PEDIATRICS
, PEDIATRICS INFANT (Birth - 12 months)
PHYSICAL
COGNITIVE DEVELOPMENT: PIAGET
WEIGHT: 5.5 - 9.5 lbs (2,500 - 4,250 g)
Sensorimotor Phase (birth-2 yrs.)
• Gains approximately 1.5 lbs (680 g) per month for the
• Object permanence is developed
FIRST 5 months
• Can only see from one’s own point
• Birth weight DOUBLES by 5 months & T RIPLES by 12 months
of view (egocentric)
HEIGHT: 18 - 22 in (46 - 56 cm) • Uses their senses & motor skills to
• Grows approximately 1 in (2.5 cm) per month in FIRST explore the world
6 months. knows object still
• Increases by 50% after 6 months up until 12 months exist w/o being seen
HEAD: 13 - 14 in (33 - 35.5 cm) SLEEP
• Increases 0.75 in (2 cm) per month in FIRST 3 months,
0.4 in (1 cm) per month from 4-6 months, & 0.2 in (0.5 cm)
per month by 12 months Birth - 4 months
• POST ERIOR FONTANEL closes by 2 - 3 months • 14-15 hours of sleep (of those, 9-11 hrs. at night)
• ANT ERIOR FONTANEL “soft spot” closes by 12 - 18 months • Between 4 months - 1 year, sleeps through
• Head circumference is 1-2 cm LARGER than chest the night w/ 1 or 2 naps during the day
circumference
DENTAL: first tooth in 6 - 10 months (average 8 months)
• 6 to 8 teeth by 1 year of age
PSYCHOLOGICAL DEVELOPMENT:
• Signs: irritable, biting, sucking, drooling, insomnia,
mild fever, rub ears, decreased appetite for solid foods
ERKISON
• Treatment:
- Analgesic (Tylenol, ibuprofen) Trust vs Mistrust (birth-18 months) develops trust when
- Frozen teething rings, cloth-wrapped ice cub, OTC needs are met (affection, comfort, food)
teething gel OR
• AVOID falling asleep with bott le in mouth (cavities) leads to future anxiety, loneliness, isolation, & fear
NUTRUTION
SIGNS OF DEVELOPMENT DELAYS
• Breast milk or iron-fortified formula is the primary source
of nutrition for the 1st year
After walking independently for
- Decreased when solid foods introduced
several months:
• At 4-6 months, solid foods introduced (graham crackers,
• Persistent tiptoe walking
mashed potatoes & bananas, oatmeal, butternut squash)
• Does NOT develop mature walking pattern
• Around 6 months, water & juice introduced
• After 6 months, 100% fruit juice limited to 4-6 oz/day
• Gradually wean from breast or bott le to a cup
Try new food one-at-a-time over
5-7 days to observe for allergies
343
, PEDIATRICS
INFANT: DEVELOPMENT MILESTONES (Birth - 12 months)
Month Gross Motor Fine Motor Language Social
1 • Attempts to hold head
up when prone (head lag)
• Strong grasp
• Maintains fisted hands
• Cries to communicate
frustration/hunger
• Gazes on parent’s
face
2
• Holds hand in open • Smiles in response
• Lifts entire head when • Cooing & gurgling sounds
position to people talking
prone • Turns head to sounds
• Grasp reflex fades & smiling
• Keeps hand loosely
3 • Raises head & shoulders
when prone (slight head lag)
open
• No longer has grasps
reflex
• Laughs & smiles
• Rolls from side to back & spontaneously
• Grasps objects with
4-5 tummy to back
• Holds head steady w/o
both hands
• Uses palmar grasps
• Babbles & copy sounds
heard
• Ccries when playing
stops
support • Copies facial
expressions
• Differentiate
• Imitates sounds
between familiar &
6
• Responds to name
unfamiliar faces
• Rolls from back to tummy • Holds bottle • Constant sounds “m,b”
• Stranger anxiety
• Babble vowels together
• Responds to other’s
“ah,eh,oh”
emotions
7
• Bears full weight on feet
• Moves object from
• Sits, leans on hands for
hand to hand
support
