V.

ANATOMY AND PHYSIOLOGY

Growth is generally used to denote an increase in physical size or a quantitative change. Growth in
weight is measured in pounds or kilograms; growth in height is measured in inches or centimeters.
Development is used to indicate an increase in skill or the ability to function (a qualitative change).
Development can be measured by observing a child’s ability to perform specific tasks such as how well a
child picks up small objects such as raisins, by recording the parent’s description of a child’s progress, or
by using standardized tests such as the Denver II.

Gross Motor Development

To assess gross motor development, an infant is observed in four positions: ventral suspension, prone,
sitting, and standing.

 Ventral Suspension Position. Ventral suspension refers to an infant’s appearance when held in
midair on a horizontal plane, supported by a hand under the abdomen. Landau reflex develops at
3 months.
 Prone Position. When lying on their stomach, newborns can turn their heads to move them out of
a position where breathing is impaired, but they cannot hold them raised.

 Sitting Position. When placed on the back and then pulled to a sitting position, a 1-month-old
child has gross head lag as in the first days of life (Fig. 29.4). In a sitting position, the back
appears rounded and an infant demonstrates only momentary head control.

 Standing Position. A newborn stepping reflex can still be demonstrated at 1 month of age. In a
standing position, an infant’s knees and hips flex rather than support more than momentary
weight.

Fine Motor Development

One-month-old infants still have a strong grasp reflex, and they hold their hands in fists so tightly it is
difficult to extend the fingers. As the grasp reflex begins to fade, a 2-month-old child will hold an object
for a few minutes before dropping it. The hands are held open, not closed in fists. A major milestone of 10
months is the ability to bring the thumb and first finger together in a pincer grasp.

Language Development

A child begins to make small; cooing (dovelike) sounds by the end of the first month. A 2-month-old
child differentiates a cry. For example, caregivers can distinguish a cry that means “hungry” from one
that means “wet” or from one that means “lonely.” This is an important milestone in development for an
infant and also in marking how far a parent has progressed in the task of learning the infant’s cues.

Play

Parents often ask what toys their infant would enjoy. Because 1-month-olds can fix their eyes on an
object, they are interested in watching a mobile over their crib or playpen. Mobiles are best if they are
black and white or brightly colored and light enough in weight so they move when some- one walks by.
They should face down toward the infant, not toward an adult standing beside the crib. Musical mobiles
provide extra stimulation.