbs, very low birth weight - less than 3 1/2 lbs
• Prematurity and low birth weight are the 2nd leading cause of infant death, after birth defects
• Maternal traits that increase risk of low birthweight


  • Underage or over-age
  • Uneducated and poor
  • Poor nutrition
  • Smoking and drinking
  • Stress
  • Infections and high blood pressure
• Immediate treatment for prematurity


  • Intravenous feeding
  • Surfactant
  • Isolette - controlled environment, like an incubator
  • Kangaroo care
• Stillbirth


  Death of fetus at or after 20th week of gestation, reduction may be due to fetal monitoring
• SIDS


  Sudden Infant Death Syndrome, 'Crib Death', sudden death of infant under 1 year of age, cause of death unexplained, may have underlying biological defect, may be associated with sleeping on stomach, triple risk model
• Deaths from injuries in infancy


  • Suffocation
  • Motor vehicle accidents
  • Drowning
  • Residential fires or burns
• No causal connection between vaccines and autism or other disorders
• Nutrition: Breastfeeding


  Breast milk almost always the best food, more digestible, reduces allergic reactions, minimizes numerous infections, may reduce risk of SIDS, better cognitive performance, recommendation is babies exclusively breastfeed for 6 months
• Other nutritional concerns


  • Solid food introduced 2nd half of first year
  • Malnutrition
  • Overweight - parental obesity strong predictor
• Reflexes: Unlearned & protective behaviors

  • Postural - reactions to changes in posture or balance
  • Locomotor - resemble later-appearing voluntary movements, walking and swimming reflexes
• Early senses of touch & pain

  Touch - first sense to develop, rooting reflex, able to experience pain at birth
• Early senses of smell & taste

  Begins to develop in womb, newborns prefer sweet tastes, fluids and odors may be transmitted through amniotic fluid
• Sense of hearing


  Functional before birth, at 1 month babies can distinguish sounds as close as ba and pa, at 4 months infants can already recognize music
• Sense of sight


  The sense least developed at birth, the eyes of newborns are smaller than those of adults, the retinal structures are incomplete, and the optic nerve is underdeveloped
• Milestones of motor development

  Denver Developmental Screening Test - screening test given to children 1 month to 6 years old to determine whether they are developing normally, assesses gross and fine motor skills
• Walk & Gibson: The visual cliff


  Apparatus designed to give an illusion of depth and used to assess depth perception in infants, demonstrated 'depth perception'
• Thelen's dynamic systems theory

  Motor development is a dynamic process of active coordination of multiple systems within the infant in relation to the environment
• Cultural influences on motor development

  Depends on the pace of the culture, African and West Indian cultures actively encourage early motor strength, other cultures discourage
• Behaviorist approach


  Babies are born with the ability to learn, operant conditioning, reinforcement and punishment, classical conditioning
• Infant memory


  Infantile amnesia - inability to remember events prior to age 3 years, operant conditioning with mobiles - babies can remember mobiles they played with days or weeks ago, infants and toddlers can remember toy trains and mobiles
• Psychometric approach


  IQ tests, developmental tests, Bailey Scales of Infant and Toddler Development - measures current development, not future functioning
• HOME


  Home Observation of the Environment, assesses parental responsiveness, number of books in home, presence of educational playthings
• Piagetian sensorimotor stage


  Jean Piaget's four stages of cognitive development
• Imitation and object permanence

  Visible - hands and feet, parts baby can see, invisible - using body parts baby cannot see like the mouth, object permanence - realizing that an object exists even when out of sight
• Information-processing approach


  Habituation - a type of learning in which familiarity is indicated by reduced response, dishabituation - increase in responsiveness after presentation with a new stimulus, novelty preference - paying more attention to new visual stimuli, demonstrating ability to tell new from old, or 'visual recognition memory'