8 • Sits w/o support • Uses pincer grasp
344
, INFANT: DEVELOPMENT
PEDIATRICS MILESTONES (Birth - 12 months)
Month Gross Motor Fine Motor Language Social
• Uses crude pincer grasp
9
• Moves object from hand
• Begins to crawl
to another
• Pulls up to stand
• Dominate hand evident
hands
10
• Understands “no”
• Changes from tummy to
• Grasp rattle by hand • Imitates sounds & gestures
sitting position
• Makes different sounds
11
• Uses neat pincer grasp
• Take steps while holding
• Places object in
onto something “cruising”
container
• Follows 1-step commands
• Plays “peek-a-boo”
w/ gestures
• Walk first steps alone! • Feeds self finger foods or “pata-cake”
12
• Says 3-5 words
• Sits from a standing • Tries to build a • Cries when
• Says “mama” & “dada”
position w/o help two-block tower parent(s) leave
• Waves “bye-bye” & shakes
• Crawls stairs • Turn pages in a book • Has favorite toys
head “no”
& people
• Tries imitate sounds
INFANT: REFLEXES (Birth - 12 months)
Babinski: Stroke outer edge of sole of foot, towards big toe. Baby's toes should fan out (Birth to 1 year)
Moro's: Sudden noise or movement cause baby to draw out arms & draw in legs (Birth to 4-6 months)
Palmar grasp: Give baby your finger, baby should tight ly grasp finger (Birth to 4-6 months)
Rooting: Stroke cheek, baby should turn head towards direction of stroke (Birth to 4 months)
Sucking: Baby latches onto mother's nipple or bott le nipple; goes hand in hand with rooting reflex (Birth to 4 months)
(Birth to 3-4
Stepping: Stand baby upright with feet touching surface, baby should step with one foot then the other
months)
Tonic neck: lie baby on back & turn his/her head, baby's extremities on same side should extend
(Birth to
4 months)
345
, PEDIATRICS INFANT (Birth - 12 months)
PHYSICAL
COGNITIVE DEVELOPMENT: PIAGET
WEIGHT: 5.5 - 9.5 lbs (2,500 - 4,250 g)
Sensorimotor Phase (birth-2 yrs.)
• Gains approximately 1.5 lbs (680 g) per month for the
• Object permanence is developed
FIRST 5 months
• Can only see from one’s own point
• Birth weight DOUBLES by 5 months & T RIPLES by 12 months
of view (egocentric)
HEIGHT: 18 - 22 in (46 - 56 cm) • Uses their senses & motor skills to
• Grows approximately 1 in (2.5 cm) per month in FIRST explore the world
6 months. knows object still
• Increases by 50% after 6 months up until 12 months exist w/o being seen
HEAD: 13 - 14 in (33 - 35.5 cm) SLEEP
• Increases 0.75 in (2 cm) per month in FIRST 3 months,
0.4 in (1 cm) per month from 4-6 months, & 0.2 in (0.5 cm)
per month by 12 months Birth - 4 months
• POST ERIOR FONTANEL closes by 2 - 3 months • 14-15 hours of sleep (of those, 9-11 hrs. at night)
• ANT ERIOR FONTANEL “soft spot” closes by 12 - 18 months • Between 4 months - 1 year, sleeps through
• Head circumference is 1-2 cm LARGER than chest the night w/ 1 or 2 naps during the day
circumference
DENTAL: first tooth in 6 - 10 months (average 8 months)
• 6 to 8 teeth by 1 year of age
PSYCHOLOGICAL DEVELOPMENT:
• Signs: irritable, biting, sucking, drooling, insomnia,
mild fever, rub ears, decreased appetite for solid foods
ERKISON
• Treatment:
- Analgesic (Tylenol, ibuprofen) Trust vs Mistrust (birth-18 months) develops trust when
- Frozen teething rings, cloth-wrapped ice cub, OTC needs are met (affection, comfort, food)
teething gel OR
• AVOID falling asleep with bott le in mouth (cavities) leads to future anxiety, loneliness, isolation, & fear
NUTRUTION
SIGNS OF DEVELOPMENT DELAYS
