Childhood Growth & Development - Chapter 16

Childhood Growth & Development (Infant/Toddler)

• Class Objectives:
• Describe normal growth and development of infants and toddlers, encompassing physical, cognitive, and psychosocial health.
• Discuss health risks, concerns, and promotion/maintenance from infancy through toddlerhood.
• Identify appropriate health teaching strategies regarding safety for infants and toddlers.

Infant - Chapter 16

• Milestones: Milestones describe general patterns of achievements at various stages. Developmental norms vary greatly but provide expectations for nurses in assessment and referrals.
• Cephalocaudal Development: Infants develop in a cephalocaudal direction (top-to-bottom). Control of the head develops first, followed by other body parts.

Infant - Physical Development

• 4 Months: Lifts head and shoulders while on abdomen, rolls over, reaches for objects, shows movement in head, arms, and legs.
• 6 Months: Doubles birth weight, sits momentarily, pulls to a sitting position, grasps objects.
• 8 Months: Sits steadily alone, grasps object with thumb and forefinger, transfers objects between hands.
• 10 Months: Walks holding support, intentionally drops toys, begins pincer grasp (index finger and thumb).
• 12 Months: Stands alone, walks 3 steps, picks up small objects, attempts self-feeding, triples birth weight.

Infant - Cognitive/Psychosocial Development

• 5 Months: Talks to self, recognizes familiar people.
• 6 Months: Increased interest in the world, babbles and squeals, cries loudly when interrupted.
• 8 Months: Plays pat-a-cake, amuses self, reserved with strangers.
• 10 Months: Knows name, plays simple games, feeds self cookies.
• 12 Months: Friendly, repeats actions for response, recognizes "no-no", displays fear, anger, and jealousy.

Nutrition

• 6 Months: Most babies are ready for solid foods. Look for signs of readiness (sitting without support, controlling neck muscles, ability to hold food in mouth, showing interest in food, etc.).
• Foods: Healthy foods that the whole family is eating are the best choice; introduce a variety of textures and soft finger foods. Read food labels for added sugar/salt. Commercial baby foods are an option but read labels.
• First Foods (Around 6 months): Iron-rich foods like puréed or minced meat, fish, chicken, tofu, mashed vegetables.
• After 6 Months: Grain products (iron-fortified infant cereal, small pieces of dry toast), puréed/mashed vegetables, and soft fruit.

Child Safety/Basic Care (Infants 0-12 Months)

• 0-4 Months: Put to sleep on back, use a firm crib mattress. Do not leave unattended on any surface. Car seat safety.
• 5-8 Months: 2 naps, protect from chewing/biting, risk of aspiration if small items are within reach; safety-lock doors on appliances; fall prevention important.
• 9-12 Months: Keep poisonous/toxic substances locked away; cover electrical outlets; gate at stairs.

Aspiration; Choking Hazards

• Prevention: Keep doors to appliances closed and discard inflated balloons. Supervise near water, baths, pools.
• Food Hazards: Small objects (Barbie shoes in a toilet roll!), hard fruits, vegetables, popcorn, nuts, and hot dog slices are choking hazards. Keep coins and milk bag corners out of reach of babies.

Falls, Poisoning, Burns

• Falls: Supervise, use gates, low mattresses.
• Poisoning: Lock cupboards.
• Burns: Turn handles, sun-protection, cover outlets, flame-retardant clothing.

Toddler - Physical Development

• Height and weight are plotted on growth charts at each visit. Growth slows compared to infancy; toddlers appear leaner. Gains 4-6 lbs per year. Birth weight quadruples by 2.5 years. Myelination of the spinal cord is complete by 2 years.

Toddler - Developmental Milestones (12-36 Months)

• 12-16 Months:* Cup/spoon use, tower of 2 blocks, beginning to walk.
• 16-18 Months:* Improved self-feeding, places objects in correct openings, walks independently (can walk backwards).
• 24 Months:* Tower of 6-7 blocks, turns pages of book, imitates oral hygiene, runs, throws ball, climbs steps.
• 36 Months:* Hangs cup, uses spoon with two fingers, copies a circle, balances, hops, climbs stairs.

Toddler - Social/Language/Cognition

• 12-16 Months:* Imitates adults, solitary play, uses words, follows commands, classifies objects with function.
• 16-18 Months:* Parallel play (not interacting), uses symbolic language, points to objects, imitates (cause/effect).
• 24 Months:* Increased independence, egocentric, uses plural words, tells stories, names objects, investigates, develops likes/dislikes.
• 36 Months:* Toilet independence, identifies gender roles, imitates, begins to share, has imaginary friends, understands more complex concepts (one idea at a time), knows two colors.

Toddler - Behavior Challenges

• Sleep: Nightmares may begin, toddlers (2-3 years) may delay sleep, head banging / rocking common
• Temper Tantrums: Peak around age 2, frustration-related.
• Toilet Training : Full physiologic control for day time, environmental and /or social changes (sibling arrival) may affect toilet training.

Toddler Safety

• Traffic/Car: Impulsive, increased mobility, teach street safety, traffic rules, supervise continuously.
• Burns: Curious, can reach higher; teach about hot things, prevent access to appliances, cooking utensils, hot liquids, open flames.

Safety Continued

• Falls: Open doorways/windows, immature depth perception, supervision required.
• Suffocation/Choking: Explore with senses, do not allow toys with small detachable parts, inspect materials regularly, remove small objects from reach, avoid small food items like popcorn nuts, hard candy etc, watch children eat small foods.

Explore the key milestones and physical development stages of infants and toddlers as outlined in Chapter 16. This quiz covers essential aspects of normal growth, health risks, and developmental norms, providing valuable insights for healthcare professionals working with young children.