objective 7 Flashcards by Kaitlyn Dominie

Period of time from 4 weeks to 1yr
Milestones (norms) vary with each child

infancy

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Effective feeding patterns
Predictable sleep/wake cycles
Bonding

neonatal phase

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Wt doubled by 2 mos
Wt tripped by 1 yr
Head growth rapid: 1-2cm/month x6 months

physical development

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present until 3 months

grasp reflex

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grasps objects between fingers and thumb
8mos

prehension

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infant extends arms when thrust downward in prone position
8mos

parachute reflex

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coordinates index finger and thumb
1 yr

pincer grasp

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Eriksons trust vs mistrust table 13.4
Love & security vital: healthy personality
Social
Stimulated by change in env
Sensory stimulation
Parents taught to talk, sing, and touch infants
Essential for thought processes and perception

emotional development

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makes small throaty noises, cries when hungry or uncomfortable, sleeps 20-24 hrs

1 month (S)

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smiles to mothers voice. Knows crying brings attention

2 months (S)`

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cries loudly when irrupted from play, babbles and squeals, sucks from spoon

6 months (S)

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plays pat-a-cake, amuses self longer, reserved with strangers

8 months (S)

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recognizes “no”, shows emotion, verbalization slows b/c of increased concentration about ambulation

12 months (S)

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1st teeth- lower contral incisors

6-10 months

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6 teeth (4 above and 2 below)

1 yr

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Posterior fontanels closes
Tears appear
Can hold head erect in mid position
Follows moving light with eyes
Legs active
Holds rattle briefly

2 months (M)

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Sits alone for a moment with hands forward for support
Solid food introduced
Turns over completely
Sees parent & self as one
Separation anxiety begins

6 months (M)

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Sits alone steadily
Uses index fingers and thumb as pincers
Can distinguish happy from fearful face
Can transfer from one hand to another
Begins to crawl, moves forward, using chest, head and arms, legs drag

8 months (M)

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Can rise self to sitting position
Creeps and crawls
Cruise furniture
Holds bottle
Complies with simple command
Fear of being left alone
Fears strangers
Waves “bye-bye”

9 months (M)

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Clings to mother in unfamiliar situation
Demonstrates emotions (affection)
Stands alone for short periods, may want
Attempts to feed self
Babinski reflex disappears before infant walks

12 months (M)

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how do we prevent accidents?

Safety locks
Drowning
Suffocation
Falls
Poisoning major cause of death
Toy safety
Car safety

Black and white contrasting mobiles

0-2 mos play

Hold and chew toys, unbreakable mirrors

3-9 mos play

Push-pull toys, lrg pic books, soft blocks, nested boxes

1yr play

fed at 3-4 hr intervals

bottle-fed infants

fed at 2-3 hr intervals

breastfeed infants

what are the DOs of introducing new foods?

Introduce slowly & one food at a time in small amounts. Rice cereal recommended as first food since it is less allergenic Introduce new solids after milk feeding (as solid food increases , formula/milk should decrease)

what are the DO NOTs of introducing new foods?

Introduce new food if infant ill (adverse effects such as allergic reaction may not be identified) Mix cereal or baby food in bottle Introduce whole milk before 1 year of age Introduce low fat milk until 2 years of age

child begins to reach for spoon

7 months (D)

Begins to use spoon independently , although not able to keep food on it

9 months (D)

what are the physical factors affecting the parent and infant readiness for feeding?

mom well, infant well, anomalies

Much more skillful at self feeding & has the ability to both rotate wrist and to elevate the elbow to keep food on the spoon

2 years (D)

what are the psychological factors affecting parent and infant readiness for feeding?

Discomfort Restlessness Restlessness Crying Extrusion reflex

what are the benefits of breastfeeding?

Faster involution All right nutrients; right proportion Changes to meet baby’s needs Easily digested risk contamination Feeling closeness Always right temp Brain development Enhances mother-infant bonding

what are the contraindications of BF?

Mother has contagious disease i.e. HIV Mother has herpes lesions on both breasts, active varicella zoster virus & untreated infectious tuberculosis Use of illicit drugs or undergoing treatment Galactosemia in infant

what are the 4 stages of lactations?

secretory differentiation secretory activation galactopo involution

Lactogensis in response to pregnancy hormones = colostrum 1st milk secreted Yellowish fluid, rich in protective antibodies Provides protein, vit A&E and essential minerals Lower calories

secretory differentiation

Occurs in response to placenta delivery Decrease in progesterone, increase prolactin The milk comes in day 2-3 until day 8

secretory activation

9 days after birth Driven by autocrine, driven by milk removal Establishment of adequate milk-supply dependent on continual production and removal of breast milk

galactopo

Occurs 40 days after last feed Milk secretion ceases

involution

what are the positions for BF?

Laid back Cradle Football Side lying

how do we prevent problems in BF?

frequency and duration of feedings flat/inverted nipples nipple confusion breast engorgement nipple trauma

Feed at least 8-12X/day Feed Q 1.5-3 hrs early weeks Cluster feeds Flexible 1st weeks; wake after 3 hrs Feed at least 15 mins on 1st breast, switch, then til satisfied (approx 15 min each breast) Begin next feed with last breast

frequency and duration of feedings

Roll between finger & thumb Consult lactation consultatnt

flat/inverted nipples

Breast feed & bottle feed Avoid supplementation 1st 3-4 wks min each breast Pacifiers- neg effect on supply, and impact on latc

nipple confusion

Pump Cold application between feeding & heat prior Manual massage

breast engorgement

Cracks, blisters, redness & bleeding Correct positioning Expressed milk on nipples, warm compress min each breast

nipple trauma

what are the 3 forms of formula feeding?

ready to feed concentrated liquid powdered

how do we prep for bottle feeding?

Bottles/nipples sterilized by boiling for 2 mins Ready to feed No dilution, wash top can, pour bottle Concentrated liquid formula Half formula, half water Powdered formula Water with recommended scoops

how do we observe for dehydration?

< 6 wet diapers/day Dry, hard stool Skin turgor Dry MM Low grade fever Sunken fontanels