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Ch. 25 Growth & Development of the Newborn & Infant
Principles of Development
Continuous process
through life Orderly
sequence
Predictable but unique ranges
Systems mature at different
rates More rapid in early
periods
Cephalocaudal pattern grow longer, head
to tail Gross to refined skills
Newborn/neonatal period of infancy from birth to
28 days Infancy 28 days to 12 months
Growth & Development
Nurse must be familiar w/normal development while obtaining health hx,
nurse can ask parent/caregiver if the skill is present and when it was attained
Ill or premature infants may exhibit delayed acquisition of physical growth and
dev skills when assessing the growth and dev, use the infants adjusted age to
determine expected
outcomes
Adjusted age subtract the # of weeks that the infant was premature from
the infant’s chronological age
Physical Growth
Ongoing assessments of growth are important so too rapid or inadequate
growth can be identified
Infants grow rapidly over the first 12 months weight, length, head
and chest circumference are all indicators of growth
Weight
o The avg newborn weighs 3.4 kg (7.5lb) at birth
o Newborns lose up to 10% of their body weight over the 1st week of
life then gain 30g/day and regains birth weight by 10-14 days of age
o Most infants double their birth weight by 4 months and triple by the time
they are 1 y/o
Height
o Avg newborn is 50cm (20in) long
o Length grows more quickly over the 1st 6 months
o By 12 months length increased by
50% Head Circumference
o Avg head circumference of full term newborn 35cm (14in)
o Increases rapidly during 1st 6 months
o Avg of 10 cm (4in) gain from birth to 1 y/o
Fontanel closure posterior 6-8 weeks (2 months), anterior at 9-18
months open for brain to grow pg. 1179
, 2
Teeth
o Occasionally and infant is born w/1 or more teeth natal teeth or dev
them in 1st 28 days neonatal teeth
, 3
o Majority do not have teeth when born 1st teeth erupt btwn ages 6 & 8
months primary teeth (deciduous teeth)
Causes↑ saliva & drooling
Enzyme released w/teething causes mild diarrhea, facial skin
irritation Slight fever may be associated; not high fever
(normal)
o Gums around emerging tooth will usually swell lower central incisors
are usually 1st to appear followed by upper central incisors
o The avg 12-month old has 4-8 teeth
o Put toys in freezer to help w/inflammation or baby Orajel
Stranger Anxiety pg. 973
o May develop at around the age of 8 months
o Previously happy and friendly infant may become clingy and
whiny when approached by strangers
o Stranger anxiety indicator that the infant is recognizing themselves as
separate from others
o As the infant becomes more aware of new people/places they may view a
stranger as threatening even if parent is there
o Fam members that don’t see the child often approach infant calmly
and slowly w/parent in sight sometimes will prevent a sudden crying
spell
Separation Anxiety
o May start is last few months of infancy
o Infant becomes distressed when parent leaves infant will eventually
calm down & become engaged w/caregiver
o 8 months’ protests loudly when mom leaves
Adaptive Behaviors
Gross Motor Skills pg. 968
Large muscles head control, rolling, sitting, & walking
Dev in cephalocaudal fashion ex. Baby learns to lift the head before learning
to roll over & sit
1 month Lifts and turns head to side in prone position, head lag when pulled to sit,
rounded back in sitting
2 months Raises head & chest, holds position. Improving head control
3 months Raises head to 45 degrees in prone, slight head lag in pull-to-sit
4 months Lifts head & looks around, rolls from prone to supine, head leads body
when pulled to sit
5 months Rolls from supine to prone and back again, sits w/back upright when
supported
6 months Tripod sits
7 months Sits alone w/some use of hands for support
8 months Sits unsupported
9 months Crawls, abdomen off floor
10 months Pulls to stand. Cruises
12 months Sits from standing position. Walks independently
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Ch. 25 Growth & Development of the Newborn & Infant
Principles of Development
Continuous process
through life Orderly
sequence
Predictable but unique ranges
Systems mature at different
rates More rapid in early
periods
Cephalocaudal pattern grow longer, head
to tail Gross to refined skills
Newborn/neonatal period of infancy from birth to
28 days Infancy 28 days to 12 months
Growth & Development
Nurse must be familiar w/normal development while obtaining health hx,
nurse can ask parent/caregiver if the skill is present and when it was attained
Ill or premature infants may exhibit delayed acquisition of physical growth and
dev skills when assessing the growth and dev, use the infants adjusted age to
determine expected
outcomes
Adjusted age subtract the # of weeks that the infant was premature from
the infant’s chronological age
Physical Growth
Ongoing assessments of growth are important so too rapid or inadequate
growth can be identified
Infants grow rapidly over the first 12 months weight, length, head
and chest circumference are all indicators of growth
Weight
o The avg newborn weighs 3.4 kg (7.5lb) at birth
o Newborns lose up to 10% of their body weight over the 1st week of
life then gain 30g/day and regains birth weight by 10-14 days of age
o Most infants double their birth weight by 4 months and triple by the time
they are 1 y/o
Height
o Avg newborn is 50cm (20in) long
o Length grows more quickly over the 1st 6 months
o By 12 months length increased by
50% Head Circumference
o Avg head circumference of full term newborn 35cm (14in)
o Increases rapidly during 1st 6 months
o Avg of 10 cm (4in) gain from birth to 1 y/o
Fontanel closure posterior 6-8 weeks (2 months), anterior at 9-18
months open for brain to grow pg. 1179
, 2
Teeth
o Occasionally and infant is born w/1 or more teeth natal teeth or dev
them in 1st 28 days neonatal teeth
, 3
o Majority do not have teeth when born 1st teeth erupt btwn ages 6 & 8
months primary teeth (deciduous teeth)
Causes↑ saliva & drooling
Enzyme released w/teething causes mild diarrhea, facial skin
irritation Slight fever may be associated; not high fever
(normal)
o Gums around emerging tooth will usually swell lower central incisors
are usually 1st to appear followed by upper central incisors
o The avg 12-month old has 4-8 teeth
o Put toys in freezer to help w/inflammation or baby Orajel
Stranger Anxiety pg. 973
o May develop at around the age of 8 months
o Previously happy and friendly infant may become clingy and
whiny when approached by strangers
o Stranger anxiety indicator that the infant is recognizing themselves as
separate from others
o As the infant becomes more aware of new people/places they may view a
stranger as threatening even if parent is there
o Fam members that don’t see the child often approach infant calmly
and slowly w/parent in sight sometimes will prevent a sudden crying
spell
Separation Anxiety
o May start is last few months of infancy
o Infant becomes distressed when parent leaves infant will eventually
calm down & become engaged w/caregiver
o 8 months’ protests loudly when mom leaves
Adaptive Behaviors
Gross Motor Skills pg. 968
Large muscles head control, rolling, sitting, & walking
Dev in cephalocaudal fashion ex. Baby learns to lift the head before learning
to roll over & sit
1 month Lifts and turns head to side in prone position, head lag when pulled to sit,
rounded back in sitting
2 months Raises head & chest, holds position. Improving head control
3 months Raises head to 45 degrees in prone, slight head lag in pull-to-sit
4 months Lifts head & looks around, rolls from prone to supine, head leads body
when pulled to sit
5 months Rolls from supine to prone and back again, sits w/back upright when
supported
6 months Tripod sits
7 months Sits alone w/some use of hands for support
8 months Sits unsupported
9 months Crawls, abdomen off floor
10 months Pulls to stand. Cruises
12 months Sits from standing position. Walks independently
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