Post Natal Development - Birth and Infancy

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The birth processStages of childbirth

First stageSecond stageThird stageFourth stage


The Baby’s The Baby’s Adaptation to Adaptation to Labor and Labor and DeliveryDelivery

Newborn’s Newborn’s appearanceappearance


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

A time of transition from the uterus, where a fetus is A time of transition from the uterus, where a fetus is supported entirely by the mother supported entirely by the mother to an independent to an independent existence. existence.

When neonate are first born:When neonate are first born: Covered by fluid from amniotic sacCovered by fluid from amniotic sac Blood from placentaBlood from placenta Brownish fluid from own faeces.Brownish fluid from own faeces. Covered with lanugo (fuzzy prenatal hair)Covered with lanugo (fuzzy prenatal hair) Covered with vernix caseosa (cheesy varnish)Covered with vernix caseosa (cheesy varnish)


The Newborn Baby

Size and Appearance Size and Appearance New babies have distinctive featureNew babies have distinctive feature a large head a large head

and a receding chinand a receding chin On the head On the head Fontanels (the soft spots) Fontanels (the soft spots) Newborns have a pinkish cast Newborns have a pinkish cast skin so thin that it skin so thin that it

barely covers the capillaries through which blood barely covers the capillaries through which blood flows.flows.

Boys tend to be slightly longer and heavier than girls, Boys tend to be slightly longer and heavier than girls, and a firstborn child is likely to weigh less at birth and a firstborn child is likely to weigh less at birth than later-borns than later-borns


The Newborn Baby

WeightWeight :: 2.8 -3.2 kg2.8 -3.2 kg LengthLength :: 51-53 cm (Boy > girl)51-53 cm (Boy > girl) Head Circumference:Head Circumference: 30-33 cm30-33 cm Breathing: Breathing:

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

Blood pressure become stable in 10 daysBlood pressure become stable in 10 days..


Is the Baby Healthy? Medical and Behavioral Screening

1. Apgar Scale2. The Brazelton Neonatal Behavioral

Assessment Scale3. 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 newborn’s condition Introduced by Dr. Virginia Apgar Access newborn

1 min after birth5 min after birth

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


APGAR SCALESign 0 1 2

Appearance Blue, pale Body pink, extremities blue

Entirely Pink

Pulse Absent Slow (below 100)

Rapid (over 100)

Grimace No response

Grimace Coughing, sneezing, crying

Activity Limp Weak, inactive

Strong, active

Respiration Absent Irregular, slow

Good, Crying

Score: 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 developmentTo 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 (baby’s 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 BlinkEye BlinkWithdrawalWithdrawalRootingRootingSuckingSuckingSwimmingSwimming

MoroMoroPalmar Grasp Palmar Grasp Tonic NeckTonic NeckSteppingSteppingBabinskiBabinski


In-born ReflexesReflexes Eliciting

StimulusResponse Developme

ntal duration

Babinski

Gentle stroke along sole of foot (heel - toe)

Toes fan out: big toe reflexes

Disappears by end of first year

Moro Sudden lost of support

Arms extended, then brought towards each other

Disappear in 6 months

Palmer Grasp

Rod of finger pressed against infant’s palm

Object grasp Disappear in 3-4 months

Rooting Object lightly brushes infant’s cheek

Baby turns towards object and attempts to suck

Disappear in 3-4 months

Sucking Insert Finger in mouth

Rhythmic sucking Disappear in 3-4 months

Walking Held baby upright. Sole of feet placed on hard surface

Infant step forward as if walking

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RootingRooting

Stroke cheek near Stroke cheek near corner of corner of mouth or or object brushes the object brushes the areaarea

Infant respond by Infant respond by turning head toward turning head toward stimulationstimulation

Disappears at 3 Disappears at 3 weeks when child weeks when child begins to be able to begins to be able to voluntarily turn head voluntarily turn head

Helps infant find Helps infant find nipplenipple


Moro ReflexHold 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 GraspSpontaneous Spontaneous

grasp of adult’s grasp of adult’s fingerfinger

Disappears at 3-4 Disappears at 3-4 months to allow months to allow reaching and reaching and graspinggrasping

Prepares infant for Prepares infant for voluntary graspingvoluntary grasping


Tonic Neck ReflexTurn 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 GrowthInfluences 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 NourishmentNourishment

Breast milk is almost always the best food for Breast milk is almost always the best food for newborns and is recommended for at least the newborns and is recommended for at least the first 12 monthsfirst 12 months

Parents can avoid obesity and cardiac problems Parents can avoid obesity and cardiac problems in themselves and in their children by adopting in themselves and in their children by adopting a more active lifestyle for the entire family--and a more active lifestyle for the entire family--and to breastfeed their babiesto breastfeed their babies


The BrainFirst 3 years of life is critical to baby’s 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


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Each part of the brain is very important in infuencing a child Each part of the brain is very important in infuencing a child development development integration between child emotions and integration between child emotions and behavior. 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.

