Lecture 4 The Infant
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1.
2.
3.
Upon completion of this lecture, the student will be able to :
Define the term infant.
State the developmental tasks of infancy.
Describe the physical development of infants from
1 month to 1 year of age.
4. Discuss milestones of motor development.
5. Discuss the development of language.
6. Describe the theories of Piaget, Freud, and Erikson concerning
infant development.
7. Define separation anxiety.
8. Discuss the development of attachment.
9. Describe the basic nutritional needs of infants from 1 month
to 1 year of age.
10. List the immunization schedule for infant under 1 year of age .
11. State four safety precautions essential in infant care.
The infant:
Is the period between 4 weeks of age to 1 year of age.
Growth :
Indicates an increase in size, measured by inches (centimeters)and
pounds(kilograms).
Development:
indicates an increase in function and mastery of tasks for the specific
phase in the lifespan.
Pattern of growth & development:
The process of growth and development is orderly and proceeds from simple
to complex in an expected pattern but at a variable pace.
Cephalocaudal
refers to the progression of the growth pattern that proceeds from head
to the toe.
For example, infants are able to lift their head before they can sit
and are able to sit before they can stand.
Proximodistal
refers to growth from the center of the body to the periphery.
Height
refers to a standing measurement.
length
is measured while the infant is lying down.
•
The length of the newborn is normally about 20 inches
(50cm).
• A normal newborn weighs approximately (3.4kg).
• The infant’s birth weight doubles by 6 months of age
and can be expected to triple by 1 year.
• Many factors influence growth and development of the
infant, both the prenatal environment and the home
environment influence growth and development of
the infant.
• The development of the personality is the interaction
between the biological and environmental factors.
• Personality: is most often defined as a unique
combination of characteristics that results in the
individuals recurrent pattern of behavior .
Trust versus mistrust
• The functioning of all humans is goal directed and involves the tasks of
developing social competence and the mastery of skills necessary for
functioning in their environment.
• Some tasks of infancy include weaning , self-feeding ,walking ,and
acquiring language and communications skills.
• Trust versus mistrust is the first psychosocial crisis in infancy that must
be resolved.
•
In the first year of life, trust develops when infants learn their basic
needs will be met .
intelligence understanding cause and effect
• Infants discover at an early age that there is a
relationship between cause and effect, and experiences
at each stage of the life cycle build on this discovery.
• From 1 to 4 months of age the infant is focused on the
parent and , when held, prefers the en face (face-to-face)
position.
• Infants who have not developed an attachment to the
parent figure do not explore readily.
• At 4 months the infant drops a spoon from the
highchair and believes it is gone.
• By 7 months, the infant will continue to look for it.
• This is called object permanence,
knowing the object is there even
though you cannot see it.
• Playing peek-a-boo with the infant at this age
helps to develop the concept of object Permanence.
MEMORY
Studies have shown that infants in the first year of life can retain
memory of a traumatic experience.
EMOTIONAL DEVELOPMENT
When placed face-to-face(en face) with an adult, an infant will mimic
the facial expression of the adult. for example, if the adults tongue is
thrust out, the infant will eventually thrust his or her tongue out also.
separation anxiety begins at 6 months of age.
The infant prefers the parent to a stranger.
ATTACHMENT
• The process of attachment begins long before the infant
is born ,when the mother feels the fetus moving in the womb.
• Separation anxiety: emerges after 6 months of age, the
infant cries or protests the parent leaving the room.
• Stranger anxiety peaks at 9 months of age when the infant is
approached by a stranger in the absence of the parent.
• The mastery of object permanence indicates the infant
understands that the parent is still available even though he
or she is not visible at the moment.
• By 18 months, memory development helps the child
remember the image of the parent and trust that the parent
will return.
• Parents who have psychiatric problems or marital
stress or who both work long hours may not have the
energy to respond to a demanding infant.
• Child abuse becomes a risk at this time, the nurse
should be alert to signs and symptoms of child abuse.
• The nurse should be alert for inconsistent statements
about injuries, bruises at various stages of healing, or
delay in seeking care.
Language Development
• Language development consists of verbal language that is both
expressive (can say it) and receptive (can understand it) and body
language that follows a predictable course of development.
Sleep patterns
• A maturing central nervous system combined with
parental responses aids in development of a sleep
pattern.
Motor Development
Growth and Development During Infancy
Age
(months)
Gross motor
Fine motor
Vocalization
Can turn head from side to side when
prone, lift head momentary from bed
Able to hold head more erect when
sitting , but still bobs forward
Grasp reflex strong
Cries to express displeasure
Activity holds rattle but will not
reach for it
Coos, babbles, chuckles
4
Rolls from back to side
Can carry objects to mouth
5
Can turn over from abdomen to back
Able to grasp objects voluntary
6
Rolls from back to abdomen
7
Sits erect momentarily
8
Sits steadily unsupported
9
Creeps on hands and knees
1
3
Begins to imitate sounds
Transfers objects from one hand
to the other
Has beginning pincer grasp using
index, four and fifth fingers
against lower part of thumb
Comprehends “no-no”
10
Stands while holding onto furniture
Grasps bell by handle.
11
Walk holding on to furniture or with
both hands held
Walk with one hand held
Has neat pincer grasp
12
Produces vowel sounds and chained syllables
– baba, dada, kaka
Says "dada", "mama" with meaning
comprehends "bye-bye" may say one word
(e,g: "hi" , "bye" . "no").
Imitates definite speech sounds
Attempts to build two-block
tower but fails
Says three to five words besides “dada” ,
“mama”
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Piaget’s sensorimotor theory of development of the infant is evident in the infant’s play
activities , which are activated by sensation and relate to the infant directly .
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Play is the work of a child .
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According to Freud’s theory of development, the infant is in oral phase, which involves
exploring with the mouth.
•
Oral sucking, biting, and chewing toys are appropriate for this stage of development .
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Often the nurse or health care worker needs to reassure the parent that picking up
everything from the floor and placing it into his or her mouth or intentionally dropping
food from the highchair tray onto the floor are developmentally normal behaviors and
definitely not signs of a badly behaved child .
Nutrition
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The best nutrition for the newborn is breast milk , which contains antibodies and easy-todigest foods.
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For mothers who cannot breastfeed, most commercial formulas provide adequate
nutrition, although the extra benefits of the antibodies and other protective ingredients
are not provided.
Teeth
•
The eruption of the first 20 deciduous teeth, which are also known as primary or baby
teeth, usually begins at 5 to 7 months of age. The upper and lower central incisors are
usually the first to erupt.
Estimating the number of erupted primary teeth in the mouth
•
The number of primary teeth that should be present in the mouth of an infant or toddler
can be anticipated by use of the following formula:
•
age in month – 6
Example : 10 – 6 = 4
• Well child visit should be scheduled before the newborn is discharged.
• Well child checkups are the best time to answer questions the parents
may have and provide anticipatory guidance concerning development
stage and needs of the growing infant.
Accident prevention
• Accidents are major cause of morbidity
(illness ) and mortality ( death ).
• The first injury prevention activity for the newborn , now required by
law in most states , is the use of car seats for infants and children .
• Keeping the crib side rails up prevents the infant
from rolling out of the crib.
• The use of safety straps when infants are placed
in highchairs or strollers also prevent falls .