1. Explain the basics and stages of growth and development!

2. How is the normal growth and development of an 11-month-old baby and the comparison with that
case?

3. Explain the factors that influence growth and development!

4. How to determine the nutritional status of the baby?

5. Explain about the type of immunization and how is the schedule given?

6. What is the relationship between neonatal asphyxia and the condition of the baby now?

7. Disorders of growth and development in the baby?

8. How is the management of the scenario above?

1. Basics of Growth and Development

a. Growth

Growth is a change in the size, size, or dimensions of cells, organs and individuals. In this case, weight
gain, height, bone age, head circumference, upper arm circumference.

Growth characteristics include the following:

1. Changes in body proportions. In newborns, the head has a relatively larger proportion than the next
age. The center of the body in newborns is around the umbilicus, whereas in adults it is as high as the
simpisis pubis.

2. Change in size (physical). The body organs will increase which results in an increase in body
requirements.

3. The emergence of new characteristics as a result of maturation of organ function. For example
permanent teeth or secondary sex signs.

4. The loss of old features. This is part of the growth process. The old features referred to here include
the disappearance of the Thymus gland, the date of the milk teeth, and the loss of primitive reflexes.

b. Development

Development is the increase in ability (skill) in the structure and function of the body more complex in a
regular and predictable pattern, as a result of the maturation process.
Based on the YAUMIL-MIMI scale, mental development, rough motor movements, smooth motor
movements, emotions, social, behavioral, and speech abilities of infants aged 9-12 months are as
follows:

a. Can stand alone without help.

b. Can walk with guided.

c. Imitating sound.

d. Repeat the sound he heard.

e. Learning states one or two words.

f. Understand simple rules or restrictions.

g. Showing great interest in exploring the surroundings, wanting to touch anything and putting things
into his mouth.

h. Participate in the game.

Developmental characteristics include:

1. Development involves change. Every growth is accompanied by a change in function. For example the
development of the reproductive system.

2. Early development determines subsequent growth. Will not be able to pass one stage of development
before passing the previous stage.

3. Development has a fixed pattern. In the head area to the caudal (cephalokaudal), in the area proximal
to the distal (proximodistal).

4. Developments have regular and sequential patterns and stages.

5. Development has a different speed and correlates with growth.

Stages of Growth and Development

The stages of growth and development consist of:

I. Pranatal period (intra uterine), divided into:

a. Embryo Period, which starts from conception to 8 weeks' gestation.

b. The period of the Fetus, which starts from 9 weeks gestation to birth. Divided into :
- Early fetus (9 weeks to Trimester 2). During this time the acceleration grows, the formation of the
body, the body's organs have been formed and begin to function.

- Advanced fetus, ie during the final trimester of pregnancy. At this time the growth was rapid. Besides
that, there is also the development of IG G transfer functions and the accumulation of essential fatty
acids (omega 3 and omega 6).

II. Postnatal period (after birth), divided into:

1. Neonatal period (0-28 days). During this time adaptations to the environment occur, changes in blood
circulation occur, and tubal organs also begin to function.

2. Infancy. Consists of :

- Early infancy (1 - 12 months). Rapid growth of the baby occurs, the maturation process continues, and
the nervous system increases.

- Late infancy (1-2 years). Growth rates begin to decline, progress in motor development and excretion
function.

3. Preschool (2 - 6 years). Stable growth, increased physical activity and increased skills in the process of
thinking.

4. School Period (-106-10 years, ♂ 8-12 years). Growth occurs faster, skills and intellectuals grow,
children like to play in groups.

5. Adolescent / Youth Period (♀10-18 years, ♂ 12-20 years). It is a transition period from the child's
period to adulthood. There was an accelerated growth, secondary sex / sex signs also began to appear.

3. Factors that influence growth and development

Factors that influence growth and development can be divided into 2 parts, namely
heredoconstitutional factors and environmental factors.

Heredoconstitutional factor

Genes contained in the nucleus of fertilized eggs during the embryo have their own characteristics in
each individual. The manifestation of the difference between this gene is known as heredity. The DNA
that forms genes has an important role in the transmission of hereditary traits.

The emergence of familial abnormalities, certain special disorders, certain types of dwarfism are due
to abnormal gene transmission. It must be remembered that some children are small because of their
genetic constitution and not because of endocrine or nutritional disorders. The genetic role in the
nature of mental development is still a matter of debate.

Emotional traits such as fear, willingness and temperament are more influenced by the environment
than heredity.

