SUMMARY OF INFANT GROWTH AND DEVELOPMENT
MONTH MOTOR DEVELOPMENT FINE MOTOR SOCIALIZATION AND TIME REFLEXES PLAY DEVELOPMENT OF
DEVELOPMENT LANGUAGE FADE SENSES
0-1 Largely reflex actions Keeps hands fisted; able to Enjoys watching face of Eyes: follow the object a
follow object to midline primary caregiver; needs short distance
with eye play time in prone position Ears: marked reaction to
bell or squealy sound
2 Holds up head up when Demonstrate social smile Makes cooing sounds; Grasp reflex Enjoys bright-colored Eyes: focus well
prone differentiates cry mobile Ears: hearing awareness is
acute
3 Holds head and chest up Follows object past midline Laughs out loud Landau reflex is strong Spends time looking at Eyes: can follow objects
when prone with eyes hands; “tummy time” across their midline Ears:
turn their head to locate
a sound
4 Turns back to front; no Stepping, tonic neck, Needs space to practice Eyes: are able to recognize
longer has head lag; bears extrusion reflexes are turning familiar objects
partial weight on feet fading Ears: able to recognize
familiar objects
5 Should turn readily front to Tonic neck reflex fading Handles rattles well Ears: Can localize sounds
back and back to front downward and to the side
by turning their head and
looking down
6 Beginning to show Uses palmar grasp May say vowel sounds Moro and tonic neck reflex Enjoys bathtub toys, rubber Eyes: infants are capable of
ability to sit “oh-oh” have faded ring for teething organized depth perception
Ears: able to locate sounds
made above them
7 Reaches out to be picked Transfer objects hand Shows beginning fear Likes objects that are good Eyes: pat their own image in
up; first tooth erupts to hand of strangers size for transferring a mirror
(central incisor)
8 Sits securely without Fear of strangers’ peaks Enjoys manipulation,
support rattles, and toys of
different textures
9 Creeps or crawls (abdomen Says the first word “da-da” Needs safe space for
off the floor) creeping
10 Puts self to standing Uses pincer grasp (thumb Plays games like patty-cake Eyes: looks under a towel
and finger) to pick up small and peek-a-boo or around a corner for a
objects concealed object
Ears: recognize their name
and listen acutely when
spoken to
11 “Cruises” walks with “Cruising” can be main
support activity
12 Stands alone; some infants Holds cup and spoon well; Says two words plus ma-ma Landau reflex fades Likes toys that fit inside Ears: can easily locate
take first step helps to dress and da-da each other (pots and pans); sounds in any direction and
(pushes arm to sleeve) nursery rhymes; will like pull turn toward them
toys as soon as walking
Development of Senses continuation:
Touch
- Skin-to-skin contact
- Clothes should feel comfortable
- Diapers should be dry
Taste
- Demonstrate they have an accurate sense of taste by turning away from or spitting out a taste they do not enjoy
- Solid foods introduced at 6 months, urge parents to make mealtime for fostering trust as well as supplying nutrition
Smell
- Can smell accurately at 1-2 hours after birth
- Respond to irritating smell by turning their head away from it
- Appear to enjoy pleasant smell of breastmilk
Prepared by: Shery Mae L. Ciencia
Reference: Adelle Pillitteri, Maternal and Child Health Nursing 6th,7th,8th edition. Volume 1
PROMOTING INFANT SAFETY
Injury Prevention Measures for Infants
Aspiration
- Be certain any object an infant can grasp and bring to the mouth is either safe to eat or too big to fit in the mouth
- Do not offer foods such as popcorn or peanuts
- Store baby powder out of reach
- Inspect toys and pacifiers for small parts that could be aspirated if broken
Falls
- Never leave an infant on an unprotected surface
- Place a gate at the top and bottom of stairways
- Do not allow your infant to walk with a sharp object in the hands or mouth
- Raise crib rails and make sure they are locked before walking away from the crib
- Do not leave a child unattended in a high chair
- Avoid using an infant walker near a stairway
Motor Vehicle
- Do not leave an infant unattended in a parked car (the infant can become dehydrated from excess heat, can move the gear
shift or be abducted)
Drowning
- Do not leave infants alone in a bathtub or unsupervised near water
Animal bites
- Do not allow an infant to approach a strange dog
- Supervise play with family pets
Poisoning
- Never present medication as a candy
- Buy medications in containers with safety caps
- Put away in a high cabinet immediately after use
- Never leave medication in a pocket or handbag
- Never take medication in front of infants
- Place all medication and poisons in locked cabinets or overhead shelves - Post emergency contact numbers
Burns
- Test warmth of formula and food before feeding
- Do not smoke or drink hot liquids while holding or caring for an infant
- Turn handles of pans toward back of stove
- Limit the child’s sun exposure to less than 30 minutes at a time
- Monitor infants near the candles
