chapter 4 Growth-and-Development-of-Infancy.ppt
- 1. INFANCY PERIOD: BIRTH TO 12 MONTHS 3/24/2024 1:13 PM 1
- 2. 2 Full term: born 38 to 42 weeks after conception Preterm (Premature): born less than 37 weeks after conception Postterm (Postmature): born more than 42 weeks after conception Low birth weight: normal gestation, weighing less than 2.5 kgs Very low birth weight: below 1.5kg Extremely low birth weight: below 1kg Small for gestational age: 10% or more below expected weight, based on length of gestation Infant Classifications 3/24/2024 1:13 PM
- 3. 3 Measuring neonatal health & responsiveness Apgar score: a quick assessment of the newborn’s heart rate, respiration, color, muscle tone, and reflexes that is used to gauge perinatal stress and to determine whether a neonate requires immediate medical assistance. Each item is given a score of 0, 1, or 2. Total score of 0–3 is severe distress, 4–6 moderate distress, & 7–10 good adjustment 3/24/2024 1:13 PM
- 4. 4 General Measurements Weight: Average birth weight 2700–4000 grams - 10% of birth weight is lost in first 3-4 days of life, primarily through fluid losses & regained by 7 days if formula fed, 14 days if breastfed. - The average weight being about 3400 g Length: Average birth length 48–53 cm. (19–21 inches). Accurate birth weights and lengths are important because they provide a baseline for assessment of risk status and future growth. 3/24/2024 1:13 PM
- 5. 5 Head: Average neonatal head circumference is 33–35 cm about 2–3 cm (1 inch) larger than chest circumference. — Head circumference is 70% of adult size — Needs to consume 120 cal. /kg of weight per day General Measurements 3/24/2024 1:13 PM
- 6. 6 —Molding, or overlapping of the soft skull bones, allows the fetal head to adjust to the diameter of maternal pelvis; the bones readjust within a few days producing a rounded appearance; molding may alter head circumference; head and chest circumference may be equal for first 1–2 years —Fontanels; Anterior diamond shape; Posterior fontanel triangular shape; (between the unfused bones of the skull); Fontanels should be flat, soft, and firm; may bulge when crying. The posterior fontanel closes at 2–3 months; anterior fontanel closes at 12–18 months —Maturation of the brain occurs at different rates in different areas; the prefrontal cortex is last to mature (in adolescence). Newborn Infant or Neonate (birth to 1 month) 3/24/2024 1:13 PM
- 7. 7 —Temperature, axillary—36.5°-37° C —Heart rate: apical—120-140 beats/min —Respiratory rate: 30–60 breaths per minute and irregular; count for one full minute; neonates are abdominal breathers and obligate nose breathers Vital Signs Elimination I.Meconium: infant’s first stool should pass within the first 24–48 hours II.Transitional stools usually appear by 3rd day after initiation of feeding III.Milk stool appears by 4th day, by 2nd week elimination pattern associated with the frequency and amount of feeding. Breast fed-pasty, yellow, odor of sour milk; formula fed light brown, firmer consistency, stronger odor. IV.Urinary output 200–300 ml by the end of the 1st week 3/24/2024 1:13 PM
- 8. 8 Cardiovascular • Functional closure of fetal shunts occurs. • Transition from fetal to postnatal circulation occurs. Respiratory • Onset of breathing occurs as air replaces the fluid that filled the lungs before birth. Renal • System doesn't mature fully until after the first year of life; fluid imbalances may occur. GI • System continues to develop. • Uncoordinated peristalsis of the esophagus occurs. • The neonate has a limited ability to digest fats. Physiology Of The Neonate 3/24/2024 1:13 PM
- 9. 9 Thermogenic The neonate is susceptible to rapid heat loss because of acute change in environment and thin layer of subcutaneous fat. Nonshivering thermogenesis occurs. The presence of brown fat (more in mature neonate; less in preterm neonate) warms the neonate by increasing heat production. Immune: The inflammatory response of the tissues to localize infection is immature. Hematopoietic: Coagulation time is prolonged. Neurologic: Presence of primitive reflexes & time in which they appear & disappear indicate the maturity of the developing nervous system. Hepatic: The neonate may demonstrate jaundice Physiology of the Neonate 3/24/2024 1:13 PM
