The Newborn

Ch. 3

Newborns Reflexes
Reflexunlearned responses that are triggered by a specific form of stimulation

An absence or abnormality of a reflex may signal there is a neurological problem

Newborns Reflexes contd

Typical reflexes: coughing, sneezing, blinking Feeding reflexes: rooting & sucking (survival reflexes)

Newborns Reflexes contd

Babinski Moro Palmar Blinking Rooting Stepping Sucking Swimming Reflex

Newborns Reflexes contd

Palmar

Babinski

Moro

Newborns Reflexes contd

Rooting

Stepping

Sucking

Assessing the Newborn

Apgar quick, approximate assessment of newborns status Apgar Index
Heart rate Respiration Muscle tone Reflexes Skin tone

Assessing the Newborn Apgar contd

Each vital sign receives score 0,1,2 Score of 7 or greater
Baby in good physical condition

Score of 4-6
Needs special attention and care

Score of 3 or less
Life-threatening situation that requires emergency medical care

Assessing the Newborn

Assessing the Newborn

Neonatal Behavioral Assessment Scale (NBAS)
Includes 28 behavioral and 18 reflex items Assesses four systems 1. Autonomic: body regulation (e.g., breathing) 2. Motor: activity level and control of body 3. State: maintaining states (e.g., alertness) 4. Social: interacting with people

Newborns States
4 states newborns alternate among
1. Alert inactivity 2.Waking activity 3.Crying 4.Sleeping

Crying
Spend 2-3 hours each day crying or on verge of crying Represents first attempts of interpersonal communication 3 distinctive types of cries
1. Basic Cry 2. Mad Cry 3. Pain Cry

Crying
Basic cry Starts softly and builds in volume and intensity Often seen when the child is hungry Mad cry More intense and louder Pain cry Starts with a loud wail, followed by a long pause, then gasping

Understanding your baby: Modern research

Priscilla Dunstan Five words that can be found in all cries Must listen during pre-cry before baby becomes hysterical http://www.youtube.com/watch?v=aewskiO 9YuY&feature=related

Understanding your baby: Modern research

Five Words 1.Neh Im hungry 2.Owh Im sleepy 3.Heh Im uncomfortable 4.Eair I have lower gas 5.Eh I need to burp

How to soothe crying

Different methods
Walking with baby put up on shoulder Lullabies Patting on back Driving around in car Swaddling

How to soothe crying

Happiest Baby on the Block Harvey Karp 5 Ss 1.Swaddling 2.Side/Stomach position 3.Shushing 4.Swinging 5.Sucking

Sleeping
Newborns sleep an average of 16-18 hours per day Sleep-wake cycle (4 hours of sleep followed by 1 hour of wakefulness) 3-4 months sleep 5-6 hours straight 6 months 10-12 hours at night

Sleeping
REM sleep (irregular or rapid-eyemovement)
Half of newborns sleep in this state Body is quite active Brain waives register fast activity, heart beats rapidly, breathing more rapid Gradually decreases from 50% of the newborns sleep to about 25% at the age of 1 year

Sleeping
nonREM sleep
Breathing, heart rate, and brain activity are steady Lie quietly without the twitching of REM sleep

Co - Sleeping
The practice of sleeping in the same room or bed with the child Research shows no evidence of increased dependence Co-sleeping has the advantage of avoiding elaborate sleep-time rituals

Sudden Infant Death Syndrome (SIDS)

SIDS: sudden, inexplicable death of a healthy baby Risk factors Premature birth and low birth weight Parental smoking Child overheating and sleeping on stomach African-American infants (often sleep on stomach) Reducing risk? Sleeping on back or sides

Dimensions of Temperament
Activity Level Positive Affect
Motor activity

Persistence
Inhibition

Pleasure, enthusiasm, and contentment Amount of resistance to distraction

Extent of shyness and withdrawal

Negative Affect
Irritability and tendency toward anger

Rothbart & Hwang Theory of Temperament

Surgency/extraversion
How happy, active, and stimulation-seeking is the child?

Negative affect
Is the child angry, fearful, frustrated, shy and not easily soothed?

Effortful control
Can the child focus their attention and inhibit responses?

