NSC305 Maternal and Child Health Nursing and Family Planning I Lecture Notes PDF

NSC305- Maternal and Child Health Nursing and Family Planning I Growth and Development of the child BY Dr Elizabeth joseph-shehu  Topic Outline  The child as an individual  Stages of Normal growth and development  Positive factors in child gro...

NSC305- Maternal and Child Health Nursing and Family Planning I Growth and Development of the child BY Dr Elizabeth joseph-shehu  Topic Outline  The child as an individual  Stages of Normal growth and development  Positive factors in child growth and development  Physical, social, psychological, nutritional and clothing need  objectives 1 2 3 4 Describe the Discuss the Discuss the Explain the child as an stages of positive factors physical, social, individual Normal growth in child growth psychological, and and nutritional and development development clothing need  The child as an individual No two children are alike: physically, Uniqueness of a child emotionally, socially and intellectually There are common needs and characteristics that Children individuality children of a https://www.hear-it.org/sites/default/files/styles/node_full_view/public/Hear- it-Children-An_Individual-Each_child_is_an_individual.jpg?itok=zgQ8-0i4 must be respected. particular age or stage of development share  Benefits of treating every child as an individual  Help to develop their personalities, talents and abilities irrespective of ethnicity, culture or religion, home language, family background, learning difficulties, disabilities or gender.  Helps adults to understand and support each individual child’s development pathway  Make the child responsible for his/her actions, giving the child independence so many seek, typically acting out as teenager while trying to assert his independence. Listen to your advice and reasoning and take the more responsible choice  Benefits of treating every child as an individual  Babies and children are vulnerable and become resilient and confident if they have support from others, also receive the chance to learn about other cultures and develop critical socialization skills that will serve them well.  Designing an environment that positively influencing all areas of children’s development: physical, social /emotional, and cognitive.  Benefits of treating every child as an individual  Language and learning are nurtured in an environment that values and plans appropriate opportunities which can support the development of behaviours that are valued in our society, such as cooperation and persistence.  Help children and youth become full participating citizens of society and help to build a sense of community  Benefits of treating every child as an individual  Language and learning are nurtured in an environment that values and plans appropriate opportunities which can support the development of behaviours that are valued in our society, such as cooperation and persistence.  Help children and youth become full participating citizens of society and help to build a sense of community  Normal growth and development  Introduction  The period of growth & Development extends through life cycle, but the period of principal changes is from conception to the end of adolescence.  It is important for the Nurses to understand the total life cycle of individuals in order to understand the behaviour of children and their mothers.  objectives  Describe terms relevant to growth and development  Understand the important of growth and development monitoring of a child.  Explain the general principles of development  Describe the stages of normal growth and development  Describe the developmental milestone of children  Terms relevant to growth and development  Growth: Can be described as an increase in size (weight & height) which facilitates a more effective functioning.  Development: Increase in complexity which demands improvement in skill and functional capacity – ability to provide progressively for greater – capacity in functioning.  Development can be achieved through three main processes Maturation, Adaptation and learning.  Terms relevant to growth and development  Maturation: This is a qualitative change not induced by learning or experience, but it comes about as a result of mere passage of time. It is simply a process of ripening.  Adaptation: This is the result of body’s accommodation or adjustment to meet its environmental needs.  Learning: Acquiring of knowledge through experience. A relative permanent change in behaviour resulting from experience,  Terms relevant to growth and development  This change is induced by interaction with the environment. The ability to learn is highly dependent upon the unborn capacity for mental development.  In contrast, learning is externally oriented while maturation is internally oriented.  The change in behaviour in a child follows pattern of stages: sitting, crawling, and standing, walking and running. Maturation and learning are interrelated.  Child Development  Physical Development: This deals with physical and physiological characteristics of an individual.  