…BRAIN

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Regions of the Cerebral Cortex

Thin layer on the brain’s Thin layer on the brain’s surface that include lobes or surface that include lobes or sections:sections:

Occipital lobeOccipital lobe Process vision.Process vision.

Temporal LobeTemporal LobeProcess hearingProcess hearing

Parietal LobeParietal LobeProcess sensory stimuliProcess sensory stimuli

Frontal LobeFrontal LobeCritical thinking & problem Critical thinking & problem

solvingsolvingFrontal cortex Frontal cortex area of the area of the

cortex that controls cortex that controls personality and the ability to personality and the ability to carry out planscarry out plans


Molding the Brain: The Role of Experience

Early experience can have lasting effects on Early experience can have lasting effects on emotional development and the capacity of emotional development and the capacity of the central nervous system to learn and the central nervous system to learn and store informationstore information

Sometimes corrective experience can make up for past deprivation


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...OTAK & NEURON...OTAK & NEURONFirst 3 years of life First 3 years of life children’s brain are children’s brain are

actively building and developing connections actively building and developing connections between the neurons cells.between the neurons cells.

Connections are developed when the brain Connections are developed when the brain are actively receiving stimulus are actively receiving stimulus process process between receiving and sending impulses between receiving and sending impulses between the cells. between the cells.

Through Through axons/dendritesaxons/dendrites send signals to send signals to other neurons & receive incoming message other neurons & receive incoming message through connection called through connection called synapses.synapses.

Brain and Neurons


Infant States of ArousalStates of arousal are different degrees of sleep

and wakefulnessInfants move in and out of 5 states throughout the

day and night:Regular sleepIrregular sleepDrowsinessAlert 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 Hold on shoulder and rock or walk and rock or walk

SwaddleSwaddlePacifierPacifierRide in carriage, Ride in carriage,

car, swingcar, swingCombine methodsCombine methodsLet cry for short Let cry for short

timetime


Adjustments to ParenthoodPhysicalPhysicalScheduleScheduleFinancialFinancialTimeTimeGender rolesGender rolesParents’ relationshipParents’ relationship

Pre-birth counselingPre-birth counselingInterventions for high-risk Interventions for high-risk

couplescouples


EarlyEarly Sensory Capacities Sensory Capacities

Touch Touch HearingHearingVisionVisionTaste Taste SmellSmell


Touch and Pain

Touch seems to be the first sense to developSensitivity 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 birthQuickly learn to like new tastesHave odor preferences from

birthCan locate odors and identify

mother by smell from birth


Taste 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 mother’s 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: SStudies conducted: Smell and Tastemell and TasteLipsitt, 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 mother’s milk and other mothers’ milk.

Schmidt & Beauchamp (1988) : Baby’s 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 Baby likes the smell of:smell of:• Banana,Banana,• MargerineMargerine• TangerineTangerine

• Baby dislikes Baby dislikes the smell of:the smell of:• AmoniaAmonia• Rotten eggRotten egg


Hearing 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 adult’s.

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

7 – 9 months

Recognize familiar words, natural phrasing in native language

10 months

Can detect words that start with weak syllables


Studies conducted:HearingDe Casper & Fifer (1980): Baby can

differentiate mother’s 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 Vision - the least developed sense at birth Newborns cannot focus their eyes very well Newborns cannot focus their eyes very well

and their and their visual acuity visual acuity fineness of fineness of discrimination, is limiteddiscrimination, is limited

However, newborns explore their However, newborns explore their environment by scanning it for interesting environment by scanning it for interesting sights & tracking moving objects.sights & tracking moving objects.

They can’t yet discriminate colorsThey can’t yet discriminate colors but but color vision will improve in a couple of color vision will improve in a couple of months.months.

Visual perception is poor at birth Visual perception is poor at birth but but improves to 20/100 by age 6 monthsimproves to 20/100 by age 6 months

Binocular vision using both eyes to both eyes to focusfocus

Perception of depth & distance at 4 or 5 Perception of depth & distance at 4 or 5 mth mth


Infants’ Scanning of Faces


Face-like Stimuli


Studies conducted: SightLanglois & 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 Pattern Perception

3 weeks Poor contrast sensitivity.Prefer large simple patterns

2 monthsCan detect fine-grained detail. Prefer complex patterns.