Rothbart & Hwang Theory of Temperament

Three dimensions are not independent
High effortful control predicts high surgency/extroversion, but low negative affect

Scores during infancy predict personality in adolescents and adults

Hereditary and Environmental Contributions to Temperament

Heredity and twin studies
Identical twins are more similar in temperament than are fraternal twins Heredity influences negative affect more than other temperament dimensions

Heredity contributes more to temperament in childhood than during infancy

Hereditary and Environmental Contributions to Temperament

Parental characteristics influence temperament
Parental responsiveness reduces infant emotionality Depressed mothers have more fearful infants

Temperament influences environments effect on children Temperament influences how others treat the child and his or her experiences

Stability of Temperament
Studies suggest that temperament tends to be somewhat stable throughout infancy and the toddler years Temperament predisposes, but does not always guarantee, later personality characteristics Parents can nurture children to behave in ways somewhat different from their temperament

Physical Development
Growth is more rapid in infancy than during any other period after birth Infants double their weight by three months triple their weight by 1 year Average is not the same as Normal Height depends largely on heredity

Nutrition & Growth

Roughly 40% of bodys energy is devoted to growth (in 2-month-old) Young babies must consume large amounts of calories relative to body weight
i.e. 50 calories/pound of body weight for 3 month old vs. 15-20 calories/pound for adult

Breastfeeding is the best way to ensure proper nourishment

Benefits of Breast-feeding
Sick less often Less prone to diarrhea and constipation Typically make transition to solid foods more easily Cannot be contaminated (significant problem in developing countries) Children who breast feed
are less likely to become obese have higher IQs as children

Nutrition
New foods should be introduced one at a time Growth slows and children need to eat less by 2 years old Typically begins picky stage

Malnutrition
World-wide about 1 in 4 children under 5 are malnourished (UNICEF, 2006) Malnourished children develop more slowly Most damaging during infancy due to rapid growth rate

The Emerging Nervous System

The brain and the rest of the nervous system consist of cells known as neurons Neurons consist of a soma, dendrites, the axon, and terminal buttons Terminal buttons release chemicals called neurotransmitters

Organization of brain
The brain has 50-100 billion neurons Cerebral cortex: the wrinkled surface of the brain Hemispheres: the two halves of the brain Corpus callosum: the thick band of fibers connecting the two hemispheres

The Making of the Working Brain

The brain weighs about three-quarters of a pound at birth about 25% of an adult brain At around 3 years of age the childs brain is about 80% of an adults brain weight

Emerging Brain Structures

3 weeks after conception
the neural plate forms (a flat structure of cells)

28 weeks after conception

the brain has all the neurons it will ever have

4th month of prenatal development

axons begin to form myelin helps to speed transmission

Emerging Brain Structures

Synaptic pruning
Synapses gradually disappear Depends on activity of neural circuits
Synapses that are active are preserved, arent active are eliminated

Completed first for brain regions with sensory & motor functions 2nd with basic language & spatial skills Finally, regions associated with attention & planning

When does a function become localized in specific part of brain?

Methods to study origins and time course of brain specialization Studying children with brain damage Measuring the brains electrical activity through electrodes place on scalp (EEG or electroencephalogram) Using magnetic fields to track brain blood flow (fMRI, functional magnetic resonance imaging)

5 General Principles of Brain Specialization

1. Specialization is early in development Ex.: newborns left hemisphere generates higher electricity in response to speech 2. Specialization takes two specific forms A. Specialized areas become more focused and less diffuse B. Stimuli triggering brain activity become more specific than general

5 General Principles of Brain Specialization

3. Different brain systems specialize at different rates Ex.: systems for sensory and perceptual processes specialize before those for higher-order processes 4. Environmental stimulation is necessary for successful specialization A. experience-expectant growth B. experience-dependent growth

5 General Principles of Brain Specialization

5. Plasticity is a benefit of the immature brains lack of specialization Atypical experiences may disrupt normal course of development (e.g., brain damage disrupting speech) Plasticity: brain is very flexible, allowing recovery of function, especially in young children

Motor Skills
Self controlled movements Gross Motor Skills
involve the use of large muscle groups (i.e. controlling the neck muscles to hold up the head and body to sit up, moving legs, etc.)

