A GkCW1n AND DLVLLCMLN1

GkCW1n an lncrease ln Lhe physlcal slze of Lhe

whole body or any of lLs parLs and can be
measured by lnches or cenLlmeLers and ln
pounds or kllograms
Measured quanLlLaLlvely
lndlcaLors lnclude bone slze helghL
welghL and denLlLlon
aLLerns are slmllar Lo all people

DLVLLCMLN1 progresslve lncrease ln sklll
and capaclLy of funcLlon
CapaclLy and sklll of a person Lo adapL
Lo Lhe envlronmenL
aLLerned and predlcLable lncreases ln
physlcal cognlLlve socloemoLlonal
and moral capaclLles of lndlvldual
8ehavloral aspecL of growLh

1he 8eg|nn|ng of L|fe
Llfe beglns aL Lhe momenL of
concepLlonLhe Llme when a reproducLlve cell
of Lhe female (ovum plural ova) ls ferLlllzed by
a male reproducLlve cell Lhe spermaLozoon
(spermaLozoa plural)
Concept|on process of belng pregnanL
lnvolvlng ferLlllzaLlon and lmplanLaLlon
Iert|||zat|on Lhe process of unlon of Lwo
gameLes whereby Lhe somaLlc chromosome
number ls resLored and Lhe developmenL of a
new lndlvldual ls lnlLlaLed

ApproxlmaLely 280 days before blrLh
Lach sex ce|| (sperm]egg) conLalns 23
chromosomes
Gamete (sex ce||) a maLure male and female
germ cell
Chromosomes Lhreadllke parLlcles LhaL conLaln
beLween 40000 and 60000 genes
Genes conLaln Lhe unA and 8nA whlch are
consldered as Lhe blueprlnL of llfe and
LransmlLLers of heredlLary characLerlsLlc LralLs
from Lhe parenLs Lo Lhe offsprlng
Iema|e gametes carry xchromosomes
Ma|e gametes carry half xchromosomes and
half ?chromosomes
Iema|e ch||d x spermaLozoon unlLes wlLh Lhe
ovum (xx) chromosome
Ma|e ch||d ? spermaLozoon unlLes wlLh Lhe
ovum (x?) chromosome

Mu|t|p|e 8|rth]1w|ns
refers Lo Lhe blrLh of Lwo or more bables wlLhln
a few hours or days
Ident|ca| 1w|ns (Un|ovu|ar) comes from a
slngle ovum ferLlllzed by a slngle sperm cell
llrsL dlvlslon of cell Lhe new cell
separaLes lnsLead of remalnlng
LogeLher unknown cause buL ls relaLed
Lo hormonal dlsLurbances
Non|dent|ca| 8|ovu|ar or Iraterna| 1w|ns are
producLs of Lwo ova ferLlllzed
slmulLaneously by Lwo separaLe sperm
cells
Iactors of Growth and Deve|opment
1 nered|ty Lhe process by whlch Lhe new
organlsm ls belng endowed wlLh cerLaln
poLenLlals (lnherlLed from Lhe parenLs)
for hls laLer developmenL
Maturat|on Lhe process by whlch
heredlLy exerLs lnfluence long afLer
blrLh
Lnv|ronmenta| Inf|uences lnLeracLlon
beLween an lndlvldual's lnherlLed LralLs
hls surroundlngs and hls nurLure
r|nc|p|es of Deve|opment

hy|ogenenet|c r|nc|p|e lL sLaLes LhaL
developmenL follows an orderly sequence LhaL
ls predlcLable and ls Lrue Lo all members of a
cerLaln race
red|ctab|e trends of deve|opment
Cepaha|ocauda| trend developmenL proceeds
from head Lo fooL dlrecLlon
rox|mod|sta| trend Lhe parLs of Lhe body
nearesL Lo Lhe cenLer (le braln) are Lhe parLs
LhaL develop earller Lg 1he baby can see flrsL
before he can walk
Cntogenet|c pr|nc|p|e Lhe raLe of Lhe
developmenL ls unlque Lo every lndlvldual lL ls
broughL abouL by one's heredlLy as well as
envlronmenLal lnfluences Lg 1hough boLh
chlldren are Lhe same age one mlghL Lalk
earller Lhan Lhe oLher
DCMINAN1 AND kLCLSSIVL 1kAI1S
uomlnanLhavlng domlnance ln Lhe soclal
hlerarchy More effecLlve or predomlnanL ln
acLlon
8ecesslve produclng a llLLle or no phenoLyplc
effecL when occurrlng ln heLerozygous
condlLlon wlLh a conLrasLlng allele

