Infant

Nursing Care of a
Family with an infant

A. Growth and Development
Physical Growth
Weight of the infant
• Double their birth weight by 4 to 6 months and triple it by 1 year
• First 6 months: average weight gain of 2 lb per month
• Second 6 months: 1 lb per month
Infant height
• height increases by 50% in first year from around 20 in to 30 in
Head circumference
• the brain reaches two thirds of its adult size
• rapid brain growth in this time period
• appear asymmetric until the second half of the first year
Physical Growth
Body proportion
• lower jaw becomes more prominent
• chest circumference is even with head circumference by 12 months
• abdomen remains protuberant until infant starts walking for a while
• Cervical, thoracic, and lumbar vertebral curves develop as infants hold up
their head, sit, and walk
• Lower extremities lengthening
Physical Growth
BODY SYSTEMS
• Cardiovascular system
• Heart rate slows from 110 to 160 beats/min to 100 to 120 beats/min by the
end of the first year.
• Pulse rate may slow with inhalation (sinus arrhythmia)
• The heart is becoming more efficient is shown by a decreasing pulse rate
and a slightly elevated blood pressure
(from an average of 80/40 to 100/60 mmHg)
Physical Growth
Respiratory System
• An infant slows from 30 to 60 breaths/min to 20 to 30 breaths/min by
the end of the first year.
• The lumens of the respiratory tract remain small and mucus production
by the tract to clear invading microorganisms is still inefficient, upper
respiratory infections occur readily and tend to be more severe than in
adults
Physical Growth
GI tract
• Functions mature gradually during the infant year
• The ability to digest protein is present and effective at birth, the amount of amylase, which
is necessary for the digestion of complex carbohydrates, is deficient until approximately
the third month.
• Lipase, necessary for the digestion of saturated fat, is decreased in amount during the
entire first year.
• Extrusion reflex: food placed on an infant’s tongue is thrust forward and out of the mouth,
prevents some infants from eating effectively if they are offered solid food this early. Until
age 3 or 4 months
• Kidneys remain immature and not as efficient at eliminating body wastes as in an adult.
Physical Growth
Endocrine system
• remains immature in response to pituitary stimulation (adrenaline)
• may not be able to respond to stress as effectively as an adult Infant's immune
system
Immune System
• becomes functional by 2 months
• Can actively produce IgG & IgM by 1 year IgA, IgE, & IgD are not plentiful until
preschool age
• not mature until 6 months
• -an now shiver & has additional adipose tissue
Physical Growth
Teeth
• The first baby tooth (typically a central incisor) usually erupts at age 6 months,
followed by a new one monthly.
• Fluoride supplementation should be administered at 6 months of age
• Some newborns (about 1 in 2,000) may be born with teeth (natal teeth) or have
teeth erupt in the first 4 weeks of life (neonatal teeth).
• The lower central incisors are the teeth most frequently involved in this early
growth.
• Deciduous teeth are essential for allowing proper growth of the dental arch.
Motor Development
GROSS MOTOR DEVELOPMENT: ability to accomplish large
body movements
FINE MOTOR DEVELOPMENT: measured by observing or
testing
PREHENSILE: ability to coordinate hand movements
Motor Development
Assessing gross motor development involves 4 positions
• ventral suspension position
• Prone position
• Sitting position
• Standing position
Motor Development
Ventral suspension position: an infant's appearance when held in midair on
a horizontal plane and supported by a hand under the abdomen
Newborn: allows head to hang down -1 month old: lift head momentarily
2 month old: hold head in same plane as rest of body
3 months & on: lift & maintain head well above
6-9 months: parachute reaction present, when infants are suddenly lowered
toward an examining table, the arms extend as if to protect themselves from
falling
Motor Development
Prone position: newborns can turn their head to move it out of a position where breathing is
impaired, but they cannot hold their head raised for an extended time
1 month: lift head & turn easily to the side
2 month old: raise head & maintain position but cannot raise chest high enough to look
around
3 month old: lifts head & shoulders well off table & looks around
4 month old: lifts chest off bed & look around actively while turning head side to side, can turn
from front to back (neck-righting reflex occurs, causes babies to lose balance & roll sideways
when lifting head)
5 month old: can put weight on forearms when prone
9 month old; can creep (has abdomen off floor & moves one leg w one arm & then the other
leg w the other arm)
Motor Development
Infant rolling
most babies turn front to back 1st when rolling over, and then turn back to front 1 month later
Sitting position
newborn: when placed on back and then pulled to a sitting position, has extreme head lag (present
until about 1 month), In sitting position back appears rounded & infant demonstrates only momentary
head control
2 months: can hold head fairly steady when sitting up, but head tends to bob & still shows a head lag
4 month old: no longer has a head lag
5 month old: straightens back when sitting
6 months: can sit momentarily w/o support
7 month old: can sit alone only when hands are held forward for balance
8 month old: sits alone w/o support
9 months: can lean forward & regain balance
Motor Development
Standing position
newborn: stepping reflex present until 1 month
3 months: try to support part of weight on feet
4 months: able to support weight on legs because stepping reflex has faded
5 months: tonic neck reflex gone & moro reflex fading
6 months: can almost support full weight
7 month old: bounces in place
9 month old: can stand when holding on to something
10 months: can pull themselves into standing position, but cannot let themselves down
11 months; can move around when holding on
12 months: can stand alone for a moment
Motor Development
When should the infant start walking?
-child has until 22 months to walk & will still be within normal limits
Fine motor development