Social Development: Deals with the development of the awareness of one in relation to others and interactional style of the child at home, in the school and among his age group i.e. peer group.  Emotional Development: This deals with the development of affection and cognition of the child.  The individual is an entity, a whole: any malfunction in one area may therefore affect the other areas e.g. a physical defect may cause social or emotional problems.  General Principle of Development Principle of the Direction of Growth  Cephalo –Caudal: Follows the spine downwards Growth proceeds from the head to the other part of the body. E.g the brain attains 70% of it’s growth by the age of 2 years – Parent should provide adequate stimulation from infancy. To stimulate visual perception, toys of bright objects should be presented to the baby from the first week of life.  General Principle of Development Principle of the Direction of Growth  Proximo-distal: States that growth proceeds out from the central axis of the body e.g the trunk develops before the buds (i.e. arms and legs). As the child matures general movement becomes specific, for example he uses the whole hand first before picking up small object with pincer grasp (i.e. between thumb and forefinger).  General Principle of Development Principle of the Direction of Growth Child should be given opportunity for learning by either experience or instruction when he is ready to acquire the skill or by direct experience through instruction from others.  General Principle of Development Principle of Differentiation:  This stipulates that growth proceeds from simple to complex,  from homogeneous to heterogeneous  and from general to specific e.g. fertilization starts from a single cell to trillions of cells that form human body.  General Principle of Development Principle of Asynchronous Growth  This emphasis that development shift from one part to another at different times.  That means the various parts of the body do not grow simultaneously.  When focus of growth is on one particular part the other parts rest.  e.g. at conception placental develops before the fetus.  General Principle of Development Principle of Discontinuity  This principle of Growth rate states that the rate of growth changes at different periods  e.g. there is accelerated growth from birth to 2 years, then slows down until 10 years when adolescent growth takes over. Principle of complexity of Growth  Growth is a complex process and interwoven e.g. physical impairment is likely to cause emotional and social problems  General Principle of Development Principle of uniqueness of the individual  Each individual is a unique entity with its quality.  NO two people are the same even identical twins are not exactly the same. Principle of the modifiability of the Rate pattern of Growth.  This states that growth although is innate, and the urge to grow is very strong, some factors can modify growth.  factors that can modify growth Genetic Accident:  Genetic abnormality can cause genetic impairment such as albinism and mental retardation. Interference with fetal Development:  Accident or falls during pregnancy may result in fetal abnormalities.  Diseases such as German measles or high fever exposure to radiation before 34 weeks.  Poor nutrition slows down rate of growth and poor brain development  factors that can modify growth Environmental Influence:  If a child develops where there is a poor or no mental stimulation it will lead to retarded intellectual development.  The first 6 years of life is critical in the development of intellect. Parent should therefore provide necessary stimulation for their children. Emotional Growth of the child:  If a child is raised in an emotionally tense environment where there is frequent marital disorder, display of hostility and aggression, the child could develop emotional problems.  He could be aggressive or withdrawn.  Separation ofchild from the mother before five years could affect the child’s emotional development.  Understanding Language  Children learn to understand language before they speak. Language development starts with the cry at birth.  At 12 months – Baby can use 3-4 words.  At 18 months – 3-4 year his vocabulary increase rapidly.  At 2 years –Baby can use 272 – 300 words.  At 3 years – 800, 1,000 words, 80% legible.  Normal growth and development of infant from birth to 1 year 1 month  Weight gain – steady weight gain.  Height – Increase of 2.5cm is expected in the first 6 month.  May lift head up intermittently, cannot hold head up; can turn head side to side.  Posture at birth is face down and can lie on its stomach.  Stare indefinitely at his surrounding notices face and bright objects. Smiles indefinitely and cries when  Normal growth and development of infant from birth to 1 year 2 months  Posterior fontanelle closes, raises his chest up with arms, can hold head erect in mid-position.  Can follow a moving light or object with is eyes. Begins social behaviour – smile in response to another’s smile.  Learnt that he gets something from cry, sound of cry varies with the reason for crying.e.g. sleep, pain, hunger etc.  