1he Infant and Ch||d

1he Newborn (NLCNA1L)
1he flrsL 28 days of llfe

r|nc|p|es of Newborn Care
1 LsLabllsh and malnLaln paLenL alrway
2 MalnLaln approprlaLe body
LemperaLure
3 lmmedlaLe assessmenL of Lhe newborn
4 roper ldenLlflcaLlon
3 nursery Care

Newborn Adaptat|on]Ad[ustment Depends on
1 CeneLlc composlLlon
2 CompeLency of Lhe recenL lnLrauLerlne
envlronmenL
3 Care recelved durlng Lhe labor and blrLh
perlod
4 Care recelved durlng Lhe newborn or
neonaLal perlod (from blrLh Lhrough Lhe
flrsL 28 days of llfe)

AGAk SCCkL
(V|rg|n|a Apgar)

I|rst M|nute of L|fe deLermlnes Lhe labor
process and how Lhe newborn LoleraLes lL
I|fth M|nute of L|fe 1rue Apgar Score Pow Lhe
newborn ad[usL Lo Lhe exLrauLerlne llfe

S|gn 0 1
Appearance]
Co|or
a|e]b|ue Lxtrem|t|es
b|ue body
p|nk
|nk a||
over
u|se]neart
kate
0 100 100
Gr|mace]kef|ex
Irr|tab|||ty
No
response
Gr|mace
weak cry
Sneeze
good
strong
cry
Act|v|ty]Musc|e
tone
L|mp]
f|acc|d
Some
f|ex|on of
extrem|t|es
We||
f|exed
extrem|
t|es
act|ve
mot|on
kesp|ratory
Lffort]Cry
Absent Weak cry Good
strong
cry

Interpretat|on of kesu|ts

0 Severe|y Depressed |n ser|ous danger and
needs |mmed|ate oxygenat|on and
resusc|tat|on
46 Moderate|y Depressedneeds st|mu|at|on
and oxygenat|on
710 nea|thy 8aby roceed to regu|ar New
born care


Dom|nant 1ra|ts kecess|ve 1ra|ts
8rown eyes 8lue green gray or
hazel eyes
Curly halr SLralghL halr
uark or bruneLLe halr LlghL blond or red
halr
normal halr 8aldness
normal hearlng ueafness
normal slghL nlghL bllndness
nearslghLedness
larslghLedness normal vlslon
normal Color vlslon Color bllndness
normal Colorlng Alblnlsm(lack of
plgmenL)
normal blood cloL Pemophllla
8lood Lype A 8lood Lype C
8lood Lype 8 8lood Lype C
normal flngers or Loes LxLra flngers or Loes
normal dlglLs ShorL dlglLs
normally
proporLloned llmbs
uwarfed llmbs
8oman nose SLralghL nose
8road llps 1hln llps
NUkSLk CAkL
a Check ldenLlflcaLlon band
b 1ake anLhropomeLrlc measuremenLs
LengLh 4634 cm average30cm (20ln)
Pead Clrcumference 3333cm
ChesL Clrcumference 3133 cm
Abdomlnal Clrcumference 3133cm
*head and chesL clrcumference wlll be
equal aL 12 monLhs
c 1ake LemperaLure 36337 degree
Celslus
d Speclflc nurslng acLlon
Clve lnlLlal oll baLh Lo cleanse Lhe baby
of blood and vernlx caseosa
uress Lhe umblllcal cord
Crede's prophylaxlsprophylacLlc of Lhe
newborn's eyes agalnsL gonorrheal
con[uncLlvlLls
vlLamln k admlnlsLraLlon prevenLs
hemorrhaglc dlseases
WelghL 1aklng 2333 kgs
Average blrLh welghL 6373 lbs 3
34kgs
WelghL doubles aL 6 monLhs Lrlple aL
12 monLhs and quadruple aL 24
monLhs
Large CesLaLlonal Age (LCA)33kgs
Small CesLaLlonal Age (SCA)23 kgs
ldeal rocedure welgh baby's cloLhes
puL on Lhe baby's cloLhes welgh Lhe
baby wlLh hls cloLhes on Lhen subLracL
Lhe welghL of Lhe cloLhes wlLh Lhe LoLal
welghL of Lhe baby
leedlng
lnlLlal feedlngls a LesL feedlng
conslsLlng an ounce of sLerlle waLer
(glucose waLer has been found Lo be
lrrlLaLlng Lo Lhe lungs lf asplraLed) ls
glven Lo flnd ouL lf Lhe newborn can
swallow wlLhouL asplraLlng
e hys|ca| Assessment
ulse 120160 beaLs per mlnuLe (bpm)
8esplraLlons3060 bpm
8lood pressure noL rouLlnely measured
unless conLracLlon of aorLa ls noLed
80/40 mmPg aL blrLh
100/30 mmPg afLer 10 days

