GROWTH AND DEVELOPMENT OF AN INFANT

Demographic data: Date:

Name: Ward:
Age: Diagnosis:
Sex: Hospital Number:
Classification/Developmental age group:

S.No Growth and Development – Book picture Child’s Remarks

Picture

1 Physical development

Biological development

Temperature: 36.5o C

Pulse: 110 – 150 beats/ mt

Respiration: 25-45 breath / mt

Blood pressure: 80/60 +/- 20/10 mm of Hg

Length:

at birth-45-50 cm

less than 6month – 2.5 cms/month

7-12 month = 1.5 cms/ month

Length at 1 year = 75 cms

Weight: Age in months + 9/2

1-6 mth = 680 gms/month

7-12 mth = 340 gms/month

Birth weight doubles at 6 months

Triples at 1 year

Weight at 1 year = 9-10 kg

Head circumference (HC)

Increase 1.5cm per month during first 6 mts

0.5 cm in second 6 months

 Chest circumference (CC)

Usually 1-2 cms lesser than HC

HC and CC equalizes by one year

Dentition

6-8 months : Two lower central incisors erupt

7-9 months: Two Upper central incisors erupt

9-12th month: lower lateral &upper lateral

2 Mile Stones

1st Month : Flexed position

2nd Month : Social smile( Coos/ vocalizes)

3rd Month : Head control/Palmar grasping

4th Month : Roll over

5th Month : Sit with support

6th Month : Hitches

7th Month : Crawls

8th Month : Creeping

9th Month : Stands with support

10th Month :Stands alone

11th Month : Walks with support

12th Month : Walks alone

3 Gross Motor :

• Turns Head to one side on prone (1 month)

• Has good head control (3 months)
• Able to lift the head and front portion of the chest
(4th month)
• Able to raise the chest and upper part of the abdomen
(5-6 month)
• Rolls from back to side.
• Rolls from abdomen to back.

To maintain locomotion:

• 6 months-bear most of the body’s weight on legs

when held in standing position.
• 8 months: bear weight.
• 8-10 months: increase mobility by crawling and then
by creeping.
• Crawling-pulling self forward without abdomen
touching.
• Creeping-moving on hands and knees with
abdomen.
• Cruising- delibrate steps will be taken while holding
on to something.

4 Fine Motor Skills:

1st Month: Primitive grasp refex enables the infant to hold

objects with thetightly clenched fist.

2nd Month: Primitive refex fade.

5th Month : Holds a rattle

6th Month : Reaches for object

Transfer objects from one hand to the other.

7th Month : Holds feeding cup

 8th Month : Eats finger food, drinks from cup with
assistance.

9th Month : Picks up objects

Pincer grasp well established

12th Month : Holds crayons

5 Psycho sexual (Freud)

Oral stage – Need for sucking pleasure

First 6 month: Seek pleasure by sucking

Next 6 months :Seek pleasure by biting anything that

touches the lips and mouth.

6 Psycho Social: (Erick Erickson)

Sense of trust Vs mistrust

• If baby gets love,affection and adequate care from

mother/caregiver they develop trust on them.If not
they develop mistrust.
• Recognizes parents.
• Has fear of strangers.
• Complete dependence on care giver

7 Intellectual development : (Jean piaget)

Sensory motor (0 to 2 yrs)

Sub stage I ( Birth to 1 month )

Functional assimilation /repetition of reflexive do actions

such as sucking even though not hungry.

Generalized assimilation:

Infant no longer sucks only the breast but other non nutritive
item like fist.

Recognitory assimilation:

Occurs when the hungry infant does not accept a substitute

for the breast.
 Sub stage II (1 to 4 months )

Primary circular reaction

Involuntary action becomes voluntary action which is

closely related to child’s own body

Eg:Initially child brings the hand towards mouth without

any purpose (Involuntary)

After child keeps the finger in the mouth will start to suck
and whenever it is hungry and feels sleepy child will put
finger in the mouth to start sucking (Voluntary)

Sub stage III (4 to 8 months)

Secondary circular reaction

Involuntary action becomes voluntary action which is

related to child’s environment

Eg:When an infant is given a rattle make the noise

(Involuntary)

The infant will try to repeat the action to make this noise
(Voluntary)

End of the Sub stage III,infant knows the objects and other
persons are separate from themselves.Attached to parents
&strangers anxiety develops.

Sub stage IV (8 to 12 months)

Co ordination of secondary schemas

The secondary reactions that the infant learned earlier are

combined and extended to deal with new situations.

The infant begins to perceive a relationship between cause

and effect .

Imitate sound and gestures of other persons in environment.

8 Moral development: Kohlberg

Preconventional Morality stage 0 (0 to 2 years)

• What infant likes is good ,what they dislike is bad.

 • Egocentric
• Has definite likes and dislikes
• Unable to understand rules to judge what is good or
bad in terms of rules or authority.

9 Spiritual development : (Fowler)

Un differentiated /Primary faith– feeling of trust, warmth

and security from the foundation for the later development
of faith

Child has no beliefs and convictions

10 Language / speech development:

Receptive language –

Responds to human voices

Expressive language –

• Cries when hungry or uncomfortable

• 3 months-coos
• 4 months-laughs aloud
• 6 months-mono syllables (ba,da,pa)
• 9 months-bisyllables (mama.baba,dada)
• 12 months-1 – 2 words with meanings
• Comprehends meaning of simple words
• Obeys simple commands

SENSORY CHANGES:

Vision

Has binocular vision

Looks at hands while lifting

Has developed colour preferences

Has hand to eye co-ordination

Follows rapidly moving object

Able to fixate on very small objects

 Hearing

Turns head to side when sounds are made

Imitates sound

Responds to own name

11 Play :

Solitary play/Onlooker play

Birth to 5 months

Activities of kicking , wiggling ,playing with their hands

reaching for objects ,attempting to turn over

5 to 8 months

Finds pleasure in motor activity , playing with feet ,sitting,

bouncing the body ,grasping ,moving on the floor, Hitching.

8 to 10 months:

Along with motor activity vocalization has a continuous

source of pleasure. Sits alone, like to lean over the side of
the carriage or arm of the high chair .Roll with ease ,crawl
and creep: pull into a sitting position ,stretch to obtain toys
out of reach.

10 to 12 months:

• Infants can play alone for longer periods.

• Uses own body parts to play
• Plays with toys.

12 Problems:

Health Problems

Falls

Suffocation

Aspiration or swallows foreign bodies

Near Drowning

Burns
 Poisoning

Motor vehicle accident

Developmental Problem

Maternal deprivation

Needs of the infant:

Need for sucking & Safety

Play and sensory stimulation

Social and emotional need, love & security from primary

care giver

Need for warmth, Need for sensory stimulation

Dependence progressing to independence

Discipline leading to self control

Developing self esteem

Meeting the nutritional need

Urine output 1ml/ kg/ hour

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