- Do not allow infants to blow out matches or candles
- Keep electric wires and cords out of reach
- Cover electrical outlets with safety plugs
PROMOTING NUTRITIONAL HEALTH OF AN INFANT
Tips to help introduce solid foods to infant
1. Introduce one food at a time, waiting 3-7 days between new items
2. Introduce the food before formula or breastfeeding when infant is hungry
3. Introduce small amounts of a new food
4. Respect infant’s food preferences; a child cannot be expected to like all new tastes equally well
5. Use only minimal to no salt and sugar on solid food to minimize the number of additives
6. Remember that the extrusion reflex is present for the first 4 months of life, so any food placed on an infant’s tongue will be
pushed forward and extruded
7. To prevent aspiration, do not place food in bottles to drink with formula
8. Even though you don’t like a particular food, introduce it with a positive attitude. It could be your child’s favorite
PROMOTING INFANT DEVELOPMENT IN DAILY ACTIVITIES
Bathing
- Should be fun
- Helps learn different textures and sensations
- Provides opportunity to exercise and kick
- Good opportunity for parent to touch and communicate with the child - Parents should never leave infants alone in a tub
Diaper-Area Care
- Change diapers frequently every 2 to 4 hours
- Air drying or sleeping without a diaper may be a solution when an infant develops a rash
- Parents should wash the skin with clear water or a commercial alcohol-free diaper wipe, then pat or allow the skin to air dry
at each diaper change
- No need to use powder
- Remind parents to wash their hands to reduce the possibility of spreading infection
Dental Care
- Toothbrushing can begin even before teeth erupt by rubbing a soft washcloth over the gum pads
- Parents must be responsible for this activity well past infancy
- Toothpaste is not necessary
- An initial dental check-up be made by 2 or 2.5 years old and should continue at 6-month intervals until adulthood
Dressing
- Infants need long pants to protect their knees when they begin to creep
- They need soft-soled shoes or merely socks or booties to keep their feet warm
Sleep
- Most require 10-12 hours sleep at night or several naps during the day
- Let baby sleep in a separate space close by rather than on the bed with parents to avoid possible suffocation - Do not
place pillow in the infant’s crib
- Always place an infant on his or her back to sleep to reduce risk of sudden infant death syndrome (SIDS) PROMOTING
HEALTHY FAMILY FUNCTIONING
Teething
- Gums are sore and tender before a new tooth breaks the surface
- Infants are resistant to chewing for a day or two and slightly cranky
- Rubbing the gumline with a finger or soft cloth can help a new tooth erupt
- Teething rings that can be placed in the refrigerator or freezer provide soothing coolness against tender gums
Thumb-sucking
- Sucking is a strong need in early infancy
- Many infants begin to suck a thumb or finger at about 3 months of age and continue the habit through the first few hours of
life
- The sucking reflex peaks at 6-8 months; thumb-sucking peaks at about 18 months
- Normal and does not deform the jaw
- It does not cause baby talk or any other speech concerns
Use of Pacifiers
- Benefits o Comforting
o Aid in pain relief o Decreased risk
of SIDS
- Risks o Increase incidence of acute otitis media o Negative impact on breastfeeding o Dental malocclusion
MILESTONES OF TODDLER GROWTH AND DEVELOPMENT
Age in months Fine Motor Gross Motor Language Play
15 Puts small pellets into small Walks alone well; can seat self in 4-6 words Can stack two blocks, enjoys
bottles; scribbles a chair; can creep stairs being read to;
voluntarily with a pencil drops toys for adult to
or crayon; holds a spoon well but recover
may still turn it
upside down on the way to the
mouth
18 No longer rotates the spoon to Can run and jump in place; can 7-20 words; uses jargoning; Imitates household chores such
bring it to walk up and names one body part as dusting; begins parallel play
mouth down stairs holding onto a (playing beside, not with another
person’s hand or child)
railing; typically places
both feet on one step before
advancing
24 Can open doors by turning Walks up stairs alone; still using 50 words; two-word sentences Parallel play is evident
doorknobs; unscrew lids both feet on the same step at such as “Daddy go”, “Dog talks”
same time
30 Makes simple lines or strokes for Can jump down from chairs Verbal language increasingly Spends time playing house,
crosses with a steadily; imitating parents’
pencil knows full name; can actions; play is “rough housing”
name one color and holds up or active
fingers to show age
PROMOTING TODDLER DEVELOPMENT IN DAILY ACTIVITIES
Dressing
- Can put on their socks and underpants by end of toddler period
- Pull on slacks, pullover shirts or simple dresses
- Invariably put shoes on the wrong feet and shirt and pants on backwards