Sk|n Co|or
O Acrocyanosls exLremlLles are blue
O allor paleness
O Cray lnfecLlon
O !aundlce yellowlsh dlscoloraLlon of skln
and sclera
hys|o|og|c [aund|ce normal afLer 24
hours due Lo breasLfeedlng
premaLurlLy of llver LCA prone Lo
Lrauma
atho|og|c [aund|ce upon blrLh uue Lo
hepaLlLls or blood lncompaLlblllLy
O Creen posL Lerm or feLal dlsLress
O 8lue congenlLal hearL dlsease
O WhlLe Ldema/ kldney problem
nar|equ|n s|gn because of lmmaLurlLy of
clrculaLlon an lnfanL who has been lylng on hls
slde wlll appear red on Lhe dependenL slde and
pale on Lhe upper slde
Mongo||an spots slaLegray paLches seen
across Lhe sacrum/buLLocks and conslsL of
collecLlon of plgmenL cells (melanocyLes)
ulsappear by school age
Lanugo flne downy halr LhaL covers Lhe
shoulders back and upper arms
uesquamaLlon drylng of newborn's skln
etech|ae on face and neck due Lo lncrease
lnLravascular pressure durlng dellvery
M|||a unopened sebaceous glands found on Lhe
nose chln and cheeks dlsappear
sponLaneously afLer 24 weeks
Lars and Noseshould be lnLacL no leslons and
unusual dlscharges
MouLh should open evenly when crylng
Longue appears large
palaLe should be lnLacL
Lpste|n ear|s 1 or 2 small round gllsLenlng
cysLs seen on palaLe due Lo exLra load of
calclum whlle ln uLero
LooLh may be seen lf loose should be exLracLed
Lo prevenL asplraLlon when feedlng
Cra| thrush whlLe or gray paLches on Lhe
Longue and sldes of Lhe cheeks due Lo Candlda
Alblcans acqulred durlng passage of Lhe baby
Lhrough blrLh canal of Lhe moLher wlLh
unLreaLed Monlllasls also known as oral
monlllasls
1nL INIAN1
O lrom 012 monLhs of age
O sychosexual sLage oral
O sychosoclal sLage LrusL vs mlsLrusL
O CognlLlve sLage SensorlmoLor 02 years
O CreaLesL fear SLranger AnxleLy afLer
6monLhs of age
O lay SollLary

GLNLkAL kINCILLS
1Chlldren are compeLenL
2Chlldren resemble one anoLher
3Lach chlld ls unlque
4CrowLh and uevelopmenL
OCepha|ocauda| growLh ls more advanced aL
and near Lhe head and gradually progresses
downward Lo Lhe neck Lhe Lrunk and
exLremlLles
Orox|mod|sta| growLh proceeds ouLward
from Lhe cenLer axls of Lhe body Loward Lhe
perlphery
OGenera| to Spec|f|c eg from crylng aL blrLh
Lo compleLe senLences aL preschool age
OS|mp|e to Comp|ex eg from walklng aL 12
monLhs of age Lo pedallng Lhe Lrlke aL 3
years of age
OAsynchronous growth Lhe whole body does
noL grow aL once dlfferenL reglons and
subsysLems develop aL dlfferenL raLes and
Llmes
OD|scont|nu|ty of growth rate Lhere are only
Lwo perlods of very rapld growLh feLal
lnfancy perlod and adolescence
ODeve|opment |s t|me|y Lhe noLlon of Lhe
readlness or maLuraLlon sLaLes LhaL learnlng
would come qulckly and efforLlessly once Lhe
chlld ls ready
ONew sk|||s tend to predom|nate Lhe currenL
developmenLal lssue becomes a
preoccupaLlon for Lhe chlld
O1he many aspects of deve|opment
(persona|soc|a| f|ne motoradapt|ve gross
motor and |anguage) are |nterre|ated 1hey
acL upon and reacL wlLh one anoLher
exLenslvely and lnseparably