- 10. 10 Integumentary The epidermis & dermis are thin & bound loosely to each other. Sebaceous glands are active. Musculoskeletal: More cartilage is present than ossified bone. Reproductive Females may have a mucoid vaginal discharge & pseudomenstruation due to maternal estrogen levels. Small, white, firm cysts called epithelial pearls may be visible at the tip of the prepuce. The scrotum may be edematous if the neonate is presented in the breech position. Physiology of the Neonate 3/24/2024 1:13 PM
- 11. 11 Assessment of reflexes is an essential component of the neurological assessment, along with assessment of posture, muscle tone, head control, and movement Reflexive movements that are characteristic of newborn behavior begin to appear by the end of the first trimester. Among the first of the reflexes to appear is the Babinski toe sign with later appearance of the swallowing and sucking reflexes. Reflexive movements of the newborn are indicative of the motor behavior control exerted by the newborn’s spinal cord and medulla. Neurological 3/24/2024 1:13 PM
- 12. 12 Reflexes Many of the reflexes present at birth will normally disappear around the fourth month of age. These include Moro’s reflex, the rooting reflex, and the palmar grasp reflex. Absence of these reflexes or persistence of these reflexes past the period they would normally disappear may indicate severe problems of the central nervous system. 3/24/2024 1:13 PM
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- 15. 15 - Movements are sporadic, symmetrical & involve all extremities - Extremities flexes, knees flexed under abdomen - Turns head from side to side when prone; briefly lifts head off bed. - The newborn is not capable of purposefully rolling the body from one side to the other. - Little head control and marked head lag is normal. Motor Development 3/24/2024 1:13 PM
- 16. 16 First hour of life quiet, alert, eyes wide opened with vigorous sucking Next 2–3 days sleeps most of the time, recovering from birth Sleeps 20–22 hrs/day, with brief waking periods of 2–3 hrs Sleep periods vary from 20 minutes -6 hours, little day or night variation Wake newborn to feed q4hours (recommended by most practitioners) Sleep–Wake Pattern 3/24/2024 1:13 PM
- 17. 17 Visual function at birth is limited, improving rapidly during the next few years as the structure develops. Newborn vision is about 20/200 to 20/600; cones perceive red and green. Focus on objects 8–10 inches away and can perceive Forms Preference for human face apparent The blink reflex is present in normal newborns. Tear glands begin to secrete within the first 2 weeks of life, and the infant may experience problems with mucus plugging the tear duct. Transient strabismus is a normal finding during the first few months. Vision 3/24/2024 1:13 PM
- 18. 18 Auditory systems function at birth Hearing begins prenatally; fetuses can hear during the last few months before birth. Because hearing thresholds are higher for newborns, sounds must be louder for newborns to hear them compared to adults Hearing impairment at birth may be related to Vernix and amniotic fluid that is temporarily in the ears. Newborns can determine the direction of a sound. Congenital hearing loss is strongly linked to genetic influences. Hearing 3/24/2024 1:13 PM
- 19. 19 Newborns respond to touch. Newborns can feel pain, heat, cold, and pressure Touch & Smell Newborns can distinguish between odors. The newborn will react to strong odors such as ammonia and fresh onion. Infants are able to detect the smell of their mother’s breast milk as early as 6 to 10 days after birth. The ability to smell and differentiate smells continues to improve as the child matures Infants have a small nasal bridge and are obligate nose breathers until 1 month of age. 3/24/2024 1:13 PM
- 20. 20 —The sense of taste is immature in newborns, although they can distinguish among sugar, lemon, and salt. —Newborns prefer sweet tastes. —Sensitivity to strong tastes becomes heightened at 2 - 3 months. —The sense of taste is not fully developed until approximately 2 years of age. Taste Tonsils —. The tonsils, located in the pharyngeal cavity, are part of the lymphatic system. — Tonsillar tissue is usually not evident in the newborn —The tonsils in young children are generally larger than in adults. 3/24/2024 1:13 PM
- 21. 21 — Mews and makes throaty noises. — Shows interest in human face.. Psychosocial Development —Interactions during routine care between newborn and parent lay foundation for deep attachment Socialization And Vocalization 3/24/2024 1:13 PM
