Chapter 7 The Infant Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Definition Infant-period between 4 weeks and 1 year Growth-indicates increase in size weight and height/length; birth weight will be triple by age of 1 year old Development-increase in function and mastery of specific phases in lifespan Growth and development orderly from simple to complex Cephalocaudal-refers from head to toe Proximodistal-refers to growth from center of body out to periphery Development is a lifetime process; interaction among child, parent, and environment Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Definition Defense mechanism-reaction that is protective or helps to conceal conflicts or anxieties Coping skills-behavior that helps an individual adapt or manage a stressful situation Infants thrive with parenteral support and praise; if needs of infant are not met the child may not develop may not be achieved. Ethnic and cultural practices influence nutrition & behavior development Ordinal position has to do with the child’s place in the family Personality is a unique combination of characteristics that result in recurrent pattern of behavior Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Developmental Tasks of Infancy Include Trust versus Mistrust, Intelligence, Emotional Development, Attachment, Language Development, Motor Development, Physical Activity, Autonomy, Sleep Patterns, and Play. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Trust Versus Mistrust Erikson first stage of development according to his theory The first psychosocial crisis in infancy that must be resolved Trust develops when infants learn that their basic needs will be met Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Understanding Cause and Effect Discovered at an early age A cry elicits a response from adults so the cry becomes a means of communication En face position-first 4 months likes to held up to face to face contact Object permanence-comes to realize that things do not disappear, but continue to exist; Peek-a-Boo Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Memory Infants can retain memory of a traumatic experience General comforting may not be enough to achieve full emotional recovery Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Emotional Development An infant will mimic the facial expression of the adult Interaction between parent and infant is necessary in the first months of life and is important for later social development Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Attachment Begins long before the infant is born, when the mother feels the fetus moving in the womb Parents slowly develop an instinctive response to infants’ cues Also helps to promote development of trust because when infant cries it begins to know that mother will come to rescue or cuddle him/her After 2 or 3 months-responsive smile from infant brings happiness to parents’ work at interacting By 5 or 6 months infant recognizes and prefers parents; also responds accordingly to parents body language Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Separation Anxiety Begins at 6 months of age Infant cries or protests when the parent leaves the room By 18 months, memory development helps the child remember the parent's image and to trust that the parent will return after an absence Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Language Development Verbal language is both expressive and receptive and parents should talk in native and natural language Nonverbal language-body language-as for example parental stimulation when put down As infant communicates with cries or smiles There appears to be an innate ability to develop language skills Preverbal stage of language development would be things such as body language Start to sound M’s and D’s at 7 to 8 months First words between 9 and 10 months See Figure 7-2. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Motor Development Closely related to the development of perception, emotion, and cognition Many motor skills are dependent on the disappearance of newborn reflexes Table 7-2: Development of Locomotion, Prehension, and Perception Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Physical Activity Must be provided with a safe and stimulating environment to move and explore Early motor competence and confidence can contribute to the enjoyment of physical activity throughout childhood and beyond Interactive physical activity should focus on exploring environment and movement See Figure 7-3 and Box 7-1. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Autonomy Striving for independence starts early in infancy Self-consoling behavior is an early form of independence Will also start to want to self-feed in order to start to build some independence Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Sleep Patterns A maturing central nervous system combined with parental responses aids in the development of sleep patterns The goal is to help infants develop self-regulatory skills so that they return to sleep without prompting Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Role of Play in Fostering Growth and Development Piaget's sensorimotor theory of development is evident in the infant's play activities such as activities of peek-a-boo According to Freud's theory of development, the infant is in an oral phase so in following with his theory teething rings would b appropriate for an infant By applying learned skills to environmental experiences, children learn about the world around them Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Role of Play in Fostering Growth and Development Appropriate toys for infants: Newborn-mobiles to help develop focusing and following of objects with eyes 3 months-interactive mobiles that play music or sounds 6 to 7 months-Peek-a-boo to help solidify object permanence concept 1 year old-Push and pull toys; toy cups and phones Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Health Maintenance Tasks can include Nutrition, Teeth, Immunizations, and Accident Prevention. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Nutrition Proper nutritional intake is essential to support optimum development The newborn has a rooting and sucking reflex; fed on demand 2-3 hour intervals Will continue with non-nutritional sucking and this is normal during infancy Introduction of foods before 6 months of age is not recommended; New foods should be introduced one at a time Should be given breastmilk or formula until 1 year old; will try to self feed which will help with need for independence If starting infant on milk need to give whole milk because of the need of the fats for the nervous system Can be given meats and eggs by 11 months See Cultural Considerations: Breastfeeding (p. 107) Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Teeth Primary or baby teeth begin eruption at 5 to 7 months of age Allow chewing of food Nursing caries Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Immunizations Well-child visits should be scheduled after birth before the newborn is discharged from the hospital Growth, development, health, and nutrition of the infant should be checked every 2 months and appropriate immunizations scheduled Table of Immunizations Appendix A See Appendix A. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Accident Prevention Major cause of morbidity and mortality First injury prevention activity for the newborn is the use of car seats; rear facing seats protect head and neck Placing infant in supine position when sleeping Supporting and not leaving infant in tub without support and supervision Safety Alert (p. 109) Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

CHILD ABUSE SIGNS AND SYMPTOMS Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.