SLCIIIC 8LnAVICk

1Newborn when on prone avolds suffocaLlon by
Lurnlng hls head from slde Lo slde
2Cne month a) llfLs head lnLermlLLenLly when on
prone b) momenLary vlsual flxaLlon on human
faces and ob[ecLs (m|d||ne v|s|on)
31wo months a) #soc|a| sm||e" b) responds Lo
famlllar volces by movlng Lhe whole body c) no
head conLrol yeL head lags when pulled Lo
slLLlng (SupporL head and neck when carrylng Lhe
baby) d) shed Lears
41hree months a) can ralse head buL noL chesL
when on prone b) head ln bobblng moLlon
some head conLrol when pulled Lo slL c) bubbles
and cobs d) 180 v|sua| arc (per|phera| v|s|on) e)
laughs aloud
3Iour months a) can ralse head and chesL when
on prone b) when on suplne head malnLalned ln
Lhe mldllne arms and legs are symmeLrlcal and
hands broughL LogeLher ln Lhe mldllne c) may
have bald occlpuL d) grasps ob[ects w|th|n reach
and br|ngs to mouth (dlaper plns cllps eLc
should be kepL ouL of reach) e) head conLrol
when pulled Lo slL no head |ag no more
bobblng head sLeady when uprlghL f) susLaln
parL of own welghL when helped Lo sLandlng
poslLlon
6I|ve months a) ro||s over (ralse slde ralls of
crlbs Lo prevenL accldenL falls b) raklng grasps c
sLranger anxleLy c) mlrror lmage
7S|x months a) doub|es b|rth we|ght b) erupLlon
of flrsL LooLh (usually lower cenLral lnclsor) c)
s|ts w|th m|n|ma| support d) can be pulled from
slLLlng Lo sLandlng poslLlon e) ohoh f|rst
sy||ab|e
8Seven months a) plays wlLh feeL b) says dada
or mama but nonspec|f|c c) plvoLs (creeps)when
on prone (keep ralls on sLalrs secured) d)
Lhumbflnger grasp e) transfers ob[ects from
one hand to another
9L|ght months a) s|ts a|one stead||y w|thout
support for an lndeflnlLe perlod b) peak of
stranger anx|ety
10 N|ne months a) can hold boLLle wlLh good
handmouLh coordlnaLlon b) craw|s c)
understands s|mp|e gestures and requests (bye
bye or cake d) Lake some sLeps when held e)
neat p|ncer grasp
11 1en months a) pu||s se|f to stand b)
responds Lo own name
1L|even months a) stands w|th ass|stance b)
attempts to wa|k w|th he|p
13 1we|ve months a) wa|ks w|thout he|p b)
tr|p|es b|rth we|ght c) drlnks from cup d) can
say Lwo words oLher Lhan mama and dada

DLVLLCMLN1 DUkING INIANC

hys|o|og|ca| Deve|opment

Nervous Muscu|ar and Ske|eta| Systems
8raln grows half lLs adulL slze durlng lnfancy
mosL occurrlng ln Lhe cerebral corLex
8raln sLem reaches mosL of lLs maLurlLy by 1
year of age
MyellnaLlon conLlnues
osLerlor fonLanelle closes aL abouL 3 monLhs
AnLerlor fonLanelle closes abouL 1218 monLhs
8ody LemperaLure becomes less sLable
Moro and SLepplng 8eflex dlsappears aL 3
monLhs
CsslflcaLlon of bones progresses
lncrease lnLraneural connecLlons and ln
complexlLy of axon and dendrlLe sLrucLure
nerve flbers and cellular membranes maLure
resulLlng Lo lncrease senslLlvlLy Lo sLlmull
uevelopmenL of musculoskeleLal sysLem
progresses from Lhe head downward and from
Lhe cenLer of Lhe body ouLward
Crawllng beglns followed by learnlng Lo walk

Sensory Crgans
Lyes begln Lo focus and flxaLe LogeLher by 68
monLhs
Pearlng 1asLe and smell become more
dlscrlmlnaLlng

Gastro|ntest|na|
Solld food can be handled aL abouL 36monLhs
of sysLem age and chewlng beglns aL abouL 68
monLhs
8apld growLh on slze of sLomach
lmprove absorpLlon of waLer from large
lnLesLlne whlch causes sLools Lo change from
sofL Lo formed
Cardlac sphlncLer maLures Lhus regurglLaLlon
ceases

kesp|ratory System
Alveoll lncrease ln number and complexlLy
1he welghL of Lhe lungs Lrlples ln Lhe flrsL year
8esplraLory raLe 2040cpm aL 12 monLhs

