CHD 1220: Child Development for Teachers Instructor: Kristi Cheyney, PhD Assistant Professor of Early Childhood Education Santa Fe College, Gainesville, FL (352)

WHAT WILL YOU KNOW? When do the most important parts of the fetus form? Does medical assistance safeguard or impede the birth process? What usually occurs in the first few minutes of a newborn’s life? Why do substances and circumstances sometimes harm the fetus and sometimes have no impact. What are the immediate and long-term causes and consequences of low birthweight? Why do some mothers suffer from postpartum depression, and how does that affect the baby?

Prenatal Growth Three main periods of prenatal development

Prenatal Growth Can you define these terms related to timing and technology? Beginning of pregnancy Length of pregnancy Trimesters Due date

Vulnerability During Prenatal Development

Germinal Period: First 14 Days Zygote begins duplication and division within hours of conception. Development of the placenta Implantation (about 10 days after conception) Organism grows rapidly The Most Dangerous Journey In the first 10 days after conception, the organism does not increase in size because it is not yet nourished by the mother.

The Embryonic Period: From the Third Through Eighth Week Embryo Primitive streak becomes the neural tube and later forms the brain and spine of the CNS. Head takes shape. Eyes, ears, nose, and mouth form. Heart begins to pulsate. Extremities develop and webbed fingers and toes separate.

The Embryonic Period (a) 4 weeks past conception (b) 7 weeks

Fetus: From Ninth Week Until Birth The third month –Rapid growth with considerable variation –Average: 3 months; 3 ounces; 3 inches –9 th week: SRY gene triggers develop of sex organs –3 rd month: Neurological sex differences begin

Fetus: The Middle Three Months Middle three months Digestive and excretory system develop Fingernails, toenails, and buds for teeth form, and hair grows (including eyelashes)

Fetus: The Middle Three Months Brain Experiences rapid growth Follows proximodistal sequence from brainstem to midbrain, to cortex Develops many new neurons (neurogenesis) and synapses (synaptogenesis) Begins to regulate basic bodily functions as entire CNS becomes responsive

Fetus: The Middle Three Months Age of viability Age at which a preterm newborn may survive outside the mother's uterus if medical care is available About 22 weeks after conception Brain is able to regulate basic body functions (e.g., breathing)

Fetus: The Final Three Months Last three months Involves expansion and contraction of lungs Includes final maturation of heart valves, arteries, and veins Provides time for extensive growth and folding in cortex One of the Tiniest Rumaisa Rahman was born after 26 weeks and 6 days weighing only 8.6 ounces (244 grams). She has a good chance of living a full, normal life.

Prenatal Growth of the Brain

Birth Fetal brain signals the release of hormones to trigger the female's uterine muscles. Labor begins Average duration for firstborn babies: 12 hours Quicker labor for later-born babies Birthing positions vary Sitting, squatting, lying down, water births Cultural and personal preference

A Normal, Uncomplicated Birth

The Newborn’s First Minutes Newborns Usually cry spontaneously Color changes from bluish to pinkish Eyes open, fingers grab, toes stretch Newborn mortality = 1 in 250 in U.S. Apgar scale Quick assessment of newborn's heart rate, breathing, muscle tone, color, and reflexes Completed twice (1 minute and 5 minutes after birth) Score of 0, 1, or 2 in each category Desired score: 7 or above

Criteria and Scoring of the Apgar Scale ScoreColorHeartbeatReflex Irritability Muscle Tone Respiratory Effort 0Blue, paleAbsentNo response Flaccid, limp Absent 1Body pink, extremities blue Slow (below 100) GrimaceWeak, inactive Irregular, slow 2Entirely pink Rapid (over 100) Coughing, sneezing, crying Strong, active Good; baby is crying

Medical Assistance Characteristics of childbirth depend on several variables –Parents’ preparation –Position and size of fetus –Customs of culture In most developed nations childbirth includes –Sterile procedures –Electronic monitoring –Drugs to dull pain or speed contractions

Medical Assistance Surgery: Cesareans Are controversial Involve surgical birth Vary by rates and reasons for use Present advantages for hospitals; more complications after birth

Too Many Cesareans or Too Few? Rates of cesarean deliveries vary widely from nation to nation. Latin America has the highest rates in the world (note that 40 percent of all births in Chile are by cesarean), and sub-Saharan Africa has the lowest (the rate in Chad is less than half of 1 percent). The underlying issue is whether some women who should have cesareans do not get them, while other women have unnecessary cesareans.

