Newborn & Infancy PDF

👶🏻 Newborn & Infancy Reviewed Category Developmental Objectives: Newborn To describe (i) developmental tasks, (ii) impact of birth of a baby on family, (iii) characteristics of premature at-risk newborns, (iv) challenges of premature Infancy To describe (i) developmental tasks of infants, (ii) maj...

👶🏻 Newborn & Infancy Reviewed Category Developmental Objectives: Newborn To describe (i) developmental tasks, (ii) impact of birth of a baby on family, (iii) characteristics of premature at-risk newborns, (iv) challenges of premature Infancy To describe (i) developmental tasks of infants, (ii) major behavioural milestones of each period of infancy, (iii) interaction between domains of performance, (iv) why developmental sequence is important for OTs 💡 Infant → 37 weeks or more in gestational age Motor behaviours Highly predictable actions As OTs, we need to learn how to intervene in therapeutic situations Neonatal reflexes (typically disappears after 1 y/o) Reflex Presentation Rooting Stroke the baby’s cheeks & baby will turn & start sucking Stepping Precursor to walking Babinski Stroke bottom of foot & toes will curl open Newborn & Infancy 1 Grasping Close their hands when an object is in their palms Moro Throw arms out & open when startled Asymmetrical Tonic Neck Stroke one side of the neck, arm on that side will extend while other arm bent towards the body (”fencing posture”) Permanent reflexes Breathing Eye blink Papillary → closing eyes when exposed to bright light Swallowing Activity & Participation Entrainment → mother & infant social exchange Communication Environment & family issues → engrossment → sense of absorption & preoccupation fathers have in the newborn Occupations of infants Rest → sleep 16-17 hours/day Feeding → breast feeding VS bottle feeding (demand & supply theory) “Self” care → bath, toileting/diaper changing Things to look out for in Singapore context Environment Practice of confinement in the first month & use of confinement lady Conflict between multiple caregivers that are related to newborn’s occupations such as breastfeeding, sleep, bath Family-centred practice Post-natal depression Transitioning of parents into parental role Having siblings Newborn & Infancy 2 Developmental milestones Birth to 3 months Antigravity behaviour in prone Fine motor → reflexive palmar grasp, reaching when visually triggered (wave arms) Oral motor reflexes (bite, gag, suck-swallow, rooting) Cognitive-language → crying, cooing, gurgling, nervous system is shaped by environmental experience (synaptic pruning) Personal social development → smile, imitate gestures in their repertoire (e.g. sticking out tongue), engage in reciprocal exchange with caregivers Chess & Thomas temperament dimensions (easy, difficult & slow to warm up) Newborn & Infancy 3 4 to 6 months Fine motor → palmar grasp with ulnar side of the hand bias, visually guided reaching & pattern of raking Oral motor → first spoon feeding & appearance of first teeth Cognitive-language → bisyllabic sounds develop, secondary circular reactions & object permanence Personal-social → interactive & enjoys social exchange, laughs & squeals Newborn & Infancy 4 7 to 9 months Gross motor → commando crawls, translate body through space on belly & experiments with quadruped, sitting erect with hands free & ability for free play Fine motor → grasp continues to be refined, scissors grasp Oral motor → spoon feeding is more proficient, first solids, holds cookies & self-feeds Cognitive-language → babbling many sounds, begin to manipulate objects, object permanence is secure, begin to show negative affect around strangers Personal-social → separation protest, infant becomes and “emotional being” Newborn & Infancy 5 10 to 12 months Gross motor → pulling to stand, pre-walking (pull to stand, cruising, walks with two hands held & stands briefly), toddling Fine motor → pincer grasp, resisted release & flinging Oral motor → drinks from sippy cup, self-feeding Cognitive-language → true words, object permanence is secure Personal-social → stranger anxiety, characteristics of attachment types (secure, avoidant & ambivalent) Newborn & Infancy 6 Newborn & Infancy 7 At-risk infant Types of risk Biologic risk (e.g. mother’s disability, drug use, maternal age) Environmental risk (e.g. low SES, inadequate parental caregiving, teenage pregnancy) Substance abuse → alcohol, drugs etc. can lead to higher levels of mortality & morbidity Small for gestational age (SGA) → infants born at less than 10th percentile for weight HIV exposure → from mother to infant through placental circulation; infant will have a high probability developing full blown paediatric AIDS in the first 2 years of life Premature infants Born before 37 weeks of gestation Social effect → parents may experience issues with anticipatory grief (when parents are afraid infant will not survive) or problems with efficacy as a parent Newborn & Infancy 8 Characteristics: Physiologic immaturity → development of lungs in the last postnatal trimester enables infant to breathe independently at term brith → premature infants can get respiratory distress syndrome (RDS) Newborn & Infancy 9