4 monthsCan detect patterns even if boundaries are not really present

12 months

Can detect objects if two-thirds of drawing is missing


Steps in Depth Perception

Birth – 1 Birth – 1 month month

Sensitivity to motion cues

2 – 4 2 – 4 monthsmonths

Sensitivity to binocular cues

5 –12 5 –12 monthsmonths

Sensitivity to pictorial cues. Wariness of heights


Improvements in VisionBrain development helps Brain development helps

infants reach adult levels of infants reach adult levels of vision skills:vision skills:

2 months: Focus and color 2 months: Focus and color vision vision

6 months: acuity, scanning 6 months: acuity, scanning & tracking& tracking

6–7 months: depth 6–7 months: depth perceptionperception


Integrating Sensory Information

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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


Motor Development MaturityMaturity affect infant perceptual and motor abilities. affect infant perceptual and motor abilities. Milestones of Motor DevelopmentMilestones of Motor Development

Babies first learn simple skills and then combine them into Babies first learn simple skills and then combine them into increasingly complex increasingly complex systems of action Week 1Week 1 : Motor ability progress: Motor ability progress Month 1Month 1 : Chin lift: Chin lift Month 2Month 2 : Reach for object: Reach for object

Denver Developmental Screening TestDenver Developmental Screening Test measures:measures: Gross motor skills (those using large muscles), such as Gross motor skills (those using large muscles), such as

rolling over and catching a ball, and rolling over and catching a ball, and Fine motor skills (using small muscles), such as grasping a Fine motor skills (using small muscles), such as grasping a

rattle and copying a circle. rattle and copying a circle. Language development (for example, knowing the definitions Language development (for example, knowing the definitions

of words) of words) Personality and social development (such as smiling Personality and social development (such as smiling

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Motor DevelopmentNewborn are not able to control their body Newborn are not able to control their body

movement movement no coordination. no coordination.Most movements are due to inborn reflexes Most movements are due to inborn reflexes

(rooting, moro, palmer grasp etc) (rooting, moro, palmer grasp etc) Humans begin to walk later than other species, Humans begin to walk later than other species,

possibly because babies' heavy heads and short possibly because babies' heavy heads and short legs make balance difficultlegs make balance difficult


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Milestone in motor develpment

Birth

Lift headPull self upto stand

Push chestup with arms

Pull up withassistance

Roll from stomach

2 4 6 8 10 12 14 16months

Walk wellalone

Remainsitting withoutassistanceonce up

Walk holdingon to furniture

Sit up withoutassistance

Stand wellalone

Stand holdingon to furniture

Walk backward

Seifert; Child & Adolescent Development 4/eFigure 5.A


Motor Development

How Motor Development Occurs:How Motor Development Occurs:Maturation in ContextMaturation in Context

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


Motor Development

Cultural Influences on Motor DevelopmentCultural Influences on Motor Development

Chances to explore their surroundingsChances to explore their surroundings motor motor development likely to be normal development likely to be normal

Some cultures actively encourage early Some cultures actively encourage early development of motor skills development of motor skills


Motor Development Training Motor Skills ExperimentallyTraining Motor Skills Experimentally

Gesell concluded that children perform Gesell concluded that children perform certain activities when they are ready, and certain activities when they are ready, and training gives no advantage training gives no advantage

Interaction of biology and environment are Interaction of biology and environment are involved in infant motor developmentinvolved in infant motor development


Social developmentBaby's ability to interact with other peopleDevelops thru regular interaction with

babies,:FeedingCleaningCaring/loving

Newborn can imitate facial expression.


AttachmentWhat is attachment?What is attachment?

The The most importantmost important form of social development that form of social development that occurs during infancy is ATTACHMENT, the positive occurs during infancy is ATTACHMENT, the positive emotional bond that develops between a child and a emotional bond that develops between a child and a particular individual. particular individual.

BowlbyBowlby v viewed attachment as iewed attachment as based on infant's needs for based on infant's needs for safety and securitysafety and security (especially from the mother) (especially from the mother)


Infant AttachmentAttachment

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 childinformation about the environment


Infant AttachmentInfant AttachmentCritical for allowing the infant to explore the worldCritical for allowing the infant to explore the worldHaving a strong, firm attachment provides a Having a strong, firm attachment provides a safe basesafe base

from which the child can gain independence.from which the child can gain independence.Attachment:-Attachment:-

adaptive adaptive suggests that the tendency to form relationships is at suggests that the tendency to form relationships is at

least partly biologically based.least partly biologically based.


Infant AttachmentMary Ainsworth (1978) identified three

major attachment styles:- Secure strong bondingAvoidant negative bonding Anxious/ambivalent display a combination of

positive and negative bonding


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Post Natal Development - Birth and Infancy