Podcast
Questions and Answers
What was the overall cesarean section (CS) rate in Türkiye between 2018 and 2023?
What was the overall cesarean section (CS) rate in Türkiye between 2018 and 2023?
Which of the following methods is NOT mentioned as part of unmedicated delivery?
Which of the following methods is NOT mentioned as part of unmedicated delivery?
Approximately what percentage of women choose pain relief during labor?
Approximately what percentage of women choose pain relief during labor?
Which of the following is a common cause of neonatal jaundice?
Which of the following is a common cause of neonatal jaundice?
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What does the Apgar Scale assess in newborns?
What does the Apgar Scale assess in newborns?
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Which of the following states is characterized by the infant's eyes being closed and breathing being regular?
Which of the following states is characterized by the infant's eyes being closed and breathing being regular?
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Which of the following is NOT a childbirth complication listed?
Which of the following is NOT a childbirth complication listed?
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What is the average weight of a neonate at birth?
What is the average weight of a neonate at birth?
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Which screening test helps detect disorders such as PKU and galactosemia?
Which screening test helps detect disorders such as PKU and galactosemia?
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How is low birth weight defined?
How is low birth weight defined?
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What preference do 6-day-old infants display regarding odor?
What preference do 6-day-old infants display regarding odor?
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At what age do most children master the skill of rolling over?
At what age do most children master the skill of rolling over?
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Which motor skill is typically mastered closest to the age of 14 months?
Which motor skill is typically mastered closest to the age of 14 months?
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Which of the following statements about the sense of sight in infants is true?
Which of the following statements about the sense of sight in infants is true?
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What does the Denver Developmental Screening Test primarily assess?
What does the Denver Developmental Screening Test primarily assess?
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What significant development occurs around 6 months of age when infants approach a ledge?
What significant development occurs around 6 months of age when infants approach a ledge?
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Which scenario best describes the concept of Dynamic Systems Theory in development?
Which scenario best describes the concept of Dynamic Systems Theory in development?
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At what age do most infants start to show an ability to distinguish new speech sounds from those they have already heard?
At what age do most infants start to show an ability to distinguish new speech sounds from those they have already heard?
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What significant change has been observed in childbirth practices in developed countries over the years?
What significant change has been observed in childbirth practices in developed countries over the years?
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During which stage of childbirth does the cervix dilate?
During which stage of childbirth does the cervix dilate?
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What term is used to describe the process of labor beginning?
What term is used to describe the process of labor beginning?
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What is the typical duration of the second stage of vaginal childbirth?
What is the typical duration of the second stage of vaginal childbirth?
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What has led to an increase in cesarean delivery rates among mothers?
What has led to an increase in cesarean delivery rates among mothers?
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What is often included in birthing centers and modern hospitals to enhance the childbirth experience?
What is often included in birthing centers and modern hospitals to enhance the childbirth experience?
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What factors are identified as influencing the overall health and survival chances of newborn infants?
What factors are identified as influencing the overall health and survival chances of newborn infants?
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Which of the following is NOT typically a complication associated with childbirth?
Which of the following is NOT typically a complication associated with childbirth?
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Which statement regarding the outcomes of cesarean births in Turkey is true?
Which statement regarding the outcomes of cesarean births in Turkey is true?
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What is a common reason for opting for a cesarean section during labor?
What is a common reason for opting for a cesarean section during labor?
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What is considered very low birth weight?
What is considered very low birth weight?
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Which of the following is NOT a risk factor for low birth weight?
Which of the following is NOT a risk factor for low birth weight?
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What is a common immediate treatment for a premature infant?
What is a common immediate treatment for a premature infant?
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What long-term outcome is associated with low birth weight?
What long-term outcome is associated with low birth weight?
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What is defined as the death of a fetus at or after the 20th week of gestation?
What is defined as the death of a fetus at or after the 20th week of gestation?
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Which factor is NOT mentioned as protective for child development?
Which factor is NOT mentioned as protective for child development?
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What is a primary cause of death during infancy worldwide?
What is a primary cause of death during infancy worldwide?
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What is the effect of breast milk on cognitive performance compared to formula feeding?
What is the effect of breast milk on cognitive performance compared to formula feeding?
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What characteristic of brain neurons is associated with sending and receiving information?
What characteristic of brain neurons is associated with sending and receiving information?
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Which reflex is present at birth and typically disappears by two months of age?
Which reflex is present at birth and typically disappears by two months of age?
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Which of the following is a sensory capability that begins to develop in the womb?
Which of the following is a sensory capability that begins to develop in the womb?
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What is the percentage of infants in Turkey classified as overweight?
What is the percentage of infants in Turkey classified as overweight?
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What is a common misconception about vaccines?
What is a common misconception about vaccines?
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Which factor contributes to greater risks during infancy?
Which factor contributes to greater risks during infancy?
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Study Notes
Birth and Physical Development during the First Three Years
- Childbirth has changed in developed countries.