Birth Alternatives to hospital technology Place of birth: Hospital labor room; birthing centers; home Supports: Doulas

Home Births Planned home births are more common in many developed countries. Almost all babies are born at home in poorer nations. Some research indicate home births entail risks for the baby. Every study finds benefits for the mother. Key to good choice is being “medically informed”.

What Is a Doula? Person trained to support laboring woman Time contractions Provide encouragement Do whatever else is helpful Are particularly helpful for immigrant, low-income, or unpartnered women

Harm to the Fetus Harmful substances Prenatal teratogens Any agent or condition, including viruses, drugs, and resulting in birth defects or complications Behavioral teratogens Agents and conditions that can harm the prenatal brain, impairing the future child's intellectual and emotional

Risk Analysis Factors Risk analysis discerns which chances are worth taking and how risks are minimized. Critical time Dose and/or frequency of exposure (Threshold effect) Innate vulnerability

Risk Analysis: How Much Is Too Much? Threshold effect Certain teratogens are relatively harmless until exposure reaches a certain level. Thresholds are controversial. Example: Alcohol consumption Embryo exposed to heavy drinking can develop fetal alcohol syndrome (FAS). FAS is more apparent when women are poorly nourished and cigarette smokers.

Risk Analysis: Innate Vulnerability Genetic vulnerability Some zygotes carry genes that make them vulnerable. Male fetuses are more vulnerable to teratogens than female ones. Mother’s genes affect the prenatal environment she provides. Neural-tube defects are more common in certain ethnic groups (e.g., Irish, English, and Egyptian).

Conflicting Advice Advice from Doctors Problems Provision of potentially dangerous prescriptions for pregnant women Failure to take time to understand woman’s life patterns Advice from Scientists Problems Provision of contradictory interpretation of research that led to opposite message Internet site usage Many Internet sites provided inadequate or incorrect information about drug safety

What about the Father? Indirect influence of risk for adverse birth outcomes (Misra et al., 2010) Father’s attitude Father’s behavior Relationship between mother and father Immigrant paradox

What Do We Know? Prenatal teratogens can cause Structural problems during embryonic period and several diseases throughout pregnancy Behavioral problems and reproductive impairment later in life Social response to evidence is controversial.

Prenatal Diagnosis Early prenatal care may Protect fetal growth Make birth easier Render parents better able to cope Provide early recognition of potential problems Raise anxiety Present false positives

Trouble Ahead

Low Birthweight

Low Birthweight and the Mother Maternal behavior Maternal health and illness Maternal drug use before and during pregnancy

Consequences of Low Birthweight High risk infants and children Are later to smile, to hold a bottle, to walk, and to communicate Middle childhood, formerly SGA children Have smaller brain volume Remember that risk analysis gives odds, not certainties!

The New Family: The Newborn Brazelton Neonatal Behavioral Assessment Scale (NBAS) Test often administered to newborns that measures responsiveness and records 46 behaviors, including 20 reflexes Parents who watch their infant perform on the NBAS are amazed at the newborn’s responses—and this fosters early parent–child connection.

The New Family: The Newborn Newborns seek to protect themselves with three sets of reflexes Maintaining oxygen: Breathing, hiccupping, sneezing Maintaining constant body temperature: Crying, shivering, tucking legs to body, pushing Managing feeding: Sucking, rooting, swallowing

The New Family: The Newborn Other reflexes are not necessary for survival but signify the state of brain and body functions. Babinski reflex Stepping reflex Palmar grasping reflex Moro reflex

New Mothers About half of all women experience physical problems after birth. Between 8 and 15% of women experience postpartum depression. Feelings of sadness and inadequacy Symptoms from baby blues to postpartum psychosis May involve struggles with adequate baby care Varied causes

New Fathers Not only fathers, but the entire social network and culture are crucial influences. Father's role: Being there Helping mother stay healthy Helping mother manage stress (affects fetus) Providing legal acceptance the birth Couvade Symptoms of pregnancy and birth experienced by fathers.

Parental Alliance Involves commitment by both parents to cooperate in raising the child Is especially beneficial when infant is physically vulnerable

Family Bonding Parent-infant bond Bonding involves strong, loving connection that forms as parents hold, examine, and feed the newborn. Early skin-to-skin contact is not essential for human bonding.