Infant Growth and Development Quiz

Theories & Principles of Growth & Development

• All children progress through predictable stages of growth and development.
• Growth and development are continuous processes from conception to death.
• Growth and development proceed in an orderly sequence, but different children progress at varying rates.
• Body systems do not develop at the same rate.
• Development is cephalocaudal (head to tail).
• Development proceeds from proximal to distal body parts.
• Development progresses from gross skills to refined skills.
• There is an optimal time for learning and integration of experiences.
• Neonatal reflexes must disappear before further development occurs.
• Much of skill development results from practice.

Importance of Knowing Growth & Development to the Role of a Nurse

• Health promotion and illness prevention.
• Health restoration and maintenance.

Factors Affecting Growth & Development

Genetic Influences

• Genetic makeup determines a child's potential for growth and development.
• Some considerations include gender.

Gender

• Females are typically born weighing less and being shorter than males.
• Boys tend to be taller and heavier than girls during pre-puberty.
• Girls' growth spurt occurs 6 months to 1 year earlier than boys.
• Males tend to be taller and heavier than females by the end of puberty.

Race and Nationality

• Influences height and weight.

Intelligence

• High intelligence does not correlate with faster physical growth.
• Children with high intelligence may excel academically over physically.

Health

• Chronic illness can hinder growth and development.

Environmental Influences

• Quality of Nutrition
• Socioeconomic Level
• Parent-child Relationship
• Ordinal position in the family
• Health influences (environmental sources)

Types of Play

• Observation: Infants watch others play intently.
• Parallel: Toddlers play alongside others but do not interact with them.
• Associative: Pre-schoolers engage in similar activities with some interaction alongside one another.
• Cooperative: School-aged children engage in structured play with a goal or objective.
• Independent: Children of all ages engage in play independently.

Family with an Infant

• Physical Growth: Physiologic changes in the infant year reflect increased maturity and organ growth.
• Weight: Most infants double their birth weight by 4-6 months and triple it within a year.
• Height: Infants increase in height by 50% or 20-30 inches during the first year.
• Head Circumference: Increases rapidly reflecting brain growth, reaching 2/3 of adult size by the first year. Sometimes, brains may be asymmetric initially due to sleeping position.

Body Systems

• Cardiovascular: Heart rate slows from 120-160 to 100-120 by the end of the first year; pulse rate can slow with respiration; blood pressure may be slightly elevated.
• Circulatory: Physiologic anemia is common 2-3 months.
• Respiratory: Respiration slows from 30-60 breaths/min to 30 breaths/min by the end of the first year.
• Gastrointestinal: Digestive system is immature at birth; the ability to digest proteins is present at birth; levels of amylase and lipase are lacking initially until closer to 3 months old.
• Liver: Remains immature which can affect conjugation of drugs.
• Kidneys: Immature; not as efficient as in adults - less efficient waste disposal.
• Endocrine: Response is immature to some pituitary hormones, potentially affecting production of insulin by the pancreas.
• Immune: Becomes functional after 2 months. Produces antibodies, but others are not plentiful until preschool age.

Teeth

• First baby tooth typically erupts at 6 months, one monthly thereafter.
• Some newborns are born with teeth.
• Deciduous teeth are essential for arch growth and protection.

Motor Development

• Cephalocaudal development (head to toe) and gross to fine motor control develops in a progressive, predictable sequence.
• Infants should be evaluated along two major aspects:
  • Gross motor development (large body movements).
  • Fine motor development (coordination and prehensile ability).
• Evaluation can occur through observing/testing:
  • Ventral suspension.
  • Prone.
  • Sitting.
  • Standing.

Language Development

• Infants typically start making small cooing sounds from 1 month.
• Cry differentiation (e.g., hungry, wet) can happen by 2 months.
• Responding to faces (smiling, nodding) occurs closer to 3 months.
• Laughs are common by 4 months.
• Simple vowel sounds emerge by 5 months.
• Imitating sounds begins between 6-7 months.
• First words are often da/da and bye/bye by 9-10 months.
• Two-word phrases are a milestone at 12 months.

Play

• Infants enjoy watching mobiles over their cribs, which should be black and white or brightly colored.
• They spend time observing people around them.
• Handling small blocks or rattles happens by 3 months.
• Playpens or floor space is beneficial for 4 month old infants as they exercise developing skills.
• Toddlers are open-minded as they are curious about different items and start interacting through play.
• Toddlers develop their cognitive and social skills alongside their exploration of various toys and environments.

Developmental Milestones

• The text summarizes various stages and milestones for infants, including physical, cognitive, language, and emotional development.

Family With a Toddler (1-3 Years)

• Physical Growth: Physical growth slows down.
• Weight, Height, Head Circumference: Growth slows slightly; additional weight gain is roughly 5-6 lbs per year.
• Body Contour: Abdominal muscles are weak; toddlers have prominent abdomens.
• Nutritional Needs: Appetite may decrease, but nutritional intake is crucial.
• Head Circumference: Increases slightly.
• General Development: Children develop greater independence in their physical and mental abilities; they start to interact with others better and develop further understanding, potentially including ideas about gender distinctions; they start to explore the potential of their own abilities and how they can physically alter their environment.

Toddler Body Systems

• Respiratory: Lungs enlarge; Respiratory infections less common. Stomach acid increases; stomach capacity increases.
• Brain: About 90% of adult size in brain development.
• Other Systems: Control of urinary and anal sphincter development.

Toddler Cognitive Development

• Sensorimotor Development: Toddlers continue to develop through sensory motor processes (between 12-18 months), and have a growing interest in discovering new ways to handle and interact with various objects.
• Object Permanence: Develops well before the end of the toddler period, when they have an understanding that objects still exist even when out of sight.
• Preoperational Thought: At the end of the toddlerhood period, cognitive development enters the preoperational thought stage; they experiment with using symbols to solve problems and begin exhibiting behaviors and actions that may be considered "creative" in nature.

Nursing Role in Toddler Health Promotion

• Safety: Watch out for accidental ingestions, falls, and play injuries.
• Educate on safe practices for toddlers in various settings.
• Appropriate toy selection and interaction guidance.
• Dietary: Promote nutritional intake through education and appropriate diet selection.

Toilet Training

• Toilet training is a significant task for toddlers.
• This process requires cognitive understanding and physical readiness.
• Physical readiness is typically followed by the toddlers desire to take pride in the accomplishment; this is a step that can easily be undermined by parental oversight or expectation.
• Nurses can support families by guiding them towards a productive toilet training regimen.

Parental Concerns (Toddlers)

• Toilet Training: Challenges in toilet training and support for parents.
• Behaviors: Discussion of ritualistic behaviors, discipline strategies, separation anxiety, and temper tantrums in toddlers.
• Health Considerations: Include additional items for physically challenged or ill toddlers to gain a sense of autonomy.