Week 5 Infant Toddler development PDF

Childhood Growth & Development INFANT/TODDLER Class Objectives 1. Describe the normal growth & development of infants & toddlers, including physical, cognitive and psychosocial health 2. Discuss risks to health, health concerns, health promotion and maintenance from infant to toddler 3. Ident...

Childhood Growth & Development INFANT/TODDLER Class Objectives 1. Describe the normal growth & development of infants & toddlers, including physical, cognitive and psychosocial health 2. Discuss risks to health, health concerns, health promotion and maintenance from infant to toddler 3. Identify appropriate health teaching around safety concerns for parents of children from infancy through to toddlerhood. The Infant – Chapter 16 Milestones – describe general patterns of achievements at various stages Norms vary greatly, but provide expectations for nurses to assess, and initiate referrals Human infants develop in a “Cephalocaudal” direction – top to bottom – gain control of head first and then move downward Infant – Physical Development By 4 months: Lifts head & shoulders when on abdomen Should be able to roll over & reach for objects Moves head, arms & legs when excited By 6 months: Doubles birth weight Sits alone momentarily Pulls to a sitting position Grasps objects By 8 months: Sits steadily alone Holds object with thumb & forefinger Can transfer hand-to-hand  By 10 months: Can walk holding a hand/support Drops toys (intentionally) one at a time Starting the pincer grasp – index finger and thumb to pick things up By 12 months Can stand alone & most can walk 3 steps Can pick up small objects using well-established pincer grasp Attempts to feed self Triples birth weight Infant – Cognitive/Psychosocial Development By 5 months: By 10 months: Talks to self Knows name Recognizes familiar persons Plays simple games Can feed self a cookie By 6 months: Increased interest in the world By 12 months: Babbles & squeals Friendly Cries loudly when interrupted from Wil repeat acts that elicit a response play Recognizes “no no” By 8 months: Shows fear, anger & jealousy Plays pat-a-cake Amuses self for longer periods Reserved with strangers Nutrition At about 6 months, most babies are Can sit up without support, lean forward, ready for solid foods. Along with and have good control of their neck muscles. other foods, you can continue to breastfeed as long as it is Ability to pick up food and try to put it in comfortable for you and your baby, their mouth. even well into the toddler years. Hold food in their mouth without pushing it You’ll know baby is ready to start out with their tongue right away. other foods when they: Show interest in food when others are eating. Open their mouth when they see food coming their way. Can let you know they don’t want food by leaning back or turning their head away. Nutrition -There are many ways to introduce solid food. The first foods usually vary from culture to culture and from family to family. -Healthy foods that the whole family is eating are the best choice. -commercial baby foods can be offered, but read the label to ensure there is no added salt or sugar. -A variety of textures (such as lumpy, tender-cooked and finely minced, puréed, mashed or ground), and soft finger foods are recommended Nutrition Continued First foods - Around 6 months Iron-rich foods Puréed, minced, diced or cooked meat, fish, chicken, tofu, mashed beans, peas or lentils, eggs, iron-fortified infant cereal. After 6 months Grain products Iron-fortified infant cereal, small pieces of dry toast, small plain cereals, whole grain bread pieces, rice and small-sized pasta. Vegetables Puréed, mashed, lumpy or pieces of soft cooked vegetables. Fruit Puréed, mashed or lumpy soft fruit. Pieces of very ripe soft fresh fruit, peeled, seeded and diced or canned fruit (not packed with syrup). Milk products Dairy foods like full-fat yogurt, full-fat grated or cubed pasteurized cheeses, cottage cheese. 