- 22. 22 — Reflexive. — Newborn learns to turn to the nipple — Learn Gains satisfaction from feeding and being held, rocked, fondled, and cuddled that crying results in parents’ response —.Has an intense need for sucking pleasure. — Quiets when picked up. Cognitive & Emotional Development 3/24/2024 1:13 PM
- 23. 23 —Infancy most rapid period of growth; especially during the first 6 months —Growth monitored by plotting on standardized growth chart Infant (1 month to 1 year) Weight —Infants gain 680 g per month until age 5 months, —Birth weight doubles at 5–6 months —An average weight for a 6-month-old child is 7.26 kg —Weight gain slows during the second 6 months By 1 year of age the infant’s birth weight has tripled, to an average of 9.75 kg 3/24/2024 1:13 PM
- 24. 24 —Grows 2.5 cm (1 inch) per month for the first 6 months —Slows during the second 6 months —Grows 1.25 cm (1⁄2 inch) for second 6 months —Average height is 65 cm at 6 months and 74 cm at 12 months —Birth length increases by 50%, mainly in the trunk, by 1 year Length 3/24/2024 1:13 PM
- 25. 25 —Closure of the cranial sutures occurs, with the posterior fontanel fusing by 6 to 8 weeks of age and the anterior fontanel closing by 12 to 18 months of age (the average age being 14 months). —Head circumference increases approximately 2 cmmonth from birth-3 months, 1 cmmonth from 4 to 6 months, and 0.5 cm per month during the second 6 months. —The average head size is 43 cm at 6 months & 46 cm at 12 months —By 1 year of age head size has increased by almost 33%. Head Growth 3/24/2024 1:13 PM
- 26. 26 —Increases by 2–3 cm. for the first 6 months (1 inch less than head circumference) - 6-12 months (0.5 cmmonth) —Chest and head circumferences equal at 1 year —The heart grows less rapidly than does the rest of the body. Its weight is usually doubled by 1 year of age, whereas body weight triples over the same period. —The size of the heart is still large in relation to the chest cavity; its width is approximately 55% of the chest width. Chest Circumference 3/24/2024 1:13 PM
- 27. 27 —Heart rate 80–130 —Respiratory rate 30–50 up till 6 months; 20–30 till 2 years —B/P 90/50 on average Vital Signs Dentition —Beginning signs of tooth eruption by 5–6 months —Chewing and biting 5–6 months 3/24/2024 1:13 PM
- 28. 28 —Rudimentary fixation on light or objects; ability to follow light to midline; and differentiates light and dark at birth —Hearing and touch are well developed at birth —Rudimentary color vision begins at 2 months and improves throughout the first year —Able to fixate on moving object 8–10 inches away, 45 degrees range at 1 month Sensory 3/24/2024 1:13 PM
- 29. 29 — Follows objects 180 degrees at 3 months —Beginning hand eye coordination at 4 months —Can fixate on very small objects at 7 months —Begins to develop depth perception 7–9 months —Able to discriminate simple geometric forms at 12 months —Able to follow rapidly moving objects at 12 months —Locates sound by turning head to side, looking in same direction at 3 months Sensory 3/24/2024 1:13 PM
- 30. 30 • Most newborn infants sleep when not eating, being changed or bathed • Most infants sleep 9–11 hours a night by 3–4 months • Total daily sleep is approximately 15 hours • Nighttime sleep hours and amount & length of naps vary among infants • Most infants take routine morning & afternoon naps by 12 months • Sleep with REM (rapid eye movements) may represent about 50% of the time newborns spend sleeping; this percentage gradually decreases with age. Sleep 3/24/2024 1:13 PM
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- 33. 33 Gross Motor Developmental Milestones Milestone Age Good head control 2–3 months Rolls––front to back 4–5 months Rolls––back to front 5–6 months Sits alone 5–6 months Creeps or crawls 7–8 months Pulls to standing, cruises 9–10 months Stands alone 11–12 months 3/24/2024 1:13 PM
- 34. 34 Fine Motor Developmental Milestones —Grasps & briefly holds objects & takes them to mouth at 3 months —Uses palm grasp with fingers encircling object, transfers cube from hand to hand at 6 months —Crude thumb-finger pincer grasp, bangs hand held cubes together at 9 months —Places tiny object, such as raisin into container, makes marks with crayon at 12 months —Builds tower of two cubes, scribbles with crayon at 15 months Assessment Alert Head lag at 6 months requires further neurological evaluation. An infant who does not pull up to a standing position by 11 or 12 months needs evaluation for dysplasia of the hip. 3/24/2024 1:13 PM