- Labor begins, including three stages, and alternative delivery methods exist.
- Newborn infants adjust to life outside the womb; methods for assessing normal development.
- Childbirth complications that endanger newborns and their outcomes.
- Factors affecting baby's survival and health.
- Brain and sensory development.
- Early milestones in motor development and influencing factors.
Generations of Childbirth Customs
- Pre-20th Century: Childbirth was a modest, female-only ritual, midwives were common, and death rates were high for both mothers and babies. One in four babies died in their first year.
- Modern Generations: Death rates have dramatically decreased due to antibiotics and prenatal care.
Humanizing Childbirth
- Home births offer more intimacy.
- Birthing centers and hospitals provide a more intimate environment, with soft lights, a supportive father/partner, and baby stays in the room.
Birth Process
- Parturition brings on labor, typically two weeks before delivery.
- Uterine contractions lead to the cervix becoming flexible.
- Estrogen levels stimulate these changes.
Three Stages of Vaginal Childbirth
- First stage: Longest, typically 12-14 hours for first child; the cervix dilates.
- Second stage: 1-2 hours; contractions intensify , and the baby's head moves through the birth canal; concludes with baby emerging.
- Third stage: 10-60 minutes; the placenta and umbilical cord are expelled.
Cesarean Delivery
- Surgically removing a baby from the uterus through the abdomen.
- 57% of births in Turkey
- 17% worldwide
- Often used when labor progress is slow or is obstructed.
- Common with: First and/or large babies, older mothers, previous C-sections
Trabzon State Hospital Turkey 2023 Data
- Includes detailed birth data for each month of 2023 for Trabzon State Hospital, showing total births, normal births, C-section births, C-section rates, and primary C-section rates
Cesarean Section Rates in Türkiye 2018-2023
- This is higher than the WHO 10-15% acceptable rate
- National data analysis using the Robson Ten Group Classification system revealed CS rates rising over the years.
- Data analysis and possible measures against increasing rates are being discussed, with a total birth count (2018-2023) of 6,161,976 and an overall CS rate of 57.55%.
Unmedicated Delivery
- Natural childbirth: Mothers receive training in fitness, breathing, and relaxation techniques.
- Traditional cultures: Experienced helpers, often called doulas, offer emotional support during labor.
- Prepared childbirth (e.g., Lamaze): The emphasis is on using techniques to manage pain during labor.
Medicated Deliveries
- Local or regional anesthesia: Blocks pain receptors in the brain but may have complications
- Relaxing analgesics; commonly used for pain relief.
- Approximately 60% of women opt for pain relief.
Size and Appearance of the Newborn
- Average newborn is 50.8 cm long and 3.4 kg.
- Fontanels are soft plates on the head.
- Lanugo is fuzzy prenatal hair.
- Vernix caseosa is an oily protection against infection.
Body Systems of the Newborn
- Breathing problems (anoxia or hypoxia): These challenges can lead to birth trauma.
- Meconium: Stringy waste in the fetal intestine.
- Neonatal Jaundice: Yellowing of skin and eyeballs; often caused by liver immaturity; usually does not require treatment,
Assessments: Apgar Scale
- Used to assess a baby's condition immediately after birth.
- Assesses appearance, pulse, grimace (reflexes), activity, and respiration.
- Numerical values (0, 1, or 2) are given to each category.
Assessments: Brazelton NBAS
- Assesses responses to physical and social environments.
- Includes motor organization, reflexes, attention/interactive capacity, and CNS stability
Neonatal Screening Tests
- Detects correctable disorders.
- Includes PKU, galactosemia, and hypothyroidism.
Infant Arousal States
- Described by levels of eye openness, breathing patterns, and body movements during different stages of wakefulness and sleep.
Childbirth Complications
- Birth trauma
- Postmaturity
- Prematurity
- Low birth weight
Low Birthweight
- Weighing less than 2.5 kg is considered low birthweight.
- Very low birthweight is less than 1.6 kg; this occurs in 15.5% of all births, predominantly in developing countries.
- This is a leading cause of infant death, often after birth defects
Maternal Traits That Increase Risk of Low Birth Weight
- Underage or older mothers.
- Low education and poverty
- Poor nutrition
- Smoking and alcohol use
- Stress
- Infections
Immediate Treatment for Prematurity
- Intravenous feeding.
- Surfactant.
- Isolette (controlled environment).
- Kangaroo care.
Long-Term Outcomes of Low Birth Weight
- Higher risk of neurological and cognitive impairment.
- Lower academic achievement.
- Social, behavioral, and attention problems
Postmaturity & Stillbirth
- Postmature (gestational age over 42 weeks).
- Stillbirth is the death of a fetus after the 20th week of pregnancy.
- Fetal monitoring may contribute to reduction in the rate of postmaturity births .
Overcoming Birth Complications
- Higher family socioeconomic status (SES).
- Quality early environment.
- Educational day care.
- Educating parents about children's health.