Card|ovascu|ar System
PearL doubles ln welghL ln flrsL year
LefL venLrlcle becomes more muscular ln order
Lo pump blood more effecLlvely ln Lhe growlng
body
PearL raLe slows and blood pressure rlses as
Lhe hearL becomes more efflclenL
ulse raLe beLween 100 and 133 bpm
8 100/83 mmPg aL 1 year
1oLal body fluld ln relaLlon Lo body welghL
decllne by 1 year lluld lnLake remalns crlLlcal
because waLer Lurnover ls greaLer and
proporLlon of body surface ln relaLlon Lo body
slze ls larger Lhan older chlldren and adulLs
WhlLe blood cell value reaches Lhe adulL level
8ed blood cell hemaLocrlL and hemoglobln
values drop

Gen|tour|nary
8eproducLlve organs remaln lmmaLure and
dormanL
LrecL penls and cllLorls may be observe buL
wlLhouL sexual slgnlflcance
1ubular reabsorpLlon ln kldneys slowly
lmproves Lo prevenL dehydraLlon
Cver hydraLlon occur easlly because of
lmmaLurlLy of kldney funcLlonlng

Dent|t|on
ueclduous LeeLh begln Lo erupL beglnnlng aL 3
monLhs

S|eep]Act|v|ty
Sleeps abouL 1618 hours a day aL 6 monLhs
and 12 hours a day aL abouL 1 Z years
napplng Lo prevenL undue faLlgue Lwlce a day
Lhen once a day
S|ze
Caln as much as one ounce a day durlng early
weeks
uoubles blrLh welghL aL 36 monLhs
LengLh lncrease by 30 durlng Lhe flrsL year
Pead grows slowly ln comparlson wlLh resL of
Lhe body resulLlng ln a change ln head and Lrue
proporLlons

1nL 1CDDLLk

lrom 13 years old
lreud Anal SLage
Lrlckson AuLonomy vs Shame and uoubL
LA?
a arallel
b Age approprlaLe Loys pushpull Loys
bulldlng blocks Loys Lo rlde on
poundlng pegs sLuffed Loys
CreaLesL lear SeparaLlon anxleLy (22 Z years)

8ehav|or 1ra|ts
PeadsLrong and negaLlvlsLlc (favorlLe word ls
nC!")
AcLlve moblle and curlous vulnerable Lo
accldenLs (seL llmlLs and exerL exLernal conLrol)
Love and Cons|stency Lwo mosL lmporLanL
concepLs ln chlld rearlng
uecrease ln appeLlLe because of Lhe slower
growLh raLe
attern of we|ght ga|n
1 llrsL 6 monLhs 68 oz/week
2 Second 6 monLhs 24 oz/week
3 Second year of llfe Z lb per monLh
CharacLerlsLlcs
1 uawdllng of meals
2 leLlsh wlLh foods
3 AppeLlLe of Lhree year old are more
caprlclous Lhan LhaL of one year old
4 8lgld repeLlLlve rlLuallsLlc and
sLereoLyped ln Lhelr behavlor
1emper tantrums ln order Lo conLrol
self and oLhers
Management lgnore Lhe behavlor or
dlrecL Lhem Lo acLlvlLles LhaL Lhey can
masLer
3 oor sense of Llme 1lme schedule
revolves around acLlvlLles noL Lhe clock
6 AdulLs should Lalk Lo very young
chlldren on eye level Lo avold fear
7 SLarL Leachlng brushlng of LeeLh slnce
all 20 declduous LeeLh are ouL by 2 Z 3
years
8 CrlLlcal erlod of 1olleL Lralnlng
C|ause to read|ness to to||et tra|n|ng
1 Can already sLand alone
2 Can walk sLeadlly
3 Can keep hlmself dry for lnLervals of aL
leasL 2 hours
4 Can demonsLraLe awareness of voldlng
or defecaLlng
3 ls able Lo use words or gesLures
regardlng LolleLlng needs
6 ls deslrous of pleaslng Lhe prlmary
careLaker
Age of AchlevemenL
1 8owel ConLrol 18 monLhs
2 uay Llme bladder conLrol 2 Z years
3 nlghL Llme bladder conLrol 3 years