• Breast milk or iron-fortified formula is the primary source
of nutrition for the 1st year
After walking independently for
- Decreased when solid foods introduced
several months:
• At 4-6 months, solid foods introduced (graham crackers,
• Persistent tiptoe walking
mashed potatoes & bananas, oatmeal, butternut squash)
• Does NOT develop mature walking pattern
• Around 6 months, water & juice introduced
• After 6 months, 100% fruit juice limited to 4-6 oz/day
• Gradually wean from breast or bott le to a cup
Try new food one-at-a-time over
5-7 days to observe for allergies
343
, PEDIATRICS
INFANT: DEVELOPMENT MILESTONES (Birth - 12 months)
Month Gross Motor Fine Motor Language Social
1 • Attempts to hold head
up when prone (head lag)
• Strong grasp
• Maintains fisted hands
• Cries to communicate
frustration/hunger
• Gazes on parent’s
face
2
• Holds hand in open • Smiles in response
• Lifts entire head when • Cooing & gurgling sounds
position to people talking
prone • Turns head to sounds
• Grasp reflex fades & smiling
• Keeps hand loosely
3 • Raises head & shoulders
when prone (slight head lag)
open
• No longer has grasps
reflex
• Laughs & smiles
• Rolls from side to back & spontaneously
• Grasps objects with
4-5 tummy to back
• Holds head steady w/o
both hands
• Uses palmar grasps
• Babbles & copy sounds
heard
• Ccries when playing
stops
support • Copies facial
expressions
• Differentiate
• Imitates sounds
between familiar &
6
• Responds to name
unfamiliar faces
• Rolls from back to tummy • Holds bottle • Constant sounds “m,b”
• Stranger anxiety
• Babble vowels together
• Responds to other’s
“ah,eh,oh”
emotions
7
• Bears full weight on feet
• Moves object from
• Sits, leans on hands for
hand to hand
support
8 • Sits w/o support • Uses pincer grasp
344
, INFANT: DEVELOPMENT
PEDIATRICS MILESTONES (Birth - 12 months)
Month Gross Motor Fine Motor Language Social
• Uses crude pincer grasp
9
• Moves object from hand
• Begins to crawl
to another
• Pulls up to stand
• Dominate hand evident
hands
10
• Understands “no”
• Changes from tummy to
• Grasp rattle by hand • Imitates sounds & gestures
sitting position
• Makes different sounds
11
• Uses neat pincer grasp
• Take steps while holding
• Places object in
onto something “cruising”
container
• Follows 1-step commands
• Plays “peek-a-boo”
w/ gestures
• Walk first steps alone! • Feeds self finger foods or “pata-cake”
12
• Says 3-5 words
• Sits from a standing • Tries to build a • Cries when
• Says “mama” & “dada”
position w/o help two-block tower parent(s) leave
• Waves “bye-bye” & shakes
• Crawls stairs • Turn pages in a book • Has favorite toys
head “no”
& people
• Tries imitate sounds
INFANT: REFLEXES (Birth - 12 months)
Babinski: Stroke outer edge of sole of foot, towards big toe. Baby's toes should fan out (Birth to 1 year)
Moro's: Sudden noise or movement cause baby to draw out arms & draw in legs (Birth to 4-6 months)
Palmar grasp: Give baby your finger, baby should tight ly grasp finger (Birth to 4-6 months)
Rooting: Stroke cheek, baby should turn head towards direction of stroke (Birth to 4 months)
Sucking: Baby latches onto mother's nipple or bott le nipple; goes hand in hand with rooting reflex (Birth to 4 months)
(Birth to 3-4
Stepping: Stand baby upright with feet touching surface, baby should step with one foot then the other
months)
Tonic neck: lie baby on back & turn his/her head, baby's extremities on same side should extend
(Birth to
4 months)
345