- 35. 35 Cognitive Development (Piaget) Sensorimotor (birth to 2 years) Learning takes place through the child’s developing sensory and motor skills The child progresses from reflexive activity to purposeful acts Initially the infant focuses on own body; discovers own body parts at 2–4 months; gradually shifts attention to objects in the environment Learning by simple repetitive behaviors: repeating pleasing actions; learning that sucking gives pleasure, leads to generalized sucking of fingers, rattle Prolonging interesting actions for reasons that result; grasping and holding becomes shaking, banging& pulling. Shaking makes one noise, shaking more or less makes a different noise 3/24/2024 1:13 PM
- 36. 36 —Imitates simple acts and noises —Beginning understanding of object permanence, searches for dropped objects. —Object Permanence: the understanding that objects continue to exist even when they cannot be seen, heard, or touched. Can find partially hidden object at 6 months Briefly searches for dropped object; begins to understand object permanence 7–9 months Develops sense of object permanence at 10 months Searches for objects where seen last, even if not hidden at 12 months Sensorimotor (birth to 2 years) 3/24/2024 1:13 PM
- 38. 38 • Language Development —Vocalization is distinct from crying at 2 months —Vocalizes to show pleasure; squeals at 3 months —Laughs at 4 months —Begins to imitate sounds at 6 months —One syllable utterances ma, da, mu, hi at 6 months —Chained syllables baba, dada at 7 months —Dada, mama with meaning at 10 months —Five word vocabulary at 12 months Assessment Alert Language Developmental Milestone is: First words with meaning “dada,” “mama” around 10 months. 3/24/2024 1:13 PM
- 39. 39 —Trust vs. Mistrust (birth to 1 year) —Infants whose needs for warmth, comfort, love, security, and food are met learn to trust. Infant’s whose needs are significantly delayed or unmet, learn to mistrust —Erikson reasons that the quality of parent–infant interactions determines development of trust or mistrust Psychosocial Development (Erikson) 3/24/2024 1:13 PM
- 40. 40 —Parents and infants develop a strong bond that grows into deep attachment as the parent cares for the newborn —Stares at parents’ face when parent talks to infant at 1 month —Smiles socially at 2 months —Recognizes familiar faces at 3 months —Demands attention, enjoys social interaction with people at 4 months —May show aggressiveness by occasional biting —Plays peekaboo and pat-a-cake at 11 months Psychosocial Behaviors 3/24/2024 1:13 PM
- 41. 41 —Separation Anxiety: emerging awareness that infant is an individual distinct from primary attachment caregiver Separation Protest: crying when the caregiver leaves Due to anxiety about being separated from their caregivers a. Develops around 9 months; peaks at around 18 months b. Suggestions for parents (1) Recognize that bedtime, going to childcare, having a childcare provider at home are all separations (2) Gradually introduce child to new situations and caretakers (3) The child learns to accept separation through multiple, brief separations and reunions (4) Games such as “peek-a-boo” and “hide-and-seek” may be helpful Emotion and personality development 3/24/2024 1:13 PM
- 42. 42 —Begins to express fear; animal noises, the dark —Stranger anxiety Emerging awareness and preference for mother / primary caregiver; early indicator of healthy attachment process emerging around 6 months & intensifies in the following months Fears 3/24/2024 1:13 PM
- 43. 43 • —Oral stage (birth to 1 year) —Actions center on oral activities. The infant sucks, tastes, bites, chews, swallows, and vocalizes for pleasure Psychosexual Development (Freud) Communication with Infant —Talking softly, singing, rocking, cuddling 3/24/2024 1:13 PM
- 44. 44 During the first year of life, at least six visits to the health care facility are recommended. These are essentially considered well-baby visits and usually occur at 2 weeks, 2 months, 4 months, 6 months, 9 months, and 12 months. During these visits, the nurse collects data regarding the infant’s growth and development, nutrition, and sleep; the caregiver–infant relationship and any potential problems. The infant’s weight, height, and head circumference are documented, and the infant receives immunizations to guard against disease. Family teaching, particularly for first-time caregivers, is an integral part of health promotion and maintenance Routine Checkups 3/24/2024 1:13 PM