Protective Factors for Development
- Individual traits like sociability, intelligence.
- Supportive adults in the child's life.
- A sense of meaning or purpose in the child's life, such as academic or job success.
Death during Infancy
- Primary causes globally: Preterm delivery, sepsis/pneumonia, and asphyxia at birth
- Infant deaths in the first year; in Turkey 7.6%; in high-income countries 5.3%.
- Turkey infant death rates are associated with lack of education, poor nutrition, and poor environmental conditions.
SIDS (Sudden Infant Death Syndrome)
- "Crib death."
- Sudden death of an infant under one year.
- Causes are unexplained.
- Underlying biological defects (e.g., heart gene mutations) may be possible.
- Sleeping position (on the stomach) may be correlated with SIDS incidence.
Deaths from Injuries
- 90% of injury deaths in infancy are due to suffocation, motor vehicle accidents, drowning, and residential fires/burns.
Immunizations
- Vaccination rates are about 90% for children.
- Vaccination efficacy varies regionally.
- No causal link has been found between vaccines and autism or other disorders.
Proportions of Physical Growth
- Illustrative diagram of changing body proportions from fetal age to around 25 years.
Nutrition: Breastfeeding
- Breast milk is generally considered the best food for infants.
- Easier to digest, reduces allergic reactions, minimizes infections, may lower SIDS risk, and promotes better cognitive development.
- Recommendation: Exclusively breastfeed for 6 months.
Bottle Feeding
- Formula should have iron added.
- Necessary for mothers with infectious illnesses.
- Does not reduce the emotional bond between mother and baby.
other Nutritional Concerns
- Solid foods are introduced into infant diets during the second half of the first year.
- Malnutrition is still a concern.
- Overweight is a significant concern, especially in Turkey, with 8.5% of infants overweight, parental obesity is a strong predictor.
Parts of the Brain
- Diagram showing brain development over time from fetal ages to adulthood.
Brain Cells
- Neurons send and receive information.
- Glial cells nourish and protect neurons.
- Neurotransmitters are chemical messengers.
- Myelination helps in quicker signal transmission.
Neuronal Growth: Two Processes
- Integration: Neurons controlling muscle groups are integrated.
- Differentiation: Each neuron takes on a specialized function.
Reflexes: Unlearned & Protective Behaviors
- Postural reflexes: Adapt to changes in posture or balance
- Locomotor reflexes: Mimic future voluntary movements like walking and swimming reflexes
Early Human Reflexes
- List of notable infant reflexes (Moro, Darwinian (grasping), Tonic, Rooting, Babkin, and Babinski) and their triggering videos.
Babies Reflexes
- Table displaying reflexes and the age at which they typically appear and disappear.
Role of Experience in Brain Development
- Postnatal brain development is highly influenced by experiences.
- Brain plasticity: The brain adapts to new experiences .
- Threats like sensory deprivation, malnutrition .
- Corrective experiences can mitigate past negative impacts, such as deprivation.
Early Senses of Touch & Pain
- Touch is one of the first senses to develop.
- Rooting reflex demonstrates early touch sensitivity.
- Newborns experience pain at birth.
Early Senses of Smell & Taste
- Smell and taste development begins while in the womb.
- Newborns show preferences for sweet tastes.
- Fluids and odors can be transmitted through the amniotic sac.
Nature vs. Nurture?
- Odor preference demonstrates a role for experience; 6-day-old infants prefer their mother's scent over others.
- Certain tastes are innate behaviors; sweetened water calms newborn cries irrespective of maturity.
Sense of Hearing
- Hearing is functional before birth.
- 3-day-old infants can recognize new speech sounds compared to those already heard.
Sense of Sight
- Sight is the least developed sense at birth; 20/20 vision develops by 6 months.
- Binocular vision, crucial for depth perception, develops around 4.5 months.
Milestones of Motor Development
- Table of motor skills and the ages at which they are mastered by 90% of children.
Baby Milestones- Motor Developments
- Video links related to motor development.
Denver Developmental Screening Test
- Test for gross and fine motor skills
- "Average" categories: head control, hand control, locomotion.
The Visual Cliff
- Do infants perceive depth?
- 6-month-old infants avoid the "dropoff' of a 'visual cliff', showing depth perception!
- YouTube link about this
Dynamic Systems Theory
- Learning occurs through the environment.
- Children use their experience to interpret the world around them.
- Examples of the theory using the environment.
Cultural Influences on Motor Development
- Cultural norms influence motor development rates.
- African and West Indian cultures tend to actively promote early motor abilities.
- Various cultures have different approaches to encouraging and limiting babies' early mobility.
Research in Action: Autism
- Brain disorder: Autism spectrum disorder is a neurological developmental disorder characterized by persistent impairments in social communication, interaction, and restricted repetitive patterns of behavior, interests, or activities.
- This has associated disorders.
CDC Rates for Autism
- Data on prevalence and reporting of autism rates over different years (2014-Present).
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