Infant & Toddler Development

( 0-3 years)

“ We reach backward to our parents and forward to our children and through their children to a future we will never see, but about which we need to care.– Carl Jung

If I could have watched you growAs a magical mother might.

If I could have seen through my magical transparent belly,

There would have been such ripening within…

Anne Sexton, My Little Girl, My String Bean

Pregnancy• Physical care

– intrauterine development– prenatal environmental influences– exercise and nutrition

• Emotional Care– Stress and Anxiety– Support System

• Educational Care– approaches to childbirth– medical interventions

Prenatal Development 38 weeks of pregnancy 3 general periods of development

1- the period of the zygote2- the period of the embryo3- the period of the fetus

Period of the Zygote (fert.-2wks) Zygote multiplies and travels through fallopian

tube to the uterus where it will attach to the uterine lining at about the 7-10th day after fertilization.Implantation occurs and now the mother’s blood begins to nourish the organism.It is now called the embryo

Period of the Embryo-2wks-2mos.

4t

Period of the Fetus (2mos.-birth) 12th week -3 inches long and weighs 1 ouncecan move arms, legs, fingers, and toescan form a fist, can curl toes, fingerprints are presentcan smile, frown, suck its thumb and swallowsex is distinguishablecan urinateeyelids open and closefingernails/toenails appear

12th week is the end of the 1st Trimester

2nd Trimester16 weeks - 5 1/2 inches long and 4 ounces in

weightmovements can be felt by motherend of 2nd trimester- all neurons are now in placeglial cells (support and feed neurons) are still

growingand will do so until after birthfetuses will try to shield their eyes with their

hands from the light of a surgical fetoscopy procedure

3rd Trimester22 -26 weeks - Age of Viability- fetus has a chance of survival if born nowcerebral cortex enlarges 24 wks - fetus can feel pain28 wks - awake 11% of the time

- blink eyes-reaction to sounds - sweet and bitter32 wks - hearing is well integrated

- can learn to show preference for particular sounds at birth

Prenatal Environmental InfluencesTeratogens-“Teras” greek word

“monstrosity”

Teratogens (cont.)Alcohol- Fetal Alcohol Syndrome (FAS)occurs to mother’s who drink heavily

moderate drinkers can have some effectsfacial deformities, defective limbs and heartbelow average intelligence, MR

Smokinghigher pre-term births and lower birth weightsfetal and neonatal deaths higherinfants who are awake more on a consistent basisrespiratory problems and sudden infant death syndrome

are more common among the offspring of mothers who smokeduring pregnancy (2-3 x more likely than non-smokers)

Maternal FactorsExercise

- regular & moderate can lead to increased birth weight - regular & vigorous can lead to lower birth weightNutrition- operates the same as teratogens-sensitive period- famine during 1st trimester- miscarriages & physical defectsbeyond 1st trimester- survived but underweight & small headsdamage to CNS- fewer brain cells and lower brain weight,especially if during the last trimester when the brain is growing rapidly in sizedistort the pancreas, liver, kidney and blood vessels and increase the risk heart disease and diabetes in adulthood

Emotional Care

Stress and Anxiety- intense fears, anxieties produce physiological changesrespiration and glandular secretions- adrenaline secretions restricts blood flow to the uterus and oxygen to babyone study showed anxiety in pregnancy related to newborn irritability, hyperactivity, eating and sleeping problemsSupport System-risks are greatly reduced if mother has husband, family or friends to give emotional supportreassuring mother of fetal well-being reduced anxiety and babies were less irritable and scored hi on neonatal tests

Sensory Richness of Prenatal Life

“Conception and pregnancy constitute the 1st chapter of our personal history… even in the prenatal environment the developing human being is dynamic and interacting”

Dr. Silvana Quattrochi Montanaro

Children sweeten labors. Francis Bacon, Essays, 1625

Approaches to Childbirth

• hi tech hospital delivery

• natural childbirth in the hospital

• natural childbirth in a Midwife Center

• natural childbirth in the home

Birth

Apgar Scale: 2x test for health status of babyComplications: oxygen deprivation-

1-22% of babies with Cerebral Palsy (CP)have experienced “anoxia” (inadequate oxygen supply). CP results from brain damage and produces difficulties in muscle coordination, “clumsy walk”, uncontrolled movements, and unclear speech. The disorder can range from mild tremors to severe crippling and mental retardation.2-Respiratory Distress Syndrome- often occurs to infants born more than 6 wks early, lungs are poorly developed, air sacs collapse and lack of oxygen causes permanent brain damage

Birth

Complications: pre-term and low birth weightbabies < 35 weeks and weight < 51/2 lbsbirth weight often predicts survival and development• frequent illness, inattention, over-activity, low

intelligence test scores, deficits in motor coordination and school learning sometimes extend into the childhood years

• lower the weight, the greater the risk for problemsSmall for Date babies- greater risk because probably

experienced poor nutrition/dysfunctional placenta

Interventions- for pre-term babies• coaching in recognizing and responding to baby’s needs

babies gained steadily in mental performance to match full-term babies

• “kangaroo care” holding infant close to chest= promotes oxygenation of body, temperature regulation, better feeding and more alertness- parents gain confidence about being able to care for their preterm baby

• medical, parent training, cognitively stimulating day carenormal range at 3 in intelligence, psychological adjustment and growth

• But will lose ground by 5 unless there is high quality intervention (cognitively stimulating day care)

• Moderate to mild birth trauma –did well if in stable family environment-those exposed to poverty, family disorganization and mental illness did not do well