- 45. 3/24/2024 1:13 PM 45 TB= Lt upper arm DPT= Lt. outer mid. Thigh IM HepB1= Rt. outer mid .thigh IM
- 46. 46 Children are immunized against hepatitis B virus, Rota virus, diphtheria, tetanus, pertussis, rotavirus, Haemophilus influenzae type b, polio, measles, mumps, rubella, pneumococcal disease, and tuberculosis disease. In addition, they may be immunized against the hepatitis A virus. Immunizations are begun shortly after birth. Immunizations 3/24/2024 1:13 PM
- 47. 47 —Encourage parent to stay and provide care for infant; hospitalized infants experiencing repeated bodily intrusions, multiple caregivers, and separation from the parent are at risk for difficulty with establishing boundaries and building trust —Diminish stranger anxiety by limiting the number of caregivers who have contact with the infant Nursing Intervention Alert Parents of infants that are ill, have congenital defects, or who are hearing or visually impaired will need extra support and teaching on how to compensate and minimize developmental delay for those children. Nurses play an instrumental role in teaching, modeling interactions, and care for the compromised infant. Nursing Care of the Hospitalized Infant 3/24/2024 1:13 PM
- 48. 48 Speak softly and handle gently, but firmly, have calm, unhurried approach Keep infant in view of parent; if possible have parent hold infant; upright position tolerated best; encourage parent to cuddle infant after procedure; if parent not available place familiar stuffed animal near infant Diminish stranger anxiety; have primary nurse perform or assist with procedure; limit number of strangers entering room during procedure 3/24/2024 1:13 PM
- 49. 49 Sensorimotor considerations; use sensory soothing measures; firm gentle handling and stroking; hugging and cuddling; soothing, calming, quiet voice Analgesics as needed Do not perform painful procedures in crib Expect older infants to resist; restrain safely if needed 3/24/2024 1:13 PM
- 50. 50 Caring for the infant: I. Care of umbilicus and circumcision II. Support of thermoregulation in neonate III. Prevention of diaper rash, skin care Parent Teaching 3/24/2024 1:13 PM
- 51. 51 To prevent diaper rash: I. Soiled diapers should be changed frequently. II. Check Q2-4 hours while the infant is awake to see if the diaper is soiled. Waking the baby to change the diaper is not necessary. III. Cleanse the diaper area with water and a mild soap if needed IV. Commercial diaper wipes also may be used, but they are an added expense 3/24/2024 1:13 PM
- 52. 52 IV. Care of the teeth Clean teeth with damp cloth Frozen teething ring to reduce inflammation and manage pain Tylenol may be given for teething pain disrupting sleep and feeding Topical baby Oral Jel, benzocaine, may be used if instructions followed carefully. Prevent dental carries by avoiding having infant falling asleep with bottle, causing milk to linger, avoid apple juice bottles for older infants before sleep Fluoride supplement at 6 months and up for breast or formula fed, if water supply not adequately fluorinated V. Shaking a baby can result in Shaken Baby Syndrome which causes hemorrhaging & swelling in the brain, spinal cord injury, or eye damage Parent Teaching 3/24/2024 1:13 PM
- 53. 53 Safety Promotion and Injury Prevention Injuries are a major cause of death during infancy, especially for children 6 to 12 months old. The three leading cause of accidental death injury in infants were I. Suffocation II. Motor vehicle–related injuries III. Drowning —Use infant car seat —Check bathing water temperature/formula temperature —Ensure crib mattress fits snugly; no pillow in the crib —Position supine or supported on side for sleep until infant can turn over because prone position may increase sudden infant death syndrome (SIDS). SIDS-unexpected unexplained death of a seemingly healthy infant 3/24/2024 1:13 PM
