Birth and Physical Development PDF

Birth and Physical Development during the First Three Years Chapter 4 Guideposts for Study l How has childbirth changed in developed countries? l How does labor begin, what happens during each of the three stages, and what alternative methods of delivery are availab...

Birth and Physical Development during the First Three Years Chapter 4 Guideposts for Study l How has childbirth changed in developed countries? l How does labor begin, what happens during each of the three stages, and what alternative methods of delivery are available? l How do newborn infants adjust to life outside the womb, and how can we tell if a new baby is developing normally? l What complications of childbirth can endanger newborn babies, and what are the prospects for infants with complicated births? © 2012 by the McGraw-Hill Companies, Inc Guideposts for Study l What factors affect babies’ chances of survival and health? l What influences growth, and how do the brain and the senses develop? l What are the early milestones in motor development, and what are some influences on motor development? © 2012 by the McGraw-Hill Companies, Inc  Generations of Childbirth Customs l Pre 20th Century: – Birthing was a modest “female only” ritual – Use of midwives was predominant – Death rates high for mother and baby – One out of four babies died in first year l Modern Generations: Dramatic reductions in death rate due to: – Antibiotics – Prenatal care © 2012 by the McGraw-Hill Companies, Inc “Humanizing” Childbirth: A Social Trend l Home births have brought back intimacy of event l Birthing centers and hospitals – Soft lights – Father or partner as coach – Baby stays in room © 2012 by the McGraw-Hill Companies, Inc  Birth Process l Parturition – brings on labor – Two weeks before delivery – Uterine contractions – Cervix becomes flexible – Stimulated by rising estrogen levels © 2012 by the McGraw-Hill Companies, Inc  Three Stages of Vaginal Childbirth © 2012 by the McGraw-Hill Companies, Inc Stages of Childbirth l First: Longest, typically 12–14 hours for first child, cervix dilates l Second: 1–2 hours, contractions stronger and closer together, baby’s head moves through birth canal; Stage 2 ends with baby emerging from mother’s body l Third: 10–60 minutes, placenta and umbilical cord expelled from mother © 2012 by the McGraw-Hill Companies, Inc  Animation Labor and Birth l https://www.youtube.com/watch?v=samWyTj FmS8 © 2012 by the McGraw-Hill Companies, Inc Cesarean Delivery l Surgically removing baby from uterus through abdomen l 57% of all births in Turkey l 17% of worldwide l Often used when labor progresses slowly l Changing preferences among women and some physicians l Common with: First and/or large babies Older moms Mothers with previous C-sections © 2012 by the McGraw-Hill Companies, Inc Trabzon State Hospital Turkey 2023 Primary Total C-Section C-Section 2023 Normal Births C-Section Births Births Rates Rates January 275 119 156 %56,7 %21,8 February 243 112 131 %53,9 %21,8 March 264 115 149 %56,4 %23,1 April 261 132 129 %49,4 %23,8 May 272 118 154 %56,6 %29,0 June 261 123 138 %52,9 %24,1 Cesarean Section Rates in Türkiye 2018-2023; overview of National Data by Using Robson Ten Group Classification System Mustafa Mahir Ulgu1, Suayip BIRINCI2, Tugba Altun Ensari3, Melih Gaffar Gözükara4 1ActingDirector-General, Ministry of Health of Turkey 2Vice-Minister, Ministry of Health ofTurkey 3Ankara Yildirim Beyazit University, Faculty of Medicine, Department of Obstetrics and Gynecology 4Ankara Yildirim Beyazit University, Faculty of Medicine, Department of Public Health Since World Health Organization has determined the acceptable CS rate should not be more than 10-15%, also stated use of a classification system to compare different patient groups and facilities. Türkiye has the highest CS rates globally and has been rising over the years. This study aims to assess CS rates between 2018-2023 using National Health Data and to analyze according to the Robson Classification system and WHO reference values to discuss possible measures against increasing rates. In this study, we assessed the rates of CSs between 2018 and 2023; the CS rate including all 5-years, and analysis of CS rates for each Robson group as advocated by WHO. Total number of births recorded between 2018-2023 was 6.161.976. The overall CS rate was 57.55 %. Number of the total CS operations was 3.546.049. Unmedicated Delivery l Natural Childbirth Mother receives training in fitness, breathing and relaxation l Traditional cultures - Use of doula Experienced helper provides emotional support to mother l Prepared Childbirth – Lamaze – Mother learns to substitute other responses