- Encourage parents to give up perfection for the benefit of the child’s developing sense of autonomy
Sleep
- They may begin napping twice a day and sleeping 12 hours each night, and end it with one nap a day and only 8 hours of
sleep at night
- Some toddlers begin having night terrors or awake crying from a bad dream
- Other toddlers resist naptime as part of their developing negativism
- A toddler loves a bedtime routine: bath, pajamas, a story, toothbrushing, being tucked into bed, having a drink of water,
choosing a toy to sleep with, turning out the lights
Bathing
- Enjoys bath time
- Provide toys such as a rubber duckie or plastic fish
Dental Care
- Encourage parents to offer fruit or protein foods for snacks rather than high-carbohydrate items such as cookies to limit
exposure of the child’s teeth to carbohydrate
- Remind parents not to put a child to bed with a bottle of milk or juice to help prevent the development of caries
- Remind parents that it is better for a child to brush thoroughly once a day probably at bedtime, than to do it poorly many
times a day
PARENTAL CONCERNS ASSOCIATED WITH THE TODDLER PERIOD
Toilet Training
- One of the biggest tasks a toddler tries to achieve - An individualized task for each child
- It should begin and be completed according to a child’s ability to accomplish it, not according to a set schedule
- Before children can begin toilet training, they must have reached three important developmental levels, one physiologic
and the other two cognitive:
o They must have control of rectal and urethral sphincters, usually achieved by the time they walk well o They
must have a cognitive understanding of what it means to hold urine and stools until they can release them at a
certain place and time
o They must have a desire to delay immediate gratification for a more socially accepted action
- The markers of readiness are subtle, but as a rule, children are ready for toilet training when they begin to be
uncomfortable in wet diapers
- They may demonstrate by pulling or rugging at a soiled diapers or they may bring a parent a clean diaper after they have
soiled so they can be changed
- Toddlers live by a pleasure principle: they want what they want when they want it
- Before they can complete toilet training, they must be able to give up an immediate pleasure: o Relieving themselves
whenever they have the urge o To gain other pleasure later on
o Improved physical comfort and another step in growing up
Ritualistic Behavior
- They will use only their spoon at mealtime or only their blankets at bedtime
- They will not go outside unless a mother or a father locates their favorite cap
Negativism
- As part of establishing their identities as separate individuals
- They do not want to do anything as a parent wants them to do
- Their reply to every request is a very definite “NO”
- Can be best eliminated by limiting the number of questions asked of the child
- Example instead of asking “are you ready for dinner?” it is better to say “come to the table, Its dinnertime”
Discipline
- Discipline means setting rules or road signs so children know what is expected of them
- Punishment is a consequence that results from a breakdown in discipline or the child’s disregard of the rules that were
learned
- Parents should begin to instill some sense of discipline early in life because part of it involves setting safety limits and
protecting others or property - Two general rules to follow: o Parents need to be consistent
o Rules are learned best if correct behavior is praised rather than wrong behavior punished
- “Time-out” is a technique to help children learn that actions have consequences
- Parents need to be certain their child understands the rule they are trying to enforce
- The parents should give one warning
- If child repeats the behavior, parents select an area that is non stimulating such as a corner of a room or a hallway
- A guide as to how long children should remain in their time out chair is 1 minute per year of age. Example a 3 year old
child would stay in the corner for 3 minutes.
Separation Anxiety
- Fear of being separated from parents begins at 6 months of age and persists throughout the preschool period - Parents
say good-bye firmly
- Prolonged good byes only lead to more crying
- Sneaking out prevents crying and may ease the parents’ guilt, but it can strengthen a child’s fear of abandonment and so
should be discouraged
Temper Tantrums
- The child may kick, scream, stomp feet, shout No,no,no, flail arms and legs, bite or bang his or her against the floor
- Occurs as a natural consequence of toddlers’ development
- They occur because toddlers are independent enough to know what they want, but they do not have the vocabulary or
wisdom to express their feelings in a more acceptable way - Managing toddlers temper tantrums: o Try to determine
the reason for the behavior o Be certain it seems like a tantrum, not something more o Think through what you do when
the child has tantrums