- 54. Nursing Intervention Alert Alert parents to major causes of injury & death: aspiration of foreign objects, suffocation, falls, poisoning, burns, motor vehicular injuries, & teach prevention. Safety Infants should be placed on their back to sleep. A pillow or bedroll can be used to keep the baby in place. Prevention of ingestion/aspiration of foreign objects a. Keep pins, buttons, and other small objects off the floor & out of reach b. Do not feed infants hard foods (e.g., nuts, hard candies) c. Do not give infant balloons d. Do not prop infant’s bottle e. Select pacifier with shield too large to enter infant’s mouth f. Learn emergency procedure for dealing effectively with choking 3/24/2024 1:13 PM 54
- 55. 55 —Infants’ activity is primarily narcissistic and revolves around their own body. Body parts are primarily objects of play and pleasure. —From birth to 3 months, infants’ Play is dependent; pleasure is demonstrated by a quieting attitude (1 month), a smile (2 months), & a squeal-cry (3 months). —From 3 to 6 months infants show more discriminate interest in stimuli and begin to play alone with a rattle or soft stuffed toy or with someone else. They interact much more during play. —Play with large toys with movable parts, noisemakers, stacking toys, blocks, pots, pans, push and pull toys, large puzzles with few pieces —Read to infant: nursery rhymes, books with various textures, books with large bright pictures; encourage infant to turn pages Play, stimulation and toys 3/24/2024 1:13 PM
- 56. 56 —By 4 months of age they laugh aloud, show preference for certain toys, and become excited when food or a favorite object is brought to them. They recognize an image in a mirror, smile at it, and vocalize to it. —By 6 months to 1 year, play involves sensorimotor skills. Infants play actual games such as peek-a-boo and pat-a-cake. They demonstrate verbal repetition and imitation of simple gestures. —Play is solitary or one sided, infants choose with whom they will interact. Play, stimulation and toys The bright colors of a toy provide visual stimulation for the infant. Play, stimulation and toys 3/24/2024 1:13 PM
- 57. 57 —Breast milk is a complete and healthful diet for the first 6 months; importance of breast-feeding mother being well nourished —Support choice to use commercial iron fortified formula if breast-feeding not desirable to mother or not a feasible option; recommend mixing powdered formula with bottled water, if water supply has lead or other impurities —No additional fluids needed during first 4–6 months, will fill infant up, not allowing for adequate nutritional calories —Cows milk, imitation milks are not acceptable —as well Breast milk or formula primary source of nutrition in second 6 months 3/24/2024 1:13 PM
- 58. 58 —Gradual introduction of solid foods during second 6 months; starting with cereals, fruits, vegetables, and meats —Do not feed nuts, food with pits, hot dogs, or any foods that could block the airway or have risk of choking —Honey not given in first year, a source of botulism —Supplements include: vitamin D, iron by 4–6 months (fetal iron stores are depleted), vitamin B12 may be needed if mother’s intake is inadequate —Fluoride beginning at 6 months —Extremely reduced protein and calorie diets can result in diseases (e.g., Marasmus and Kwashiorkor) that impair development and can be fatal 3/24/2024 1:13 PM
- 59. 59 TEMPERAMENT The infant’s temperament influences the type of interaction that occurs between the child and parents and other family members. The more dissonance (or lack of harmony) between the child’s temperament & the parent’s ability to accept & deal with the behavior, the greater the risk for subsequent parent-child conflicts. Temperament has a strong biologic component & the environment, particularly the family, may modify temperament Describing and Classifying Temperament I. Easy child II. Difficult child III. Slow-to-warm-up child 3/24/2024 1:13 PM
- 60. 60 —Consistently and promptly meeting infant’s needs builds trust; does not “spoil” infant —Setting limits is appropriate and will be required in establishing nighttime routine —Corporal punishment is unacceptable Discipline 3/24/2024 1:13 PM
- 61. 61 Gastrointestinal pain, fussy period, crying does not stop & continues for more than 3 hours, or the infant appears inconsolable, often pulling up the legs and passing gas. In breast-fed infants, colic sometimes is a reaction to something the mother has eaten. In other infants, colic may result from sensitivity to milk or milk products. Colic may indicate a medical problem, but this circumstance is very rare. Episodes generally peak at about 6 weeks of age and stop at about 3 months of age. Colic
