Child Development Milestones and Newborn Care

Developmental Milestone Red Flags

• By 3 months, should be able to raise head when prone.
• By 6 months, should sit with support and smile.
• By 9 months, should respond to their name.
• At 12 months, should exhibit gestures and be able to pull to stand.
• By 16 months, should be saying single words.
• At 18 months, should be walking independently.
• By age 2 years, should be able to form a 2-word phrase.
• At age 3, speech should be understandable.
• At age 4, should be able to dress self.
• By age 5, should be able to draw a person with a body.

Newborn Health Promotion and Maintenance

• Newborn assessment includes reviewing maternal OB and pregnancy history.
• Important to assess social factors like home environment, particularly for lead exposure.
• Newborn care visits should wait at least 24 hours post-birth for initial screenings.
• Monitor head circumference and assess fontanel size: anterior is 2-3 cm, posterior is 1 cm.
• Cephalohematoma indicates deep blood collection not crossing suture lines; caput succedaneum shows superficial swelling crossing suture lines.

Newborn HEENT Assessment

• Ensure facial symmetry to rule out nerve damage from forceps delivery.
• Evaluate eyes for symmetry and size; examine ears for abnormalities due to in-utero development.
• Check nasal patency as infants breathe primarily through their noses.

Newborn Respiratory and Cardiac Assessment

• Normal respiratory rate for newborns: 30-60 breaths per minute.
• Evaluate for common early respiratory issues in the first 12 hours post-birth.
• Heart rate should be between 100-190 bpm with common murmurs in initial days.

Newborn Abdominal and GU Assessment

• Umbilical cord typically contains 2 arteries and 1 vein; umbilical hernia is normal.
• For circumcised infants, clean with a wet cotton ball and apply petroleum jelly.

Newborn Extremities and Neuro Assessment

• Clavicle fractures are a common incidence; perform Barlow and Ortolani tests for hip dysplasia.
• Assess neonatal tone, symmetry, and movement, along with reflexes.

Newborn Skin Assessment

• Monitor for port-wine stains and hemangiomas; refer if near the eye or affecting airway.

When to Call Provider for Newborns

• Rectal temperature above 100°F or 99.5°F if mother is GBS positive.
• Monitor for poor feeding and irritability.
• Look out for breathing difficulties.

Infant Health Promotion and Maintenance

• Anterior fontanel typically closes between 12-18 weeks, posterior between 6-8 weeks.
• Consistency in growth percentiles for weight, length, and head circumference is crucial.
• Recommended immunizations during visits include DTaP, IPV, Hib, PCV, HBV, and rotavirus.

Adolescent Health Maintenance

• For females, pubarche occurs around 11 years; menarche between 9-15 years.
• Males experience a significant increase in muscle mass; gynecomastia may occur but usually resolves.
• Early adolescent challenges include mood swings and body consciousness; emphasize emotional coping strategies.
• Immunizations include TDaP, MCV4, and HPV.

Sexuality and Gender Identity Development

• Early childhood involves confusion about gender and teaching about private parts.
• Middle childhood includes appropriate terminology for body parts and introduction to gender differences.
• Late adolescence focuses on sexual expression and responsibility.

Behavioral Health Disorders

• Anxiety disorders affect 7% of youth; separation anxiety is the most common.
• Generalized anxiety disorder may present as obsessive thought patterns needing cognitive-behavioral therapy.
• Depression in children can manifest as major or adjustment disorders, and safety measures should be prioritized.

Child Maltreatment Types

• Neglect is the most common form of maltreatment and can be physical, emotional, medical, or educational.
• Suspected physical abuse should be reported, especially in non-ambulatory infants with unexplained injuries.

Sleep Disorders

• Signs include snoring, apnea, and night sweats; diagnosed via sleep studies.
• Treatment options may involve surgery or positive airway pressure devices.

Fever in Children

• Fevers above 105°F are often non-infectious. Consider appropriate treatments like amoxicillin for infections within 10 days.
• Chronic rhinosinusitis lasts for 12 weeks or longer, while allergic rhinitis is triggered by IgE-mediated responses.

Throat and Skin Conditions

• Pharyngitis signs include airway patency; Group A Streptococcus requires antibiotics like amoxicillin.
• Impetigo features gold-colored crusts, treated with mupirocin or antibiotics if systemic symptoms are present.

Test your knowledge on key developmental milestones for children from birth to age five, including crucial red flags to watch for. Additionally, assess your understanding of important newborn health promotion strategies and initial assessments. This quiz covers essential information for parents and caregivers.