GROWTH &

DEVELOPMENT OF
NORMAL NEWBORN
BY
DR: Khadiga Zain EL abdeen
 Normal Newborn

■Newborn stage is the first 4 weeks of life.

■It is transitional period for an individual as he
transfers from intrauterine life to extra-uterine
environment.
 Characteristics of the Neonate
1- physical measurement
■ Weight)
■ Average weight varies from 2500 to 4000g.
■ Birth weight is greater than 4000g indicates a large for
gestational age (LGA) and may be associate with maternal
diabetes or hereditary.
■ A birth weight less than 2500g may be associated with
prematurity, an infant that is small for gestational age (SGA), or
an infant that has intrauterine growth retardation (IUGR).
■ Low birth weight may be associated with placental
insufficiency, maternal malnutrition, pregnancy-induced
Hypertension (PIH), or maternal use of nicotine or drugs.
 Weight
■ The frequency of low weight is higher in lower socioeconomic classes,
minorities and teenager mothers.
■ In the first 3 to 5 days after birth, the neonate loses about 140 to 300 g with
average 5% of birth weight.
New born weight loss is due to:
■ Withdrawal from maternal hormones
■ Limited intake of fluid
■ The loss of feces and urine
■ Loss of excessive extracellular fluid.
They gain birth weight by 10th days of life.
They gain ¾ kg by the end of the first month.
 1- physical measurement
Length
■ Length is measured from crown to heel.
■ Average boy’s length is 50 cm and 49 cm for girls (normal
range for both sexes 47.5 to 53.75 cm).
■ They gain 3.0 cm by the end of the first month.
Head size:
■ Is measured by placing the measuring tap in a “hat band”
position just above the eyebrows.
■ A larger than normal circumference for gestational age is
associated with a bulging fontanel may indicate hydrocephalus,
whereas smaller than normal circumference may indicate
microcephaly or a growth retarded infant.
1- physical measurement

Head Circumference
■ It is 33 to 35 cm at birth.
■ Head circumference increases 2 cm by the end of the first
month.
■ Head is ¼ of the total body length.
■ The skull has two fontanels: The anterior and posterior
fontanels.
■ The anterior fontanel is diamond in shape. The junction of the
sagittal, corneal and frontal sutures forms it, i.e., it is located
between 2 frontal and 2 parietal bones. It is 3 – 4 cm in length
and 2 – 3 cm widths. It closes at 12 – 18 months of age.
■ The posterior fontanel is triangular in shape and
located between the occipital and 2 parietal
bones, where it is formed by the junction of
sagittal sutures and lambdoidal suture. It closes
usually by the end of the first month of age.

■ Head circumference increases 2 cm by the end of

the first month.
 1- physical measurement

Chest circumference:
■ Is measured at the nipple line.
■ Average chest size ranges from 30.5 to 33cm
■ The chest should be approximately 2cm smaller than the head.
 2- vital sings
■ Normal Ranges for Newborn Vital Signs
■ Normal Ranges for Newborn Vital Signs
■ Respiratory rate
30 – 60 breath / minute
■ Heart rate
120- 150 beats/ minute
■ Blood pressure
Systolic=96-64 mmHg
Diastolic= 62-30mmHg
■ Temperature
36.5-37.90C rectal
36.5-37.60C axillary
 Characteristics of the Neonate (SS)
(Vision)

■ Vision is poorly developed.

■ Neonate can see sizes, shapes, colors, and patterns.
■ Able to fixate points of contrast.
■ Show preference for observing a human face and will follow
moving objects.
■ Most infant appear cross-eyed because their eye muscle
coordination is not fully developed.
■ At first, eyes appear blue or gray when the permanent color
becomes fixed between the third and sixth month.
Characteristics of the Neonate (SS)

■ Taste
■ It is well developed as bitter and sour fluids are resisted while
■ sweet fluids are accepted.

■ Smell
■ The only evidence for infant’s ability for smell is his search for
the nipple, as he smells breast milk.
■
 Characteristics of the Neonate (SS)

(Sleep)

■ The newborn sleep approximately 15 -20 hours per day.

■ There is a gradual change in the quantity and quality of sleep as

the neonates matures.
 Behavioral Characteristics of the Neonate

1. A quiet and alert newborn is easygoing and adaptable to changes in

routine. He responds to stimuli appropriately.
2. The over responsive infant: does not adapt well to change in
routine, is fussy, and responds to a new or different stimulus by
crying.
3. The unresponsive infant: is often difficult to arouse and may
initially respond to stimulus negatively.
 Development

Motor Development
■ Infants’ motor age (development) can be assessed by calculating a motor
quotation (MQ) using the following formula:
Motor age (MA)
MQ = --------------------------------- X 100
Chronological age (CA)

For example, if a 12 month-old-infant begins to creep, the motor quotient is:

9 (MA for this skill)
------------------------------- X 100 = 75
12 (CA)
 Development

■ Values above 85 are considered within normal limits, values below

70 are abnormal and values between 70 and 85 are borderlines.
■ The infant’s movements are random, diffuse and uncoordinated.
■ He lacks muscular strength to hold head steady and erect (his head
sink down).
■ Reflexes carry out his bodily functions and responses to external
stimuli.
■
 Development

Gross: The newborn:

■ May lift head if in prone position.
■ Alerts to high-pitched voices.
■ Fine: The newborn:
■ Holds hand in fist.
■ Draws arm and leg to body when crying.
 Development
■ Cognitive Development
■ The cognitive (intellectual) development of newborn infant is
difficult to understand or observe it.
■ Emotional Development
■ The newborn infant expresses his emotion just through cry for
hunger, pain or discomfort sensation.
 Development

■ Social Development
■ Cry is his contact with environment to communicate his
physiologic needs, such as hunger.
■ He utters small throaty sound (coos) which does not have
meaning.
■ He is egocentric and depends on persons to meet his needs. He
learns through conditioning, i.e., cry means getting adults’
attention, whenever he needs their attention, he will cry.
■ He startles to face as he shows vague and indirect regard of
faces.
■