1 month old: baby holds fists very tightly
2 months: begin to grasp objects for a few min b4 dropping it
3 months: reach for objects
4 months: bring hands together & pull at clothes, thumb opposition (bringing
thumb & fingers together) begins -5 months: accept objects handed to them w
hands (fisting beyond 5 months suggests delayed motor development)
Motor Development
6 months: can hold objects in both hands, can hold a spoon to feed
themselves
7 months: can transfer toys from 1 hand to another
10 months: pincer grasp (ability to bring thumb & 1st finger together)
develops, allows them to pick up small objects, point w I finger
12 months: can hold a crayon to draw a line, can hold a cup, can take off
socks & put hands into sleeves
B. Developmental Milestone
Language Development
1-2 months: Babies communicate using sounds and gestures.
3-4 months
• Make eye contact with you
• Say ‘ah goo’ or another combination of vowels and consonants
• Babble and combine vowels and consonants, like ‘ga ga ga ga’, ‘ba
ba ba ba’, ‘ma ma ma ma’ and ‘da da da da’.
5-7 months
• Copy the sound you make like laughing
• Copy some gestures like clapping pointing and waving
• Play by making different sounds like ‘ahhh’ ‘wahh’ and ‘boo’
Language Development
8-9 months: Saying ‘mama’ or ‘dada’
put sounds together with rhythm and tone, in ways that it makes
sounds like a speech
10-11 months: Baby might communicate using noises and a small
amount of gestures, while pointing if asking for something, saying no
to something and greeting someone
Asking by pointing by looking for an object or a person
12 months: Baby might develop few words like mama and dada
referring for mom and dad
Play
1 month old: Enjoy a mobile over their crib playpen, enjoy watching
parent's faces (tell parents holding infant for long periods of time is
not bad)
4 months old: Can roll over
5 months old: Can handle blocks and squeeze toys can introduce bath
toys when infant can sit up at 6 months
7 months old: Need toys that are easy to transfer b/w each hand
Play
8 months old: Sensitive to textures ( enjoy toys with different
feelings)
9 months old: Need experience creeping (time out crib or playpen),
enjoy toys that go inside each other
10 months old: Enjoy peek-a-boo, patty cake
11 months old: Spend most of the time walking
12 months old: Enjoy nursery rhymes, music, taking things out of
containers, pull toys
Emotional Development
2-3 months: Infants begin showing spontaneous “social
smile”
4 months: begin to laugh spontaneously
5 months: may show displeasure when an object is taken
away from them
6 months: aware of difference between people who
regularly care for them and strangers
Emotional Development
7 months: Show obvious fear of strangers, may cry when
taken from parent
8 months: Fear of strangers reaches its height often
termed 8th month anxiety
9 months: Aware of changes in tone of voice
12 months: Most have overcome fear of strangers, enjoy
joining in family activities
Cognitive Development
3 months: Child enters primary circular reaction
6 months: Enters secondary circulation
10 months: Discover object permanence
12 months: Capable of reproducing events (realize hitting a
mobile moves it and then hit again, drop objects off high-
chair repeatedly)
Moral and Spiritual Development
Moral development: Infants initiate the formation of a sense of
trust and security through the provision of consistent and
responsive caregiving. Forms the foundation for moral
development, as trust is crucial for the understanding of
relationships and reliance on others.
Spiritual development: Early experiences of love and care
contribute to the development of a sense of security,
Possibly establishing the foundation of a spiritual
connection.
Psychosexual Development
Birth- 4 months:
Oral Gratification: During this stage, the infant experiences the world primarily
through oral activities.
Trust Development: Consistent and responsive caregiving during feeding
fosters a sense of trust in the infant.
4-8 months:
Teething and Mouthing: The emergence of teeth during this period leads to
the beginning of teething.
Building Autonomy: The infant starts to develop a sense of autonomy as they
engage in self-soothing behaviors, like sucking on fingers or a pacifier.
Psychosexual Development
8-12 months:
Exploration Through Mouth: As motor skills improve, the infant uses
their mouth to explore objects and the surrounding environment.
Introduction of Solid Foods: Weaning, the gradual introduction of
solid foods, becomes a significant aspect.
C. Health Promotion
Safety
Safe Sleep Practices: When putting infants to sleep, they should do so on their
backs on a solid mattress without any soft bedding or toys in the crib.
Avoiding exposure to tobacco smoke: Secondhand smoking raises the risk of
respiratory infections, SIDS, and other health problems, so it is best to keep
infants away from it.
Regular healthcare visit: Well-Baby check ups and vaccinations are important
for monitoring the infants growth and development while protecting them from
preventable diseases.
Monitoring temperature: Ensuring that the infant is not too hot or
too cold by dressing them appropriately for the environment.
●
C. Health Promotion
Nutritional Health
Promoting breastfeeding: Is one of the most crucial health promotion
tactics for baby nutrition.
Promoting Healthy habits: Is important for supporting general health and
reducing childhood obesity.
Parent and Caregiver Education: An essential component of health
promotion initiatives is teaching parents and caregivers about newborn
nutrition.
C. Health Promotion
Development in Daily Activities
Tummy time : Every day, place your infant on their tummy on a safe surface
for several minutes.
Play with toys that encourage movement: Provide your infant with toys
that encourage them to reach, grasp, and kick.
Spend time interacting with your infant - Make time each day to interact
with your infant face-to-face.
Talk and sing to your infant - Talking and singing to your infant helps them
develop their language skills.
C. Health Promotion
Promoting Health Family Functioning
Establish a Nurturing and Responsive Environment: Make your home a
welcoming, loving, and supporting environment.
Promote Healthy Habits and Routines: Establish consistent routines for
sleep, feeding, and playtime.
Engage in regular family activities: Spend time together doing things you all
enjoy, such as playing games, going for walks, or reading books.
Celebrate family milestones and accomplishments: Recognize and
celebrate each other's achievements, big or small.
D. Parental Concerns Associated with the
Stage of Childhood Period
Adapting to Changes: Although having a newborn on board in the family may
seem like the excitement of parenthood, new mothers have to learn to cope with
the responsibility of nursing and nurturing their baby along with taking care of
themselves.
Sleep Deprivation and Exhaustion: When taking care of an infant especially

