NCM 107 PEDIATRIC NURSING

HANDOUTS ON INFANCY

INFANCY

 There is tremendous physiologic development

 CNS(central nervous system) –the fastest growing system in the body.
 Myelinization takes place during the infancy
 Tremendous vision development.
 Cardiovascular and respiratory systems are functioning as essentially the same
level of an adult.
 Brain cells continue to develop in size and number
 Myelinization-refers to the development of myelin sheath around the nerve fibers-
efficient transmission of nerve impluses
Occurs in cephalo caudal direction
Takes up to 2 years for the process to be completed
 Vision- 8 weeks- alert to moving objects, attracted to bright colors and lighted
objects
4-6 months- has bifocal vision can stare and search
i year- distance vision

Neonate still depends on maternal antibodies for immunologic protection

6-8 WEEKS- ANTIGEN-ANTIBODY RESPONSE IS PRESENT
9 MONTHS- DEVELOPING THEIR OWN IMMUNITY
IMMUNE SYSTEM develops over the first year of life.
PHYSICAL DEVELOPMENT
HEIGHT-
WEIGHT- Primary indicator of nutritional status
hydration status
2 lb/ month-1st 6 months
1 lb/month-last 6 months
Average infant will double his birth weight at 5 months and triple it by 1 year.

Head Circumference or Occipito-Frontal circumference.

FONTANELS- are the 2 openings between the bones in the neonate’s skull.
ANTERIOR FONTANEL- formed at the intersection of the sagittal, frontal and coronal
sutures lines. Measures about 2 cm x 2 cm. remains open for up to 18 months.

POSTERIOR FONTANEL- formed at the intersection of the sagittal and lambdoid

suture lines. Average size is 1 cm x 1 cm. closes at 2 months
Most neonates don’t have teeth, NATAL TOOTH- present at birth.
8 months- average age of first tooth eruption- starts drooling and mouth hard objects
before eruption.

SEQUENCE OF TOOTH ERUPTION

AGE/ TOOTH ERUPTION

6 to 10 months-Central Lower incisors
8 to 10 months-Central Upper Incisors
9 to 13 months-Lateral Upper Incisors
10 to 16 months-Lateral Lower Incisors

GROSS MOTOR SKILL-refers to the child’s development of skills that require the use
of large muscle groups.
Posture
Head control
Sitting
Creeping
Standing
Walking
The infant will attain gross motor control in a cephalocaudal manner.

FINE MOTOR SKILLS-refers to the infant’s ability to use his hands and fingers to grasp
an object.

THIS CHART SHOWS THE MAJOR GROSS AND FINE SKILLS THAT THE INFANT
COULD MASTER AS HE PROGRESSES THROUGH THE FIRST YEAR OF LIFE

GROSS MOTOR SKILL/ FINE MOTOR SKILL

1 MONTH

 Can hold head momentarily but still has marked head lag
Back is rounded in sitting position with mo head control
• Strong grasp reflex
Hands remain mostly closed in a fist

2 MONTHS

 In prone position, can lift head in 45 degrees

In sitting position, back is still rounded but with more head control
• Diminishing grasp reflex
Hands open more often

3 MONTHS

 Slight head lag when pulled to a seated position

In prone position, can use forearms to lift head and shoulders 45 degrees to 90 degrees
off the table
Can bear slight amount of weight on legs in standing position
• Grasp reflex now absent
Hands remain open
Can hold a rattle and clutch own hand

4 MONTHS

 No head lag
Holds head erect in sitting position, back less rounded
In prone position, can lift head and chest 90 degrees off table
Can roll from back to side
 Hand regard
Can grasp objects with both hands
May try to reach for an object without success
Can move objects towards mouth

5 MONTHS

 No head lag
Holds head erect and steady when sitting
Back is straight
Can put feet to mouth when supine
Can roll from stomach to back
 Can voluntarily grasp objects
Can move objects directly to mouth

6 MONTHS

 Can lift chest and upper abdomen off table, bear weights on hands
Can roll from back to stomach
Can bear weight on feet when held in standing position
Sits with support
 Can hold bottle
Can voluntarily grasp and release objects
Can hold spoon to feed self
7 MONTHS

 Can sit leaning forward on hands for support

when in standing position, can bear full weight on legs ad bounce
 Transfer objects from hand to hand
Rakes at objects
Can bang objects on table

8 MONTHS

 Can sit alone without assistance

Can move from sitting to kneeling position
 has beginning pincer grasp.
Reaches for objects out of reach

9 MONTHS

 Creeps on hands and knees with belly off floor

Pulls to standing position
Can stand holding on to furniture
 Refining pincer grasp
Use of dominant hand evident

10 MONTHS

 Can move from prone to sitting

Stands with support, may lift a foot as if to take a step
 Refining pincer grasp

11 MONTHS

 Can cruise(take side steps while holding on to furniture) or walk with both hands
held.
 Can move objects into containers
Deliberately drops object to have it picked up
Neat pincer grasp

12 MONTHS

 Cruises well, may walk with one hand held

May try to stand alone
 attempt to build a two-block tower
Can crudely turn pages of a book
Feeds self with cup and spoon

LANGUAGE AND SOCIAL DEVELOPMENT

0 to 2 months

Listen to voices; quiet down to soft music, singing or talking

Distinguishes mother’s voice after a week, father’s voice by 2 weeks
Prefers human voice to other sounds
Produces vowel sounds “ah”, “eh”, “oh”

3 to 4 months

Coos and gurgles

Babbles in response to someone talking to him
Babbles with giggles, shrieks and laughs
Says “da”. “ma”, “pa” and “ga”
Vocalizes more to a real person than to a picture
Responds to caregiver with social smile by 3 months

5 to 6 months

Smack lips
Begins learning to take turns in conversation
Talks to toys and self in mirror
Recognizes names and familiar sounds

7 to 9 months
Tries to imitate more sounds begins learning the meaning of “No” by tone of voice and
actions
Experiences early literacy, enjoys listening to simple books being read
Recognizes and responds to his name and names of familiar objects

10 to 12 months
May have a few words ”bye-bye” and “hi”
Follow one-step instruction such as “go to daddy”
Recognizes words as symbol for objects
Says” ma-ma-ma” and “ da-da-da”

PLAY
Play is an integral part of the socialization process.
From birth to 3 months, infants enjoy having their body parts touched and moved and
looking at objects with contrasting colors.
They develop the ability to grasp objects and move them, so RATTLES are great toys at
this time

COGNITIVE DEVELOPMENT

Refers to the intellectual abilities of the child---his thinking, reasoning and ability to solve
problem and understand.
He develops:

SENSE OF OBJECT PERMANENCE-the realization that objects continue to exists

even when they can’t be seen.

CAUSALITY- understanding that a particular action—cause or leads to an effect.