Infant Growth and Development Milestones Appear reflexes Fade reflexes

 Trust- mistrust
 Egocentrism
 4m thumb opposition
 9m depth perception
 9-10m Pincer grasp pick small things, offer things but cant release
 Separation anxiety start 8-9, peak 18-24m

2m  Fontanelles close: Anterior 12-18 m, Posterior 2m  Grasp or planter

 Ig A additional protection from Bmilk reflex(hold anything
 More risk of e imbalance due to dec kidney function placed on palm)
to concentrate
 Social smile occurs at 2-3 m, if > 3m= neuro prob
 Head side to side 1m, Control head in same plane
2m
3m  Hold head well above body, can lift head and  Landau reflex  Extrusion reflex
shoulder well off the table and look around 3m 3m(when held in 3-4m (things on
(educate: tummy time is important daily) ventral position 1/3 outer
 Infant colic outgrows infants head, legs, tongue out)
supine extend; whn  Moro reflex
head is depressed disappears
hip,knees, elbow around 3-4
flex). Conti to 6 m. months, if +at
if +in >6m =cerebral 6= neuro prob
palsy, neuromotar  Tonic neck
defect reflex 3-4m
4m  IgG cause weak resonse to infection till 3-4m  4m thumb  Rooting reflex
 4m lift chest when prone, turn front to back opposition 3-4m
 4m No head lag whn pulled to sitting,if yes= follow  Palmar reflex
up
 4m grasp by using both hands
 Eye movt muscle by 4-6m
 4-5 play with feet, toe in mouth
5m  5m turn back to front, rests weight on forearms 
when prone (risk of fall, safety precautions)
 5m accept object handed to them
6m  Weight: 6m doubles, 1 year triples (more wt gain in  Parachute reaction
formula fed baby) 6-9m stay forever,
 Length: Grows ½-1 inch every month until 6 months infant suddenly
 Ability to adjust cool, shiver in response to cold 6m lowered arms
(before 6m nonshivering thermogenesis) extend to protect
 6m hold object in both hands from fall (in cerebral
 Develops stranger anxiety at 6 to 7 months, due to palsy -ve)
 strong feeling of attachment enable to differ b/w
stranger and caregiver
7m  7m sit leaning forward on hands tripod 
 7m transfer obj from one to other hand
 8m sit without additional support
9m  9m stand with help
 11m cruise fad k turna
 9m depth perception
 Separation anxiety start 8-9, peak 18-24m
 Don’t release object at 9-10m
 9-10m Pincer grasp pick small things, cant
release
 9-14m walk
1yr  Kidney develop and function fully (1 to 2 yr) Babinski (fanning
 Offer objects and release them (12months) of toe)12m
 Eruption of teeth: lower central incisors by 10
months…fall out by 6-7 years

 Ventral suspension- Ventral suspension measures the strength of the infant's trunk and neck. The
infant is held in a suspended prone position in the air by placing a hand under the chest. A normal term
infant will keep his/her head in the horizontal plane momentarily with flexion of both the upper and
lower extremities.

 Assess hearing at birth in rubella infx—

 4m turn head to moms noise
 Non meaningful sounds ma da ah 4-6m
 3-4m cooing
 4-6 identity mom voice
 6-7 gurgling
 7-8 babling
 More meaningful + non specific at 9-m maa paa bye, 2-3 word vocab, gestures used
 10m respond to sound of their name
 Develop trust is mistrust= schizotypal personality
 Quality of parent interaction matter
 Develops stranger anxiety at 6 to 7 months, due to strong feeling of attachment enable to differ b/w
stranger and caregiver
 Separation anxiety start 8-9, peak 18-24m
 Eating

 Iron supple preterm 2-3m; term 4-6m

 Object permanence
 No breast feed to- galactosemia baby, mom with illegal drugs, antiretrovirals,chemo, hep b,c, cmv,
untreated active tb, hiv
 Formula prepare accly don’t dilute too much--- hyponat risk
 No cow milk till 12m—risk of NEC <1yr
 Weaning breast or bottle at 6-12m
 Behaviour of ready to wean
 Throw bottle, chew nipple, refuse breast or dawdling, take few ounce milk… at 7-8m
 No weaning in time of stress or change (new baby come, illness)
 Before 18m stop bottle, never feed while lying.. otitis media risk
 Who drink milk, juice before sleep--- dental caries risk. Discourage it.
 Give plain water before sleep to >6m child
 Solid food once at a time, No add salt sugar, veg first thn fruits
 No honey till 12m--- botulism; Egg after 12 m
 Sleep in parents room on cradle,crib,bassinet; Keep mattress firm, fit tightly,bedshhet tucked
Car safety

 Rare seat on vehicle in middle

 Rare facing seat with 3-5 point harness until 2yr
 Car safety seat or booster seat till 4’9”
 <12 yr not on front seat sitting
 Prevent lead exposure- no imported toys, no lead wall paint, (lead in paint)
 If the parents are not able to be with the infant, the baby may be inconsolable due to separation
anxiety.
 Respect the infant’s schedule at home by assessing and implementing components as possible.
 Toys for hospitalized infants include mobiles, rattles, squeaking toys, picture books, balls, colored
blocks, and activity boxes
• Frequently tested content areas on the NCLEX-RN® examination:
• When does birth length double? Answer: by 4 years.
• When does the child sit unsupported?Answer: 8 months.
• When does a child achieve 50% of adult height? Answer: 2 years.
• When does a child throw a ball overhand? Answer: 18 months.
• When does a child speak two- to three-word sentences? Answer: 2 year
 When does a child use scissors? Answer: 4 years. When does a child tie his or her shoes? Answer: 5
years.Be aware that a girl’s growth spurt during adolescence begins earlier than a boy’s (as early as 10
years of age). Temper tantrums are common in the toddler (i.e., they are considered normal or average
behavior). Be aware that adolescence is a time when the child forms his or her identity and that
rebellion against family values is common for this age group.
 HESI Hint • Knowledge of normal growth and development is used to evaluate interventions and
therapy. For example, what behavior would indicate that thyroid hormone therapy for a 4-month-old is
effective? You must know which milestones are accomplished by a 4-month-old.
One correct answer would be: Has steady head control, which is an expected milestone for a 4-month-
old and indicates that replacement therapy is adequate for growth. Toddler (1 to 3 Years)