Professional Documents
Culture Documents
Birthweight
40 weeks gestation (37-42 weeks)
Normal: 2500-3800 grams (5.5 to 8.5 lbs.) 47-54 cm (18.5-21.5 inches)
Birth weight makes a difference: If infant requires ICU over 2500 grams only 2% die Under weight typical of 28 week gestation period 16% die
Infant Mortality
US ranks 27th in the world
Why? Prevalence of preterm births major factor Socioeconomic factors Access to health care How to improve? Prevent premature births. Interventions to save newborns, decrease barriers to health care, decrease teen pregnancies
EPSDT
Part of Medicaid and provides routine checkups for low-income families
IUGR
Clinical Examination of the newborn and sometimes the placenta may reveal small for gestational age
Other terms used: intrauterine growth retardation
Failure to Thrive(FTT)
Small for gestational age may set up FTT FTT to thrive is a smaller than usual growth pattern
APGAR
http://kidshealth.org/parent/pregnancy_newborn/pregnanc y/apgar.html
Activity, Pulse, Grimace, Appearance, and Respiration.
Color Heart rate Respiratory effort Muscle tone Reflex irritability Maximum score of 10 taken at 1 and 5 minutes after birth; Low scores generally reflect later problems
Infant Development
Reflex: An automatic, unlearned response Rooting Reflex: Action that occurs when one cheek is touched Sucking Reflex: Action in which an infant will suck on anything Suckle: A reflexive movement of the tongue moving forward and backwards to help with feeding
Major Reflexes
Table 8.2 page 202
Babinski: Babys toes fan out when sole is stroked
Motor Development
Illustration 8.1
Standards to consider with development Not meeting standards requires question:
Why? Organic Problem or inorganic problem; Often takes a referal to a social worker or occupational therapist/physical assessment to do an assessment
Critical Periods
Development in Pregnancy: Hyperplasia & Hypertrophy There is a time period within certain behaviors are learned
This enables sequential learning Problems meeting behaviors may disrupt development
EG: Mouth is a source of pleasure and exploration; infant on respirator may have this taken away and post respirator may be a reluctant feeder
Cognitive Development
Closely tied with Physical Development: Sensorimotor development Speech skills emerge when infant is sensitive to food textures Illustration 8.2
Digestion
Gut function develops with time Maturation of gut isnt complete at birth
Open gut
Improvements of peristalsis, production of digestive enzymes, etc becomes more mature as infant gets older Eg. Lipase activity improves with age, so infant is able to tolerate a greater assortment of fats with age.
Physical Growth
Weight for age Length for age Weight for length Head Circumference for age BMI percentile
Confirm position of infant for length measurements Head Circumference at widest part of the head
Cows Milk
Whole cows milk first introduced at 12 months
Reduced fat cows milk at 2 years Reasons:
Renal solute load Milk protein allergies Potential for Fe deficiency anemia
Low absorption of Fe GI blood loss
release; Stable independent sitting, crawling Self-feeding with hands; munching and biting
Questions
What signs is baby Sam giving to show the she needs comforting rather than food? How might Kathy (mom) change her routine to give Sam more attention? At 8 months, is Samantha too young ot overeat out of emotional needs? Should Kathy stop or continue breastfeeding to improve Sams eating?
Samantha Intervention
Intervention:
Baby needs time to become calm. She probably needs the attention of being held and
comforted. So some time should be built in. Maybe this means to give sis a snack while this happens and dinner be put off for a while.
months, introducing water and juice by cup is recommended. Formula fed can have water and juices by bottle and then by cup after 6 months as well Open cup vs sippy cup: different tongue skills developed: open cup helps develop speech skills
Inappropriate Foods
Choking hazards:
Peanuts Popcorn
Whole grapes
Hot dog pieces Hard candy
and nutrients Alternative vegetarian food products may not be of high nutritional quality or offered in appropriate sizes for infants.
Galactosemia
Hypothyroidism Sickle cell disease As many as 30 more from the same dried blood sample
WIC
Eligible households may receive WIC intervention:
Two criteria:
Household income less than 185% of poverty Presence of nutritional or health risk
These may include: Nutrition risk during pregnancy Growth shows underweight Iron status low(Hct or Hb) Diet risks: inadequate intake