Post natal Development

The Babys Adaptation to Labor and Delivery Newborns appearance

The Newborn Baby

Newborn are called Neonate. First four weeks of life (neonatal period)

A time of transition from the uterus, where a fetus is supported entirely by the mother to an independent existence. Covered by fluid from amniotic sac Blood from placenta Brownish fluid from own faeces. Covered with lanugo (fuzzy prenatal hair) Covered with vernix caseosa (cheesy varnish)

When neonate are first born:

The Newborn Baby

Size and Appearance

New babies have distinctive feature a large head and a receding chin On the head Fontanels (the soft spots) Newborns have a pinkish cast skin so thin that it barely covers the capillaries through which blood flows. Boys tend to be slightly longer and heavier than girls, and a firstborn child is likely to weigh less at birth than laterborns

The Newborn Baby

Weight : 2.8 -3.2 kg Length : 51-53 cm (Boy > girl) Head Circumference: 30-33 cm Breathing:

Initially fast, short & irregular Later more stable & with rhythm

Blood pressure become stable in 10 days.

Is the Baby Healthy?

Medical and Behavioral Screening

1.
2. 3.

Apgar Scale The Brazelton Neonatal Behavioral Assessment Scale Checks are also done for any structural or physical deformities (eg. spinal defect, cleft palate)

Silver nitrate or tetracycline is usually dropped into neonate eyes to prevent from bacterial infection while passing through birth canal.

Apgar Scale

Apgar Scale is a standard measurement of a newborns condition

Introduced by Dr. Virginia Apgar Access newborn 1 min after birth 5 min after birth

Assess:
Appearance

(colour) Pulse (heart beat rate) Grimace (reflex) Activity (muscle tone) Respiration (breathing)

APGAR SCALE
Sign
Appearance
Pulse Grimace

0
Blue, pale
Absent No response

1
Body pink, extremities blue
Slow (below 100) Grimace

2
Entirely Pink
Rapid (over 100) Coughing, sneezing, crying

Activity Respiration
Score:

Limp Absent

Weak, inactive Irregular, slow

Strong, active Good, Crying

Above 7 = (good/normal) 4 -7 = average, need monitoring 3 & Below = need immediate attention, high risk situation

Brazelton Neonatal Behavioral Assessment Scale

The

Brazelton Neonatal Behavioral Assessment Scale (NBAS) (Dr. Berry Brazelton) serves 3 purpose: As an index of neurological integrity after birth To predict future development To assesses neonates' responsiveness to their physical and social environment Screening done on 3rd day and repeat again after several days.

Brazelton Neonatal Behavioral Assessment Scale (NBAS)

Test on four distinct areas: Social behavior (interactive behaviors in the home) Motor behaviors (reflexes & muscle activities) Control of physiology (babys ability to quiet himself) Stress response (startle reaction) High score a neurologically well developed infant Low score a sluggish infant who need help in responding to social situations, or possible brain damage.

Babies In-born Reflexes

Reflexes an inborn, automatic response to a particular form of stimulation. Full term newborns come equipped with a variety of reflexes for use in dealing efficiently with stimuli present in their environment. Some reflexes are necessary for survival (eg. Rooting & sucking reflexes) Reflexes are probably genetic in origin & include a timing mechanism that allows them to fade away after a period of time.

Examples of Newborn Reflexes

Eye Blink Withdrawal Rooting Sucking Swimming

Moro Palmar Grasp Tonic Neck Stepping Babinski

In-born Reflexes
Reflexes Eliciting Stimulus Response Developmental duration

Babinski Moro Palmer Grasp Rooting

Gentle stroke along Toes fan out: big toe sole of foot (heel - toe) reflexes Sudden lost of support Arms extended, then brought towards each other

Disappears by end of first year Disappear in 6 months Disappear in 3-4 months Disappear in 3-4 months

Rod of finger pressed Object grasp against infants palm Object lightly brushes infants cheek Baby turns towards object and attempts to suck

Sucking
Walking

Insert Finger in mouth Rhythmic sucking

Held baby upright. Sole of feet placed on hard surface

Disappear in 3-4 months

Infant step forward as if Disappear in walking 3-4 months

Rooting

Stroke cheek near corner of mouth or object brushes the area Infant respon by turning head toward stimulation Disappears at 3 weeks when child begins to be able to voluntarily turn head Helps infant find nipple

Moro Reflex

Hold infant horizontally on back and let head drop slightly or produce sudden loud sound against surface supporting infant Infant response is to make an embracing motion by arching back, extending legs, throwing arms outward and then bringing them in toward the body

Disappear at 6 months
Probably in human evolution helped baby cling to mother

Palmer Grasp

Spontaneous grasp of adults finger Disappears at 3-4 months to allow reaching and grasping Prepares infant for voluntary grasping

Tonic Neck Reflex

Turn baby's head to one side while lying on back

Infant responds by lying in a fencing position with one arm extended in front of eyes on side to which head is turned other arm is flexed
Disappears at 4 months May prepare infant for voluntary reaching

PATTERNS OF GROWTH

Children grow faster during the first years, especially during the first few months. This rapid growth rate tapers off during the second and third years

Physical growth and development follow the maturational principles of the cephalocaudal principle and proximodistal principle.