Fine Motor Skills

Grasping, holding, and manipulating objects

Milestones in Motor Development

1 month - can hold up head with some support 3 months - can raise chest off floor when on abdomen 6-8 months - can control lower trunk & sit up begin to crawl 9 months - successful crawling 11-13 months - stand on their own usually by pulling up

Locomotion
Toddling
Early unsteady form of walking

Dynamic Systems theory

The idea that motor development involves many distinct skills that are organized and reorganized over time to meet demands of specific tasks i.e. walking maintain balance, moving limbs, perceiving environment, having reason to move

Posture and Balance

Infants are top-heavy and easily lose their balance Within a few months, infants use inner ear and visual cues to adjust posture Infants must relearn balance each time they achieve new postures

Stepping
Many infants move their legs in a stepping-like motion as early as 6-7 months Infants use environmental cues to judge whether a surface is suited to walking (e.g., flat vs. bumpy)

Coordinating Skills
Walking skills must be learned separately and then integrated with others Differentiation: Mastery of component skills Integration: Combining them in sequence to accomplish the task Independent walking: 12-15 months

Cultural Impact on Motor Development

Some cultural practices encourage certain skills early and others discourage them Despite cultural differences in average age of skill development, children acquire skills within a normal range

Fine Motor Skills

Reaching and grasping 4 months infants can clumsily reach for objects By 5 months, infants coordinate movement of the two hands 7-8 months infants use thumbs to hold objects

Fine Motor Skills

Feeding 6 months begin experimenting with finger foods 1 year old begin experimenting with feeding with spoon Master feeding by 2 years old

Fine Motor Skills

By 2-3 years, children can use zippers but not buttons 3-4 years, children can fasten buttons Tying shoes is a skill that develops around age 6 years

Handedness
About 90% of children prefer to use their right hand Most children grasp with their right hand by age 12 months and a clear preference is seen by preschool age Preference is affected by heredity but environmental factors influence it too

Coming to Know the World: Perception Newborns have a good sense of smell
They react to pleasant and unpleasant They turn toward pads soaked in their own amniotic fluid, or the odors of their mothers breast

Coming to Know the World: Perception Newborns can differentiate between tastes
They differentiate between salty, sour, bitter, and sweet Facial reactions are obvious reactions to sweet tastes

Touch and Pain

Babies react to touch with reflexes and other movements Babies react to painful stimuli with the pain cry a sudden, high-pitched wail and they are not easily soothed

Hearing
Startle reactions suggest that infants are sensitive to sound 6-month-olds distinguish between different pitches as well as adults By 7 months, infants can use sound to locate direction and distance

Seeing
Newborns respond to light and track moving objects with their eyes Visual Acuity (clarity of vision) is the smallest pattern that can be distinguished dependably Infants at 1 month see at 20 feet what adults see at 200-400 feet By 1 year, the infants visual acuity is the same as adults

Color
Newborns perceive few colors 1-month-old infants can differentiate between blue and gray, as well as red from green 3- to 4-month-old infants can perceive colors similarly to adults

Depth
Visual cliff research 6-week-olds react with interest to differences in depth (heart rate deceleration) By 7 months, they show more fear than interest to the cliffs deep end (heart rate acceleration and refusal to cross the deep side) Fear of depth seems to develop around the time babies can crawl

Depth
Infants at 4-6 months use retinal disparity (the difference between the images of objects in each eye) to discern depth Infants of 5 months use motion and interposition to perceive depth

Depth Perception Children use cues to infer depth, including:

Kinetic Cues Visual Expansion Motion Parallax Retinal Disparity

Depth Perception By 7 months, children use Pictorial Cues such as:

Linear Perspective Texture Gradient

Perceiving Objects
Involves interpreting patterns of lines, textures, and colors Perception of objects is limited in newborns, but develops rapidly Infants group objects together that have the same texture, color, or aligned edges

Perceiving Faces
Newborns prefer to look at moving faces until around 4 weeks, then track all moving objects At first, infants process faces as though they are unrelated elements within a collection By 7-8 months, infants process faces similarly to adults, as a unique arrangement of features

Integrating Sensory Information

Infants soon begin to perceive the link between visual images and sounds Infants seem to pay more attention to intersensory redundancy, or information simultaneously coming from different sensory modes

Origins of Self-Concept
Self-awareness Mirror test: red rouge surreptitiously rubbed on childs nose; child placed in front of mirror and behavior is observed
9-month-old infants smile at the image in the mirror but do not seem to recognize it as themselves By 15-24 months, infants see the image in the mirror and touch their own nose, suggesting they know the image is theirs

Origins of Self-Concept
Self-awareness Mirror test: red rouge surreptitiously rubbed on childs nose; child placed in front of mirror and behavior is observed
9-month-old infants smile at the image in the mirror but do not seem to recognize it as themselves By 15-24 months, infants see the image in the mirror and touch their own nose, suggesting they know the image is theirs