Normal growth and development of infant from birth to 1 year 3 months  Hold hands up in front of him and plays with fingers and hands.  Hold head erect and steady.  Lies on his back.  Shows awareness of presence of people.  Laugh aloud and shows pleasure in making sounds.  Cries less, smiles in response to mother’s face.  Normal growth and development of infant from birth to 1 year 4-5 months  Increasing aware of his surroundings,  Gasps object with the whole hand and carries it to mouth  (Proximodistal principle) can hold head steadily.  Can sit without support. Drools with saliva running down his mouth.  Becomes more talkative and respond to name, recognizing strange look and places.  Normal growth and development of infant from birth to 1 year 6 – 7 months  Teeth starts to appear (lower 2 incisor) grasp with flexion of fingers.  Hold leg and put in the mouth.  Balances well by leaning forward slightly on one or both hands.  Moves backwards in a sitting position by using his hands to push.  Begins to make sound like Ba, Da, Ma, Ta Bounces actively when held in upright position.  There is emotional instability by changing from laughing to crying and visa versa.  Doubles birth weight.  There is indiscriminate social attachment. Not attached to any particular person.  Normal growth and development of infant from birth to 1 year 8-9 months  Sit alone steadily.  Stand with help at 8 months holding furniture by 9 months.  There is perfect co-ordination of hand and eyes.  Shows first fear reaction to strangers.  Greets strangers by turning away and crying and may not stop crying until he sees familiar face.  Normal growth and development of infant from birth to 1 year 8-9 months  Affection or love of family group appears, increase interest in activities.  Can put nipple in and out of the mouth at will,  Crawl with the trunks above the floor stand supported.  May triple the birth weight.  Normal growth and development of infant from birth to 1 year 10-12 months  Stands by holding on to something, as support.  Stand alone unsupported.  Walk with help, can hold crayon or pencil, to make strokes and marks on a piece of paper.  Participates in dressing/can say two words – Mama, Dada, Baba, and Tata, knows his own name.  Recognizes meaning of “NO”, egocentric, concern only with himself, can climb stairs steps by 13  Normal growth and development of infant from birth to 1 year 13-15 months  can walk alone.  This is however not strictly by all children  Nigerian children have been found to be faster in locomotion – sit unsupported by 5-6 months and walk by 10 months.  Generally African children are trained by siblings and parents.  After 1 year of age the weight and height do not give accurate information about growth because of several factors. Stages of Normal growth and development  FIVE Stages of Normal growth and development NEWBORN  Soon after birth, an infant normally loses about 5% to 10% of their birth weight.  By about age 2 weeks, an infant should start to gain weight and grow quickly.  During the first month of life, newborns exhibit automatic responses to external stimuli.  In other words, a newborn will turn her head toward your hand when you stroke her cheek or grab your finger when you place it in her hand.  A newborn is able to see close-up objects, recognize certain smells, smile or cry to indicate a need, and move her head from side to  FIVE Stages of Normal growth and development INFANT  Infants develop new abilities quickly in the first year of life.  At three to six months, an infant can control his head movements and bring his hands together.  By six to nine months old, an infant can sit without support, babble and respond to his name.  Between nine and twelve months old, a baby can pick up objects, crawl and even stand with support.  By age 4 to 6 months, an infant's weight should be double their birth weight.  During the second half of the first year of life, growth is not as rapid.  FIVE Stages of Normal growth and development TODDLER  As children reach the ages between one and three years, toddlers learn to walk without help, climb stairs and jump in place.  They can hold a crayon, draw a circle, stack one block on top of another, use short sentences and even follow simple instructions.  Between ages 1 and 2, a toddler will gain only about 5 pounds (2.2 kilograms).  Weight gain will remain at about 5 pounds (2.2 kilograms) per year between ages 2 to 5  FIVE Stages of Normal growth and development PRESCHOOL  Between the ages of three and five years, children refine their motor skills.  They can throw a ball overhand, skip and hop, stand on one foot for ten seconds or longer, dress themselves, and draw a person with features.  FIVE Stages of Normal growth and development SCHOOL AGE  School age children are six to 12 years old.  They are capable, confident, independent and responsible.  Peer relationships, particularly relationships with friends of the same gender, are important to school age children.  The older school age child begins to develop sexual characteristics.