Untitled Quiz

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).