9 to 12 months Milk – recommended at 12 months Whole cow’s milk (3.25%) can be introduced if breastmilk is no longer available, between 9-12 months. Continue breast milk or iron-fortified formula until 1 year of age if able Infant – Safety/Basic Care 0-4 Months Put to sleep, on their back, in a crib with a tight-fitting mattress; no pillows, blankets, etc Longer periods of sleep, may sleep through household noises Routine immunizations (2 month & 4 months) Do not leave infant unattended on any surface Car seat safety Infant – Safety/Basic Care 5-8 Months By 8 months, usually takes 2 naps per day Remain with infant at all times when in tub Protect from chewing/biting items with paint, or loose materials (only approved toys) Risk for aspiration if small items are within reach Safety-lock doors on appliances Falls prevention important Infant – Safety/Basic Care 9-12 Months Keep any poisonous/toxic substances/medicines locked away Cover electrical outlets Gate at stairs Suffocation and Drowning, Aspiration Keep doors to appliances closed, If storing appliance, dryers, freezers remove doors Discard inflated balloons, discard Supervise near water, baths, pools Aspiration 25,500 Canadian children aged 14 and under, 1 in every 230 are hospitalized each year for serious injury, most are preventable See sick kids website Can you fit Barbie’s shoes inside a toilet paper roll – then choking hazard. Use approved toys Food offenders for choking are hard fruits, vegetables, popcorn, nuts and slices of hot dog Coins and milk bag corners Falls, Poisoning, Burns Falls Supervise, gates, low mattresses Poisoning Lock cupboards Burns Turn handles, sun protection, cover outlets, flame retardant clothing Toddler – Physical Development Height & weight continue to be plotted on growth chart at each visit Growth slows, compared with infancy & toddler appears leaner Gains 4-6 lb/year Birth weight quadruples by 2 ½ years of age Myelination of the spinal cord is complete by 2 years of age Developmental Milestones 12-16 months 16-18 months Uses cup/spoon Improved self-feeding Builds a tower of 2 blocks Places objects in appropriate shape opening Begins to walk Walks along; can walk backwards 24 months 36 months Builds tower of 6-7 blocks Holds cup by handles & spoon with 2 Turns pages of a book fingers Imitates oral hygiene Can copy a circle Runs, throws a ball & climbs steps Can balance, and hop on one foot Climbs stairs using alternate feet  Toddler – Social/Language/Cognition 12-16 months 16-18 months Imitates adults’ activities & is activity-oriented Parallel play – not interacting; very curious Solitary play Uses symbolic language (bye-bye) Points to familiar objects Uses words; follows simple commands Imitates from memory; realizes cause/effect Classifies objects with function 36 months 24 months Establishes toilet independence – able to say they Increased independence & autonomy are wet Egocentric Identifies sexual roles & imitates parental roles Uses plural words & tells stories Begins to share; may have an imaginary playmate Can hold a conversation & frequently asks why Names familiar objects Can understand one idea/concept at a time Investigates & explores Knows two colors Develops likes & dislikes Toddler – Behaviour Challenges SLEEP ◦ Nightmares may begin One nap/day until end of 2nd year Use rituals at bedtime; set-up for success ◦ Toddlers 2-3 years often attempt to Use of a toy or blanket can ease insecurities delay sleep ◦ Head banging/rocking may be common Use simple explanations re: expectations Use time-out (1 min per year of age) TEMPER TANTRUMS Maintain consistency & positive ◦ Peak around 2 years reinforcement ◦ Occur in response to frustration Use positive rewards, do not criticize TOILET TRAINING Recognize signals of needing to use the ◦ Full physiologic ability for day control toilet ◦ Regression occurs with environmental Restrict fluids at bedtime or social changes (arrival of a sibling, Use clothing the toddler can easily remove moving, divorce) independently Toddler Safety Traffic/Car Safety Toddlers can be impulsive, have increased mobility & are egocentric Teach street safety, traffic rules, supervise at all times Burns Toddlers are curious, and able to reach items better now; can open drawers/cupboards Teach about “hot”; do not allow to handle water faucets; place potentially flammable items out of reach; take care with cooking utensils, hot liquids, bbq, fireplace; teach general fire safety Safety Continued Falls Toddlers like to explore, open doors/windows, have immature depth perception, require supervision Teach how to safely manoeuvre stairs, fasten crib/bed rails properly; stair gates; use window guards; secure in shopping carts & supervise in playground Suffocation/Choking Explores with senses; like to bite on and taste things; Eats on the run Do not allow small children to play with deflated balloons; inspect toys and remove small objects from reach; avoid popcorn, nuts, hot dogs, hard candy & large chunks of meat or bones in fish/chicken