INFANCY

• Infancy


  Shortest of all developmental periods
• Partunate


  • Birth to 15 - 30 minutes after birth, lasts until the umbilical cord has been cut and tied
• Neonate


  • From the cutting of the umbilical cord to the end of the 2nd week of postnatal life
• Preterm


  Less than 37 weeks of gestation
• APGAR


  Assessment of health of newborn at 1 and 5 minutes after birth
• APGAR Scoring

  • Appearance (Skin Color)
  • Pulse (Heart Rate)
  • Grimace (Reflex Irritability)
  • Activity (Muscle Tone)
  • Respiration (Respiratory Effort)
• APGAR Score 5


  There may be developmental difficulties
• APGAR Score 3

  Signals an emergency / infant may not survive
• Infantile Features

  • Covered by vernix caseosa, lanugo (head / back)
  • Large, bumpy head
  • Flat, board nose
  • Reddish, soft, blotchy skin
  • Puffy eyes
  • Head is 1/4 of the total body length
  • Neck is almost invisible
  • Flesh is firm and elastic
  • Boys tend to be heavier
• Major Adjustments


  • Temperature changes
  • Infant must breathe on his own; irregular, rapid, shallow
  • Sucking and swallowing reflex developed at birth
  • Elimination (an hour after birth / feeding)
  • Plateau in growth and development
  • Hazardous phase
  • Heart beat is more rapid
  • Sleep is broken by short waking periods which occur every 2 - 3 hours
• LBW


  Less than 5 1/2 lbs
• VLBW


  Less than 3 1/2 lbs
• ELBW

  Less than 2 lbs
• SGA

  Weighs less than 90% of all infants with same GA
• Growth Rate

  • Most rapid in infancy, prepubescence, and adolescence
  • In newborn, head is relatively large; face is round; abdomen is prominent; trunk and extremities are short
  • Head growth is fastest during infancy; trunk growth is fastest in infancy and adolescence; extremities growth are fastest from 1 year through puberty

  
• Growth Measurements


  • Head Circumference
  • Weight
  • Height / Stature
  • Sitting Height
• Babyhood


  2 weeks - 2 years old, true foundation age, patterns in early life persists, the sooner the undesirable pattern on behavior is corrected, the easier it will be for the child, early foundation develops into habits through repetition, learning and experience play dominant roles in development

  
• Physical Development in Babyhood

  • Fat tissue develops rapidly due to high fat content of milk
  • Weight and height increases
  • Brain weight is 1/8 of the total weight
• Sleep Patterns

  • Short waking periods every 2 - 3 hours
  • 4 months - begins to be regulated and some infants may sleep through the night
  • 8 months - 12 - 13 hours (9 - 18 hours)
• Teeth Development

  • 6 - 7 months - first tooth, lower incisor, saliva production increases
  • 8 months - upper central incisor
  • 9 months - upper lateral incisor
  • 12 months - first lower molars

  
• Vision Development

  • Can see objects 8 inches away
  • 3 months - visual acuity is developed (picture and actual face)
  • 4 months - preference for patterns and can distinguish between colors
  • 12 months - visual acuity is 20 / 100 to 20 / 50
• Hearing Development

  • 0 - 2 months - responds to sound with random body movements
  • 3 months - moves eyes in direction of the sound
  • 6 months - localizes sounds either to the left or to the right
• Taste and Smell Development

  • Birth - able to taste
  • 0 - 3 months - differentiates between pleasant and unpleasant odors
• Touch


  Skin contact and warmth is one of the most important stimuli during 0 - 3 months
• Reflexes


  Automatic movements performed without conscious volition, usually initiated by sensory stimuli, movement progresses from primitive reflexes to voluntary, controlled movement, the sequence and rate of motor development is consistent, low level skills are prerequisites for certain higher level skills
• Primitive Reflexes


  • Sucking Reflex
  • Rooting Reflex
  • Moro Reflex
  • Plantar Grasp
  • Palmar Grasp
• Brainstem Reflexes


  • ATNR
  • STNR
• Physiologic Postural Responses


  Emerge with CNS maturation, persistent throughout life, modulated by volition, used in gross motor activities
• Righting Reactions


  Postural responses to change the head and body positions, brings the head and trunk into an upright position, aligns the trunk and limbs, used to assume anti-gravity positions
• Equilibrium Reactions


  Automatic, compensatory movements of the body parts that are used to maintain the center of gravity, more mature than righting reactions, begins at 6 months, maturing about 4 years, and persists
• Gross Motor Skills 0-3 months


  • Turns head side to side (prone / supine)
  • Lifts head, sustains in midline
  • Weights bear on forearms
  • Weights bear on forearms with shoulders collapsing
  • Held in sitting
  • Head bobs in sitting, back is rounded
• Gross Motor Skills 3-4 months


  • Holds head in midline, lower back flattens
  • Rolls from prone to side accidentally
  • Rolls from supine to side
  • Held in sitting with less support
  • Bears some weight on legs (apart and turned outward)
• Gross Motor Skills 4-5 months


  • Lifts head to 90 degrees and chest slightly (prone)
  • Head held when pulled to sit
• Gross Motor Skills 5-6 months


  • Chest and thigh lift off the surface (prone)
  • Brings feet to mouth, hands to feet
  • Rolls from prone to supine, supine to side, supine to prone
  • Supports self in sitting momentarily
  • Sits with hands propped forward
  • May be held by arms or hands, bounces in standing position
• Gross Motor Skills 6-14 months


  • Rolls segmentally initiated by head, shoulder or hips
  • Pulls to stand position at furniture
• Gross Motor Skills 7-8 months


  • Prone to sit
  • Crawls forward on belly
  • Creeps reciprocally (7 - 10 months)
  • Cervical lordosis, bears all weight in standing, bounces when held erect
• Gross Motor Skills 8-10 months


  • Sits well without support
  • W sit, side sit
  • Pulls to standing position by kneeling, half kneeling
  • Cruises sideways (8 months), cruises around furniture (9 - 10 months)
• Gross Motor Skills 9-18 months


  • Pulls to stand with legs only (9 - 13 months)
  • Walks alone with 2 hands held (8 - 18 months)
• Gross Motor Skills 10-11 months


  • Moving in and out of sitting
  • Stands momentarily
• Gross Motor Skills 11 months


  • Creeps well
  • Trunk control and equilibrium responses fully developed in sitting, rises from supine through rolling to side and pushing up to sitting
  • Walks with one hand held
  • Cruises with no hesitation