- 62. 62 _ Several interventions can alleviate this problem Creating a soothing and restful environment for the infant. Changing the infant’s formula may also decrease symptoms (soy formula has been helpful) If the mother is breast-feeding, she should eliminate from her diet any foods that produce gas (e.g., cabbage, onions, broccoli) and reduce her caffeine intake. She should also eliminate milk products from her diet, particularly if there is a family history of milk intolerance or other allergies. Colic
- 63. 63 If the infant is bottle-feeding, a formula that is not based on cow’s milk can be tried. Usually, colic caused by food intolerance will improve in 1-2 days. Laying the infant on his or her stomach across the parent’s knees, with a pacifier, while rocking often helps relieve any discomfort. Warm baths may also relax & soothe, creating a more comfortable state and helping to induce sleep Colic
- 64. 64 Common condition 3-4 days after birth (about 50% of infants) Caused by immaturity of liver Symptoms include yellowing of skin and eyes Usually not dangerous; disappears without treatment Severe cases without treatment can lead to brain damage
- 65. 65 Vitamin D Deficiency. Rickets, a disease affecting the growth and calcification of bones, is caused by a lack of vitamin D. The absorption of calcium and phosphorus is diminished because of the lack of vitamin D, which is needed to regulate the use of these minerals. Early manifestations include softening of the occipital bones and delayed closure of the fontanelles. There is delayed dentition. As the disease advances, thoracic deformities, softening of the shafts of long bones & spinal & pelvic bone deformities develop. Vitamin D Deficiency
- 66. 66 Milk allergy is the most common food allergy in the young child. Symptoms that may indicate an allergy to milk are diarrhea, vomiting, colic, irritability, respiratory symptoms, or eczema. Infants who are breast-fed for the first 6 months or more may avoid developing milk allergies entirely unless a strong family history of allergies exists. Children with severe allergic reactions to milk are given commercial formulas that are soybean. Milk Allergy
- 67. 67 Children with lactose intolerance cannot digest lactose, the primary carbohydrate in milk, because of an inborn deficiency of the enzyme lactase. Symptoms include cramping, abdominal distention, flatus, and diarrhea after ingesting milk. Commercially available formulas soybean. The child needs supplemental vitamin D. Yogurt is tolerated by these children.
- 68. Marasmus Marasmus affects babies who get insufficient protein and too few calories, as can easily occur if a mother is malnourished and does not have the resources to provide her child with a nutritious commercial substitute for mother’s milk. A victim of marasmus becomes very frail & wrinkled in appearance as growth stops and the body tissues begin to waste away. Even if these children survive, they remain small in stature and often suffer impaired social and intellectual development. 3/24/2024 1:13 PM 68
- 69. Kwashiorkor Kwashiorkor affects children who get enough calories but little if any protein. As the disease progresses, the child’s hair thins, the face, legs, and abdomen swell with water, and severe skin lesions may develop. In many poor countries of the world, one of the few high- quality sources of protein readily available to children is mother’s milk. So breast-fed infants do not ordinarily suffer from marasmus unless their mothers are severely malnourished; however, they may develop kwashiorkor when they are weaned from the breast and denied their primary source of protein. 3/24/2024 1:13 PM 69
- 70. 70 Generally refers to infants and young children whose weight is below the 3rd percentile on National Center for Health Statistics (NCHS) growth standards Traditional categories include organic FTT, nonorganic FTT, and mixed etiology FTT Newer categories include neurodevelopmental FTT & socioemotional FTT Failure-to-Thrive (FTT) 3/24/2024 1:13 PM
- 71. Nonorganic Failure To Thrive An infant growth disorder, caused by lack of attention and affection, that causes growth to slow dramatically or stop is a growth disorder that appears early, usually by 18 months of age. Babies who display it stop growing and appear to be wasting away, in much the same way that malnourished infants with marasmus do. 3/24/2024 1:13 PM 71
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