Influences on Growth
Genes interact with environment, i.e. nutrition and living conditions, general health and well-being Well-fed, well-cared-for children grow taller and heavier than less well nourished and nurtured children Better medical care, immunization and antibioticsbetter health

Growth And Nutrition

Nourishment
Breast milk is almost always the best food for newborns and is recommended for at least the first 12 months Parents can avoid obesity and cardiac problems in themselves and in their children by adopting a more active lifestyle for the entire family--and to breastfeed their babies

The Brain

First 3 years of life is critical to babys brain development. Before & after birth brain growth is fundamental to future development. It is estimated that about 250,000 brain cells are form every minute in the uterus. By birth, almost 100 billion nerve cell are formed, but not fully develop.

Molding the Brain: The Role of Experience

Smiling, babbling, crawling, walking, and talking are possible due to rapid development of the brain, particularly the cerebral cortex

BRAIN

Each part of the brain is very important in infuencing a child development integration between child emotions and behavior.
Middle brain: Limbic System Covers motivation, emotions, & long term memory, aggressive behavior, body temperature, hunger, nerve system activities, hormon secretion Outer Brain: Cortex & neocortex Divided into lobes/sections (folds) with specific functions. Placement of intelligence & higer mental process, learning, memory, thinking, language (last to develop) Also control vision, hearing, inventing.

Brain stem

Contro process such as breathing, heartbeat muscle movement, kidney process, reflex behavior, sleep, arousal, attention, balance/movement etc.
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Thin layer on the brains surface that include lobes or sections:

Regions of the Cerebral Cortex

Occipital lobe Process vision. Temporal Lobe Process hearing Parietal Lobe Process sensory stimuli Frontal Lobe

Critical thinking & problem solving Frontal cortex area of the cortex that controls personality and the ability to carry out plans
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Molding the Brain: The Role of Experience

Early experience can have lasting effects on emotional development and the capacity of the central nervous system to learn and store information Sometimes corrective experience can make up for past deprivation

Brain and Neurons ...OTAK & NEURON

First 3 years of life childrens brain are actively building and developing connections between the neurons cells.
Connections are developed when the brain are actively receiving stimulus process between receiving and sending impulses between the cells. Through axons/dendrites send signals to other neurons & receive incoming message through connection called synapses.

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Infant States of Arousal

States of arousal are different degrees of sleep and wakefulness Infants move in and out of 5 states throughout the day and night:
Regular sleep Irregular sleep Drowsiness Alert Activity Waking activity and crying

Striking individual differences in daily rhythms exist that affect parents attitudes toward and interactions with baby.

Ways to Soothe a Crying Baby

Hold on shoulder and rock or walk Swaddle Pacifier Ride in carriage, car, swing Combine methods Let cry for short time

Adjustments to Parenthood

Physical Schedule Financial Time Gender roles Parents relationship

Pre-birth counseling Interventions for high-risk couples

Early Sensory Capacities

Touch Hearing Vision Taste Smell

Touch and Pain

Touch seems to be the first sense to develop Sensitivity to touch, pain, and temperature change is well-developed at birth. Pain experienced during the neonatal period may sensitize an infant to later pain, perhaps by affecting the neural pathways that process painful stimuli Relieve pain with anesthetics, sugar, gentle holding Reflexes reveal sensitivity to touch, for example touch on mouth, palms, soles, genitals Touch helps stimulate physical and emotional development.

Newborn Senses of Taste and Smell

Prefer sweet tastes at birth Quickly learn to like new tastes Have odor preferences from birth Can locate odors and identify mother by smell from birth

Taste

Babies are born with the ability to communicate their taste preferences to caregivers. Infant facial expressions indicate they can distinguish among several tastes. Newborns' rejection of bitter tastes is probably another survival mechanism, since many bitter substances are toxic

Smell

The responsiveness of infants to the smell of certain foods is similar to that of adults showed that some odor preferences are innate. A newborn infant is attracted to the odor of her own mothers lactating breast helps to find food source and to identify own mother a survival mechanism. Newborns can identify the location of an unpleasant odor and turn head away. A preference for pleasant odors seems to be learned in utero and during the first few days after birth

Studies conducted: Smell and Taste

Lipsitt, Engen & Kye (1963) : Baby showed negative response to the smell of ammonia. Steiner : Baby showed different facial expression when exposed to different type of scent. Mac Farlane (1977): Baby can differentiate between own mothers milk and other mothers milk. Schmidt & Beauchamp (1988) : Babys ability to smell is almost equivalent to a 3 years old ability to smell. Harris & friends: By aged 4 months old, baby like the taste of salt

Baby likes the smell of: Banana, Margerine Tangerine Baby dislikes the smell of: Amonia Rotten egg