for feelings of pain © 2012 by the McGraw-Hill Companies, Inc Medicated Deliveries l Local or regional anesthesia – Blocks pain receptors in brain l Relaxing analgesic l Approximately 60% of women choose pain relief during labor © 2012 by the McGraw-Hill Companies, Inc Size and Appearance of the Newborn l Average neonate is: o 50.8 cm long o 3.4 kg o Fontanels – soft plates of head l Lanugo – fuzzy prenatal hair l Vernix caseosa – oily protection against infection © 2012 by the McGraw-Hill Companies, Inc  Body Systems of the Newborn l Breathing: Anoxia or hypoxia can lead to birth trauma l Meconium – Stringy waste in fetal intestinal tract l Neonatal Jaundice – Yellowing of skin and eyeballs – Caused by immaturity of the liver – Half of all babies experience – Usually baby does not need treatment © 2012 by the McGraw-Hill Companies, Inc Assessments: Apgar Scale Sign 0 1 2 Body pink, Appearance Blue and pale limbs blue All pink Pulse Absent Slow (< 100) Rapid Coughing and Grimace None Grimace crying Activity Limp Weak Strong Respiration Absent Irregular, slow Good, crying © 2012 by the McGraw-Hill Companies, Inc  Assessments: Brazelton NBAS l Tests responses to physical and social environment – Motor organization – Reflexes – Attention and interactive capacity – CNS instability © 2012 by the McGraw-Hill Companies, Inc  Neonatal Screening Tests l Help detect correctable disorders – PKU – Galactosemia – Hypothyroidism © 2012 by the McGraw-Hill Companies, Inc  Infant Arousal States State Eyes Breathing Movement Regular Sleep Closed Regular, slow None Irregular Sleep Closed Irregular Twitching Open or Drowsiness Irregular Some activity closed Alert Inactivity Open Even Quiet Wakeful and Open Irregular Much activity Crying © 2012 by the McGraw-Hill Companies, Inc  Childbirth Complications l Birth trauma l Postmaturity l Prematurity l Low birth weight © 2012 by the McGraw-Hill Companies, Inc Low Birthweight l Weighing less than 2.5 kg. l Very low birth weight - less than 1.6 kg. l 15.5% of all births, most in developing countries l Prematurity and low birth weight are the second-leading cause of infant death, after birth defects © 2012 by the McGraw-Hill Companies, Inc  Maternal Traits That Increase Risk of Low Birth Weight l Underage or overage l Uneducated and poor l Poor nutrition l Smoking and drinking l Stress l Infections and high blood pressure © 2012 by the McGraw-Hill Companies, Inc Immediate Treatment for Prematurity l Intravenous feeding l Surfactant l Isolette – controlled environment, like an incubator l Kangaroo care © 2012 by the McGraw-Hill Companies, Inc  Long-Term Outcomes of Low Birth Weight l Greater risk of: – Neurological and cognitive impairment – Lower academic achievement – Social, behavioral, and attention problems © 2012 by the McGraw-Hill Companies, Inc Postmaturity & Stillbirth l Postmature: 42 weeks or more l Stillbirth: Death of fetus at or after 20th week of gestation Reduction may be due to fetal monitoring © 2012 by the McGraw-Hill Companies, Inc Overcoming Birth Complications l Higher family SES l Quality early environment l Educational day care l Educating parents about children’s health © 2012 by the McGraw-Hill Companies, Inc Protective Factors for Development l Individual traits – Sociability – Intelligence l At least one supportive adult in child’s life l Child has a “sense of meaning” Rewarded at school or work © 2012 by the McGraw-Hill Companies, Inc Death during Infancy © 2012 by the McGraw-Hill Companies, Inc Death during Infancy l Primary causes worldwide: – Preterm delivery – Sepsis or pneumonia – Asphyxiation at birth l Infant deaths in first year; In Turkey 7.6% In high income countries 5.3% l Main reasons of infant deaths in Turkey are lack of education, poor nutrition and inadequate enviroment conditions © 2012 by the McGraw-Hill Companies, Inc SIDS Sudden Infant Death Syndrome l “Crib death” l Sudden death of infant under 1 year of age l Cause of death unexplained l May have underlying biological defect (heart gene mutations) l May be associated with sleeping on stomach © 2012 by the McGraw-Hill Companies, Inc Deaths from Injuries l 90% of injury deaths in infancy due to: – Suffocation – Motor vehicle accidents – Drowning – Residential fires or burns © 2012 by the McGraw-Hill Companies, Inc  Immunizations l About 90% all children today are vaccinated l Some regions are better vaccinated than others l No causal connection between vaccines and autism or other disorders © 2012 by the McGraw-Hill Companies, Inc Proportions of Physical Growth © 2012 by the McGraw-Hill Companies, Inc  Nutrition: Breast Feeding l Breast milk almost always the best food – More digestible – Reduces allergic reactions – Minimizes numerous infections – May reduce risk of SIDS – Better cognitive performance l Recommendation is babies exclusively breast-feed for 6 months © 2012 by the McGraw-Hill Companies, Inc Bottle Feeding l Formula should be iron- fortified l Necessary for women with infectious illnesses l Does NOT reduce emotional bonding between mother and baby © 2012 by the McGraw-Hill Companies, Inc Other Nutritional Concerns l Solid food introduced second half of first year l Malnutrition l Overweight q 8.5% of Turkey infants classified as overweight (10% for boys and 6.8% for girls) q Parental obesity strong predictor © 2012 by the McGraw-Hill Companies, Inc Parts of the Brain © 2012 by the McGraw-Hill Companies, Inc Brain Cells l Neurons: Send and receive information l Glia: Nourish and protect neurons l Neurotransmitters: Chemical messengers l Myelination: Fatty substance helps send faster signals © 2012 by the McGraw-Hill Companies, Inc  Neuronal Growth: Two Processes l Integration Neurons that control groups of muscles l Differentiation Each neuron takes on a specialized function © 2012 by the McGraw-Hill Companies, Inc Reflexes: Unlearned & Protective Behaviors l Postural – Reactions to changes in posture or balance l Locomotor – Resemble later-appearing voluntary movements – Walking and swimming reflexes © 2012 by the McGraw-Hill Companies, Inc Early Human Reflexes https://www.youtube.com/watch?v=0vrdkzOnGgo l Moro https://www.youtube.com/watch?v=PTz-iVI2mf4 l Darwinian (grasping) l Tonic l Rooting l Babkin and Babinski l Babies Reflexes Reflex Age When Reflex Appears Age When Reflex Disappears Stepping Birth 2 months Rooting Birth 4 months Palmar grasp Birth 5–6 months Moro reflex Birth 2 months Tonic neck reflex Birth 5–7 months Plantar grasp Birth 9–12 months Role of Experience in Brain Development l Postnatal brain is molded by development l Plasticity l Threats Sensory impoverishment Malnutrition l Corrective experiences can relieve past deprivations © 2012 by the McGraw-Hill Companies, Inc Early Senses of Touch & Pain l Touch – First sense to develop – Rooting reflex – Able to experience pain at birth © 2012 by the McGraw-Hill Companies, Inc Early Senses of Smell & Taste l Begins to develop in womb l Newborns prefer sweet tastes l Fluids and odors may be transmitted through amniotic fluid © 2012 by the McGraw-Hill Companies, Inc  Nature vs. Nurture? l Odor preference requires experience 6-day-olds prefer mother’s breast pad to another nursing mother’s l Certain tastes are innate Sweetened water calms crying newborns, whether full-term or premature © 2012 by the McGraw-Hill Companies, Inc Sense of Hearing l Functional before birth l 3-day-olds can tell new speech sounds from ones they’ve already heard © 2012 by the McGraw-Hill Companies, Inc Sense of Sight l The sense least developed at birth l 20/20 reached by about 6 months l Binocular vision (depth) develops around 4.5 months © 2012 by the McGraw-Hill Companies, Inc Milestones of Motor Development Age 90% of Children Skill Master Rolling over 5.4 months Grasping rattle 3.9 months Standing alone 13.7 months Walking well 14.9 months Building tower of cubes 20.6 months Copying circle 4 years Baby Milestones- Motor Developments https://www.youtube.com/watch?v=DTIz2D0K_EE © 2012 by the McGraw-Hill Companies, Inc Denver Developmental Screening Test l Gross motor skills l Fine motor skills l “Average” q Head control q Hand control q Locomotion © 2012 by the McGraw-Hill Companies, Inc The Visual Cliff l Do infants perceive depth? l 6-month-old babies would approach “ledge,” but avoided “drop” l Demonstrated depth perception l https://www.youtube.com/watch?v=p6cqNhHrMJA © 2012 by the McGraw-Hill Companies, Inc Dynamic Systems Theory l Learning occurs through detecting the many features of an environment l With experience, babies learn to gauge their environment – Is that ball moving away from me? – Is that ground too rough to walk on? Cultural Influences on Motor Development l Depends on the pace of the culture l African and West Indian cultures actively encourage early motor strength Bouncing and stepping exercises l Other cultures discourage … Ache mothers pull infants to their laps when they crawl away Research in Action: Autism l Brain disorder q Lack of normal social interactions q Impaired communication q Repetitive movements q Restricted range of activities and interests Asperger syndrome (not anymore…) Prevalence Related disorders CDC Rates for Autism Combined Number of Prevalence This is about Surveillance ADDM Sites per 1,000 1 in X Year Birth Year Reporting Children children 2020 2012 11 27.6 1 in 36 2018 2010 11 23.0 1 in 44 2016 2008 11 18.5 1 in 54 2014 2006 11 16.8 1 in 59