where the infant is extremely demanding like comforting the baby, putting her to
sleep, feeding her on time, changing the nappy, and so on are tasks where parents
must take care of.
.
D. Parental Concerns Associated with the Stage
of Childhood Period
Concern for the baby’s safety: Parents may sometimes feel concerned about
their baby’s safety in this big, bad world where young children are being exploited
and persecuted.
Baby refuses to eat: Mostly, babies sleep all of the time and are dependent on
their parents. Sometimes, babies tend to make their parents feel worried and
anxious with their attitude by refusing to eat.
E. Concerns of the family with a physically
challenged or chronically ill
The struggle with their own emotions- Anger, guilt- physical and mental
exhaustion: Parents will experience a range of emotions, most notably, shock,
denial, magical thinking, sadness, guilt, anger, disappointment, lack of control
and resentment related to the chronic illness or disability of their child.
Stress on the marriage: When parents learn that their child has a disability or
special health care need, they begin a process of continuous, lifelong
adjustment.
Figuring out how to support their child: feeling alone in fighting every
resource (schools, agencies, the health care team, insurance or Medi-Cal, social
worker) for the care they deem their child needs
Stress over making medical decisions for their child and not
understanding what is going on: Most parents can relate to an experience in
their lives during which a healthcare visit or medical procedure was upsetting
and anxiety-provoking.
Fear of medical treatments and their outcome: Where their child's condition
causes them to suffer, the scales may still be tipped against treatment.
Fear of an emergency situation and knowing when to get help: Parents
have additional pressures regarding an emergency situation to manage their
child’s well being as they often experience difficulty and uncertainty when
negotiating medical and support services.
Guilt around the wellbeing of siblings:
When a child is disabled, it affects everyone in a family - parents, siblings,
grandparents. Often, siblings get lost in the shuffle. All the attention is
focused on the brother or sister. Everything seems to be about them, they
get the visitors and the toys. Sometimes special occasions are forgotten
when medical emergencies arise.
F. Nutrition and the Physically ill
Caloric and Nutrient Density: Infants with certain health conditions may
have increased caloric or nutrient needs.
Gastrointestinal Issues: Some infants may experience gastrointestinal
issues, such as reflux or difficulty digesting certain nutrients.
Allergies and Intolerances: Infants with chronic illnesses may be more
prone to allergies or intolerances.
Medication Interactions: Consider the potential interactions between
medications and nutrition.
Tube Feeding: In severe cases where oral feeding is not possible,
tube feeding may be necessary.
F. Nutrition and the Physically ill
Bone Health: Certain chronic illnesses or medications may impact bone
health.
Fluid Management: Some conditions may require strict fluid management.
Individualized Plans: Each infant's situation is unique.
Long-Term Planning: For infants with chronic illnesses, consider long-term
nutritional planning.
Psychosocial Support: Chronic illness can impact the psychosocial
well-being of both the infant and the family.

Infant

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Infant

Uploaded by

Copyright:

Available Formats

Nursing Care of a

Family with an infant

Fine motor development

Sleep Deprivation and Exhaustion: When taking care of an infant especially

You might also like