1. Gender

At a certain age, men and women are very different in size, speed of growth, physical proportions and so
on, so they need normal measurements of their own. Women mature earlier, which starts adolescence
at the age of 10 years, while men start at age 12 years.

2. Race or nation

Some anthropologists say that the yellow race has a shorter tendency compared to the white race.

3. Family

Not rare in a family there are short family members while other family members are high.

4. Age

The greatest growth rate is found in the fetus, infancy, and adolescence.

Environmental factor

Prenatal Factors

1. Nutrition

Children born to mothers with poor nutrition and living in poor environments will also experience
malnutrition and be easily infected.

2. Mechanical

Trauma and amniotic fluid that are less able to cause congenital abnormalities in babies born. Similarly,
the position of the fetus in the uterus can result in talipes, dislocation, disruption, congenital torticollis,
facial palsy, or craniotabes.

3. Toxins / chemicals

Drugs such as thalidomide, phenitoin, methadion, anti-cancer drugs, etc. can cause congenital
abnormalities. Likewise with pregnant smokers, chronic alcoholics often give birth to babies with LBW,
stillbirth, disability, or mental retardation.

4. Endocrine
Congenital defects often occur in diabetic mothers who are pregnant and not receiving treatment in the
first trimester of pregnancy, less than 18 years of age or over 35 years, iodine deficiency during
pregnancy, PKU (phenylketonuria).

5. Radiation

Radiation to the fetus before 18 weeks' gestation can cause death, brain damage, microcephaly, or
other congenital defects.

6. Infection

Intra-uterine infections that often cause congenital defects are TORCH (Toxoplasmosis, Rubella,
Cytomegalovirus, Herpes Simplex). While other infections that can also cause diseases in the fetus are
Varicella, Coxackie, Echovirus, and so on.

7. Stress

Stress experienced by mothers during pregnancy can affect fetal growth, including congenital defects,
psychiatric disorders, and others.

8. Immunity

Rhesus or ABO inconsistency often causes abortion, hydrops fetalis, kernus, or stillbirth.

9. Embryonic anoxia

Decreased oxygenation of the fetus through interference with the placenta or umbilical cord causes low
birth weight.

Postnatal factors

1. Nutrition (input food qualitatively and quantitatively)

These include body building materials, namely protein, carbohydrates, fats, minerals, and vitamins.

2. Diseases (chronic diseases and congenital disorders)

Some chronic diseases such as Chronic Glomerulonephritis, Lung Tuberculosis and Celiac Disease can
result in physical growth retardation. The same thing can happen to people with congenital heart
disorders.

3. Socio-economic situation

This plays an important role in the growth of children. Obviously, it can be seen in the size of babies
born from a group of parents with less socio-economic conditions, which is lower than babies from
families with sufficient socio-economic conditions.
4. Season

In a country that has 4 seasons there are differences in the speed of growing weight and height. The
biggest increase is in the spring and the lowest in the fall. Conversely the biggest weight gain occurs in
the fall and the smallest in spring.

5. Others

Many other factors have contributed to the growth and development of children, including medical
supervision, improved sanitation, education, psychological factors, and others.

6. Birth in infants with asphyxia is a dangerous condition for the growth and development of the baby.
Where asphyxia is said if the baby cannot breathe spontaneously, irregularly and inadequately. In
accordance with the scenario, this lasts for 5 minutes. This situation certainly can result in a lack of
oxygen supply to the tissues, especially to the brain. This of course can lead to brain tissue ischemia
which can cause damage to the brain and ultimately affect the growth of the baby.

7. Disorders of growth and development that occur in these infants, namely:

Growth disorders

Babies 11 Months present should Interpretation

(according to age)
BB weight 6000 gr 7750 - 9950 grams -> 10 Not appropriate
kg
(Behrman, 1992
PB body length 70 cm 70.4 - 78.4 cm ± 75 cm appropriate
(Behrman, 1992)
LK head circumference 39 cm 6 mth: 44 cm Not appropriate
1 year: 47 cm

Developmental disorders

present should Interpretation

Babies can lie on their back and
forth.
Can't sit and yet stand-alone.
Can stand alone without help. Not appropriate to his age.
- Can walk by being guided.
- imitating sound.
- Repeats the sound he heard.
- Learning states one or two
words.
- Understand simple orders or
restrictions.
- Showing great interest in
 exploring the surroundings,
wanting
touch anything, & put things in
its mouth.
The hand can't holding rattles. - Participate in the game.