Hearing

Well developed at birth - sensitive to voices and biologically prepared to learn language Hearing is functional before birth ability to discrimination sound develops rapidly after birth. E.g. Infants respond with changes in heart rate to loud sounds (even in the womb) Can hear wide range of sounds but are more responsive to some than others i.e. prefer complex sounds to pure tones Newborns prefer complex sounds such as voices and noises to pure tones - learn sound patterns within days Newborns prefer speech that is high-pitched and expressive. There are only a few speech sounds that newborns cannot discriminate, and their ability to perceive speech sounds outside their language is more precise than an adults. Hearing is a key to language development thus hearing impairments should be identified as early as possible

Developments in Hearing
4 6 months Sense of musical phrasing

6 months

Screen out sounds from non-native languages

Recognize familiar words, natural 7 9 months phrasing in native language Can detect words that start with weak syllables

10 months

Studies conducted: Hearing

De Casper & Fifer (1980): Baby can differentiate mothers voices from others thru baby sucking pattern. Birnhold & Benacerraf (1983): 28th week baby showed his/her response thru facial expression. Wertheimer (1961) : Baby able to follow source of sound thru the clicker test.

Vision

Vision - the least developed sense at birth Newborns cannot focus their eyes very well and their visual acuity fineness of discrimination, is limited However, newborns explore their environment by scanning it for interesting sights & tracking moving objects. They cant yet discriminate colors but color vision will improve in a couple of months. Visual perception is poor at birth but improves to 20/100 by age 6 months Binocular vision using both eyes to focus Perception of depth & distance at 4 or 5 mth

Infants Scanning of Faces

41

Face-like Stimuli

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Studies conducted: Sight

Langlois & friends (1990): Babies are more attracted to attractive and beautiful human faces. Fantz (1993): Babies prefer to look at pictures of human. Aslin (1987): 4 days old babies can differentiate between green and red. Babies prefer blue and red as compared to other colors. Gibson & Walk (1960): Visual cliff experiment. 6 mth babies has already develop in-dept perception in visual.

Steps in Depth Perception

Birth 1 month Sensitivity to motion cues

24 months

Sensitivity to binocular cues Sensitivity to pictorial cues. Wariness of heights

5 12 months

Steps in Pattern Perception

3 weeks
2 months Poor contrast sensitivity. Prefer large simple patterns Can detect fine-grained detail. Prefer complex patterns. Can detect patterns even if boundaries are not really present Can detect objects if two-thirds of drawing is missing

4 months

12 months

Improvements in Vision
Brain development helps infants reach adult levels of vision skills: 2 months: Focus and color vision 6 months: acuity, scanning & tracking 67 months: depth perception

Integrating Sensory Information

By 1 month, can integrate sight and touch By 4 months, can integrate sight and sound 4- and 7-month-olds can match facial appearance (boy or man) with sound of voice

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Motor Development

Maturity affect infant perceptual and motor abilities. Milestones of Motor Development

Babies first learn simple skills and then combine them into increasingly complex systems of action

Week 1 Month 1 Month 2

: Motor ability progress : Chin lift : Reach for object

Denver Developmental Screening Test measures:

Gross motor skills (those using large muscles), such as rolling over and catching a ball, and Fine motor skills (using small muscles), such as grasping a rattle and copying a circle. Language development (for example, knowing the definitions of words) Personality and social development (such as smiling spontaneously and dressing without help).

Motor Development

Newborn are not able to control their body movement no coordination. Most movements are due to inborn reflexes (rooting, moro, palmer grasp etc) Humans begin to walk later than other species, possibly because babies' heavy heads and short legs make balance difficult

Milestone in motor develpment

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Motor Development
How Motor Development Occurs: Maturation in Context

According to Thelen, normal babies develop the same skills in the same order because they are built approximately the same way and have similar physical challenges and needs

Motor Development
Cultural Influences on Motor Development

Chances to explore their surroundings motor development likely to be normal Some cultures actively encourage early development of motor skills

Motor Development
Training Motor Skills Experimentally

Gesell concluded that children perform certain activities when they are ready, and training gives no advantage Interaction of biology and environment are involved in infant motor development

Social development

Baby's ability to interact with other people Develops thru regular interaction with babies,:
Feeding Cleaning Caring/loving

Newborn can imitate facial expression.

Attachment

What is attachment?

The most important form of social development that occurs during infancy is ATTACHMENT, the positive emotional bond that develops between a child and a particular individual. Bowlby viewed attachment as based on infant's needs for safety and security (especially from the mother)

Infant Attachment

Attachment

an infant responds positively to specific others, feels better when they are close, and seeks them out when frightened.

Attachment provides
a sense of security to the child information about the environment

Infant Attachment

Critical for allowing the infant to explore the world Having a strong, firm attachment provides a safe base from which the child can gain independence. Attachment:adaptive suggests that the tendency to form relationships is at least partly biologically based.

Infant Attachment

Mary Ainsworth (1978) identified three major attachment styles:

Secure strong bonding Avoidant negative bonding Anxious/ambivalent display a combination of positive and negative bonding